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#1 2006-06-02 11:10:48

scl
Member
Registered: 2006-06-02
Posts: 2

Coding Fraud

I am a CCS, a certified coding specialist  that has knowledge and physical proof in my possession of being asked to commit fraud by upcoding. I work as an inpatient coder at a hospital in Oklahoma. My job is now in jepardy because I went to the compliance officer with my concerns. Even if I am not fired the workplace has become so hostile I feel I cannot stay and am under a Dr's care for acute anxiety. Any suggestions? Any experience in these type of situations?

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#2 2006-06-02 11:51:56

Kit Kat K
Banned
Registered: 2005-09-13
Posts: 211

Re: Coding Fraud

What does the coding pertain to?  Does it pertain to any of the phen fen claims and class action suit that is currently going on? 

If this is the case, my attorney would be glad to speak with you.

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#3 2006-06-02 13:16:29

scl
Member
Registered: 2006-06-02
Posts: 2

Re: Coding Fraud

No, it refers to coding diagnoses that pay the greatest amount and get higher reimbursement than the hospital is entitled to based on the documetation in the medical record. It refers to leading the attending physician to make his diagnoses based on what pays the most, not what the patient has really been admitted for,

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#4 2006-06-02 16:36:02

Kit Kat K
Banned
Registered: 2005-09-13
Posts: 211

Re: Coding Fraud

contact your state's Attorney General and the office of the FBI.  With proof, you shouldn't have any problems of getting them to pay attention.  There is also the WhistleBlower law that is supposed to protect you............as well as pay YOU the amount saved/found from the company that is being investigated.

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