Mcmtg

Career Code Red: Unintentional Medicare Billing Fraud | Clinician Reviews The link is to an article that offers some clarity on the issue. Please read the entire article to get a full understanding. The problem is more widespread than you may think.

Thanks for the 'heads up'. I've got no unrealistic expectations...I plan to do my research much better the second time around. I also plan to be very upfront about my concerns related to the billing process and office safeguards to prevent billing errors/self audit process and so on. Hopefully you had a chance to read my response to the first comment above as it provides a bit more context to the situation. This was not a 'one and done' notification to the physician.

I appreciate your response. I've seen colleagues go bankrupt or jailed following failed Medicare audits ... One good friend was fined in the millions and had to close her practice because of unintentional billing errors. I'm aware of at least one who was found guilty because he continued to work in the office despite suspicion of fraud. He was accused of gaining financially from the fraud because he continued to work there and collect a paycheck. According to the court documents he said he was afraid to quit because he'd be breaking his contract and would have to pay the doctor $15,000 per terms of the contract. He lost his license to practice for 10 years and has to make restitution to the tune of $100,000. In my case I'd provided information to the physician on more than two occasions over the past 5 months about this issue but was summarily 'shut out'/not taken seriously...including suggestions that we self-audit and make any corrections. Never received a response or acknowledgement (going back 5 months, mind you).

help! I'm an NP who's just put in one year of family practice (no contract, hourly pay) at a small clinic. After doing an online seminar a few days ago I learned that I have a right to review billing statements and that I should be reviewing them regularly to make sure they are correct, especially incident-to billing. The doctor and billing manager would not let me see them (in truth, they just did not respond to my request or concerns). So, I quit the next day (no prior notice...recall that I had no contract) after much internal turmoil! Why? Because I fear they are not familiar with incident-to rules...and have likely been billing incorrectly for the past 6 months that I've been credentialed with CMS. I have never been involved in the billing process...they've kept me in the dark. I have no patients of my own as all have the doctor as PCP. My thinking was that if they won't address my concerns they probably have something to hide; I figured that if I stayed one more day then my suspicions could/would be confirmed... then I'd have to report fraud, or be indicted for continuing to work there/gaining financially from the fraud. Quitting immediately before learning anything more spared myself or the practice from going down that ugly road. I've never seen evidence of fraud...only blank stares whenever I'd mentioned that there are specific rules to follow when billing incident-to with an NP on staff... That's never a good sign...right? (I was the first NP at this practice). Any thoughts or similar experiences?