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Posted

Write what happened, as I was told when I 1st started ...."If it isn't documented, it didn't happen"

Don't lie or make shit up, because you could end up in court one day.

I have a dialysis patient now, my company made BLS "overnight", because he is a bilateral BKA, man transfers himself to stretcher/wheelchair and dialysis chair. They claim he is BLS because of being a Bilat BKA, which is crap in my opinion when we have another pt who cant walk that is "stretcher van" I document all the time that pt "transferred self" and when it asks for "reason for transport" I put "cannot justify, pt scoots self to stretcher w/o assistance" This is also the patient's request, he is trying his best to be independent, w/o legs below knees. So anyway, I do not "falsify" why he needs to be BLS, I cannot see a reason and WILL NOT lie for my company.

Posted
Write what happened, as I was told when I 1st started ...."If it isn't documented, it didn't happen".

That's why I usually don't even chart that kind of stuff.

I'll chart their ability to move their limbs and to ambulate, but medically, that is sufficient. I am not a billing clerk.

Posted

We have a ton of ambulance transfer requests where I live, not unlike most of you. In my state there is a sheet that lists what is considered medical necessity and what isn't. If a pt does not meet medical necessity, I will inform everyone involved that I am not refusing to transport the pt, but I cannot bill their insurance. That would constitute insurance fraud of some sort. Someone's paying for it: EMS, hospital, pt, or family, but not their insurance, and I will not falsify the report.

Humbly.

Posted

Heres another doozy

11am on a wednesday, go get the patietn for a evaluation of their j-tube being pulled out.

patient fits nicely in a wheelchair. distance of transfer 500 feet from nh to er door

There is a beautiful new (fairly though) wheelchair van with the driver on duty.

you have to come pick up the patient because they don't do transports to the ER for eval only transports back

patient gets a 1 hour er stay - doc looks at tube, puts it back in and patient ready to go. I'm not even finished with my previous 12 run reports(ok that's too many but you get the picture). I'm standing in the ER at the desk finishing up the run reports and the ER calls the nursing home to come get the patient. They want their bed open.

Nursing home says Wheelchair van driver is on his hour lunch break and it will be more than an hour before he gets there.

The ER says, Ok we'll have the EMS do it. They call our office and say we need a transfer.

We do the transfer, patient moves self back over to my cot and all is hunky dory.

I then write the report that I assisted the patient to the cot yet that's not freakin good enough. (another call into the sup's office). He says re-write the report.

I then ask him this question:

What do you want me to do with the receiving facilities copy? Don't we send it to them. He says "I will take care of that part" I told him that I was not going to falsify a patient report so we could get our money. He said do it or you are fired.

Can anyone guess what I said or did?

Posted
Can anyone guess what I said or did?
Tell them to take a flying leap? An anonymous call to the Medicaid folks?

The possibilities are endless :wink:.

Posted

That's why I usually don't even chart that kind of stuff.

I'll chart their ability to move their limbs and to ambulate, but medically, that is sufficient. I am not a billing clerk.

I agree DD, Im doing it to CMA, I don't trust the situation, *cough, cough* Billing fraud

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