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Posted

no I re-wrote the report and in my narrative I put in before the modified pieces that this was the 2nd of 2 reports and I underlined my changes. I fully stated that these were modifications of a already turned in report to the nursing home.

They were pissed but I asked them to go talk to legal and get their ruling. They never did. I then shredded the falsified narrative and told them never to ask me to falsify a medical record or I'd go to medicare.

Needless to say, I ceased working there on my own decision about 4 weeks later.

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Posted

I have a suspicion that, in that month, a lot of unnamed folks gave you a lot of uncomfortable grief.

Posted

yes they did my run reports were scrutinized and criticized for the entire month but they always were spot on so they had nothing to hang me on

Posted

I never once falsified anything regarding necessity of transport.

Considering I was never from my first day asked to specify how the patient got from where they were to inside the truck, I didn't. I didn't falsify. I just didn't specify.

...Unless I was trying to get rid of a problem patient. We'd have these BS frequent fliers that loved to call us because the policy was we took every request for transport no matter how blatantly no-pay it was. The hospitals hated these types so much that they'd go out of the rotation and call us to transport them back to wherever they came from just to punish us for bringing them in in the first place.

Problem was, that no way in hell were we getting paid for the ride if I documented everything, and no way in hell was the patient ever going to pay out of pocket. When that happened enough, the owner would finally authorize supervisors to refuse transportation to those individuals. As much as he hated risking pissing off a hospital that had us in the rotation, he couldn't justify tying up a truck for a freebie- especially on the overnight when most of these skells seemed to always get discharged.

So I took great pains documenting such things as "ABC ER MD refused to sign Physician Medical Necessity Certification due to lack of medical necessity for transport." :twisted:

And you know what? As underhanded and cheap was the owner was, I was never once asked to re-write a report like that. Could be because on the runs that were clearly justified, I did everything I could with my report to make sure we DID get paid. Unlike the floors, the ERs had no idea what a Physician Cert was, but if I knew it would help I'd wait as long as it took to get one signed.

You just have to know how to work the system in your favor. :wink:

Posted

Be sure for your one records and better interest to keep tracking of the date in which you were asked to falsify your report and any additional details in case you ever have to come back on this incident.

I personally would never falsify any report. Working in Law/Legal areas, there are many times that I would have been better off to do so but it just isn't the right thing to do, what happens, happens and it is our duty and job to report the facts and nothing else.

Posted

I'm a firm believer that if it's not documented, it didn't happen, and if it DID happen, then it BETTER BE DOCUMENTED the way it happened.

I'm not going to falsify my reports to make the billing department's job easier, to try to get extra money for the company and if I'm put in the position to either falsify the report or lose my job......well, prepare to pay my unemployment and you might want to be looking over your shoulder for the medicare/medicaid fraud agents coming to audit the books!

Posted

Just goes to show that if there's insurance, there's insurance fraud. This doesn't directly apply, but the parallels are there. Back when I ran the office of a body shop, I had a customer who brought in a car with only hood damage. It's typical to paint adjacent panels to blend the new paint to old paint as some color codes are difficult to match. In this case we had the replacement ahead of time, so we prepainted it. When the car did come in, we replaced the hood and looked at the color match. It matched better than the original. There was no need to blend the fenders so I called the adjuster to remove the items from the bill.

When my manager found out he acquired a new onset of Tourette's. His justification nearly to the letter was, "The overcharge on stuff like this makes up for the times they refuse to pay for other charges." Apparently the relationship is based on the theory "Screw unto others before they screw unto you." My employment was short lived after that.

Since then I'm amused by "Business Ethics" classes as they seem to have little to do with each other.

  • 4 weeks later...
Posted

The last private ambulance company i worked for during their orientation told you flat out, the patient does not walk to the stretcher ever, they are assisted, or the were lifted onto it.

Their reason that they give you is that, if the pt walked then medicare will not pay for the call. During my time there I was called into the office more than once and told to stop writting that the pt walked to the stretcher. I've never been big on lying, and I damn sure wasn't going to start on legal documents.

Posted

In all my career, only once have I ever worked for a transfer company. All other employers were EMS. But, to the credit of that employer, he never passed down those kinds of insane policies, not even in a round-about way. Never even hinted at them. And, he was quite successful, eventually being bought out by AMR for a hefty sum. Somehow he was able to be successful, treat his people right, and not ask his employees to commit fraud for him. Although, I accept the possibility that he was committing fraud without our help, but I digress. :D

Anyhow, I'd just smile and say 'yes sir' and go about my business, until next time. Next time I showed up for one of these little pep talks, I'd have a tape recorder in my pocket. You can figure out the rest from there. :twisted:

Posted

I always just stated "pt placed on stretcher", regardless of their walking ability, I did indeed place them on the stretcher.

No need to state they walked, or that I moved them; simply put, I placed them where they needed to be. How I accomplished that was irrelevant and I met the employer's requirements and assume medicare as well, sine I was never instructed to change it or stop using that phrase.

Lucky for me, I have not done transfers since the mid 90s, so glad to be away from that stuff.

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