crazynurselady

I've had this happen to me a couple of times. At first I was furious mostly because I was HUNGRY. Then, it upset me to think that someone that I was working with was having to steal to eat. I said if someone was that hungry all they had to do was ask and I would have gladly shared with them. Not sure if this was actually the situation or if it was someone who just didn't care if they took someone else's food. It happened to a couple of other people too. I started trying to keep track of when it happened and who was working to try and figure out who it might be. Haha. Eventually it stopped. I never found out who it was.

Hi. I have experienced this. I say this with the most sincerity. I would either not answer my phone (you know why they are calling you at 6:30 am) or I would answer and each and every time they ask you to come in tell them you are sick, say sorry, and hang up. I know this may sound harsh to some but I can tell you from experience...they don't give a damn. Even if you came in and worked every single time they needed you, trust me, it will be forgotten the second you screw something up. If you told them straight up in the interview that you did not want overtime or to be called for it, then stick to your guns. Of course, you run the risk of them saying you are not a team player. But if you work your schedule then I wouldn't worry about that too much. They will still call you because they have to. I was ADON at a facility and the when someone called out the scheduler would just go down the list and call anyone who was off to come in. So, also, don't take it personally. I would stick it out for a little while and see how it goes. On the bright side, if they are always needing help, that's job security. Lol. Hopefully, you won't be expected to work short handed because of call-offs. I usually try to give a job at least 90 days before I decide for sure. Good luck.

Thank you chiro13 for your comments. You being a chiropractor yourself and saying this, says it all. And it's true about the business end. We see new patients there but mostly the same people who are coming for maintenance for their neck and back pain. I hope I find something soon or may just have to quit and be jobless. Haha. I hope not.

OK so, I spoke with the chiro about his crazy note idea. He tried to act as if I didn't understand. So I told him I didn't and asked him to please explain it to me so I could. He gave me some double talk about ICD-10 and I told him that didn't have anything to do with how he was trying to get me to sign his notes under my name. I told him to please show me something in black and white that is from a legitimate source that states that this is the way for him to do his notes. I told him to go to the CMS site and find something to prove that this is legit or we could just go ahead and call Medicare ourselves and ask. I told him that I am not comfortable with this note plan and that maybe this is not the right place for me to be. He said he understood my asking. Then after a few more words, he started to walk out of my office and on the way out he said somewhat under his breath, "maybe this isn't the place for you." I just ignored it and let him walk out. But what I really wanted to say was "Hey, I'm right here. Why don't you look at me in the face if you have something you want to say." So I started getting my things together thinking that maybe that meant I was fired. I sat there and waited for lunch time because I was done seeing patients but he wasn't quite yet. Once the patients were gone, he came back to my office again. This time he was very pleasant. He told me I was right and that he was doing it wrong. Then he started telling me how much he likes working with me and how the patients like me, etc. I was pretty disgusted to say the least. But I just smiled and pretended that I was listening and that I cared. He is likely scared that I am going to report him. He went and changes all the notes back to his name. Needless to say, I am still looking elsewhere for employment. I can't get out of there fast enough. I even went ahead and took most of the few things that I had there home. This way I can just run out fast when the time comes. I still have to ask them about what levels they are billing under so that I can make sure that it is correct. I'm sure it isn't. On the bright side, I did get a couple of calls from places that I applied to. One is much closer and will hopefully their head guy will call me for an interview. The office manager called me yesterday and I called her back today because I'm not at work on Tuesdays. The other place wanted someone with ER and urgent care experience already, so I'm out of luck. But my fingers are crossed and I still have several other aps out there.

I hear ya. I'm not interested in their techniques. I am only interested in doing what I went to school for. His wife does the billing in the office. She is not a certified coder or even an MA. They don't let me know anything about the billing. I have even offered to help up front when my schedule was slow but I get a vibe like she doesn't really want me to. She doesn't mind me answering the phone when she can't get to it but she has never tried to show me how to check someone out of the office after their treatment, etc. And he has said to me a couple of times "you don't want to have to deal with billing." Or "you don't want to know or need to know about billing." Apparently, I do. I could just be paranoid, not sure. But when it comes to my license, I am. I would rather have my license free and clear and no job than to lose it and not even have hope of getting a good job. Maybe they don't know what they are doing. And he thinks he doing what he's supposed to. If that's the case, I want him to show me the proof from a legitimate source such as the CMS.

My duties that are set forth in the employment agreement are just basic. It states "The ARNP may interview clients, obtain and record health histories, perform physical and developmental assessments, order appropriate diagnostic tests, diagnose health problems, prescribe and adjust medication, perform trigger point/joint injections, manage the health careof those clients for which she has been educated, provide health teaching and counseling, initiate referrals and maintain health records. Note the part that says "for which she has been educated", I have not been educated on chiropractic techniques. It goes on to list a bunch of diseases that any ARNP could treat and be comfortable doing so. It does list low back pain, fractures, bursitis, fibromyalgia, OA, OP, sprains, and strains. I see it also has rehabilitation listed. That's not something that we do in a primary care setting. Ridiculous. I have a sick feeling in my stomach when I think about it. I hope I get some phone calls soon.

Hi IhflanurseNP. Thanks for your input and responding. I am I'm pretty sure he's having his wife bill under my name for Medicare because it pays more. But I'm not sure exactly how she is billing it. I'm not signing any of those notes. I'm going in tomorrow and I'm going to let him know that I am not comfortable with this set up. If he fires me, I'm going to call Medicare and let them know that I am no longer working for them so they can't continue to bill under my name. Another thing, I talked with the NP that worked there previously and she told me that they tried to get her to change a date on a note so that the chiro's wife could get the insurance to pay the hospital bills for a minor accident his wife was in before I started there. She ended up with Bell's Palsy a month later and tried to say it was because of the accident. The previous NP obviously refused to do it. She has moved out of state but we keep in contact. She agrees that this new note tactic is shady. I'm going to ask him to show me something from Medicare billing that says this is how he should do it and that says it is legal. Never in my life did I imagine I would find myself in such a predicament. But here I am. I can't go in the office accusing someone of attempting to commit fraud, of course. I have to be calm and stay as professional as possible. I will let you all know how this turns out. I have already put out about 12 new aps. Either way I want out of there. I want to do primary care or urgent care. Wish me luck!

Thank you for your response Psychcns. The collaborating physician is rarely in the office. He is basically a buddy of the chiro and he is the MD that is "overseeing" me. I was provided a collaboration agreement but it is basically just canned, nothing very specific. But it is with the MD not the chiro. I have looked at urgent care clinics as far as 50 miles from me. I have recently looked again and applied to many of them, even though, once again, they want someone with at least a year of practice. Fingers crossed. The chiro is treating the patient (or his MA/CA - when they have one and they stay). Another issue. He treats them on the opposite side of the office on a cox table ad in the PT area where they do some exercises and apply heat and cold packs, and they stand on a machine that shakes them for like 15 minutes. Sorry, forgot what it's called. And, frankly, don't care. Ha! He came and told me this arrangement with the notes was going to begin on October 1st along with the transition to ICD10. Which I do the coding for the diagnoses as well. I am not a coder. He told me he would input his portion on the note that would be assigned to my name and then I would need to put in a short note as if I had assessed the patient and then sign it. He said that I should maybe just pop my head in the treatment room and peek at each patient. His name is nowhere on the note. It will look as if I am doing the chiro therapy. Does this sound normal to you? I just don't know. I got a bad feeling in my gut. I am going into work tomorrow and I am going to talk to him about it and let him know that I am not comfortable doing this. I may not have a job after tomorrow. UUUGH. Thanks for listening. I will update and let you know how it goes.

Hi. I am new to this forum. I found your post by accident and joined because of it. I am experiencing the same problem. I passed cert and got my license. I applied at many places but they all wanted someone with experience. So I took the first job that was offered tome after getting turned down. Plus the area I live in is a small community, so not that many NP jobs available. So, I went to work for a chiropractor and I am going through the same issues. I have been co-signing his notes since I started there in July. And now he expects me to sign all his chiropractic notes under just my name. I have not signed any of them because I don't see his name on them anywhere. I'm not sure this is legal and I'm very concerned about the possibility of Medicare fraud. I am not a chiropractor, so why is he trying to get me to sign his notes as if I have performed the treatments? This does not make sense to me. Do you or anyone else know if this is normal? Or legal? I know it's been a while since you made this post so I hope you or someone can give me some advice. I'm worried. I have already started looking for another job. Short of calling Medicare and asking them directly, I don't know what I should do. I wish I could just quit but I need the income until I can find something else. But if this is shady, then I am going to quit anyway. Plus, NO benefits...NONE.