Part 1- Bookkeeping Errors
As a medical administrative assistant, you have been employed with a group of occupational medicine facilities for over 3 years. You have been asked to go to another occupational medicine facility to fill in for a few hours because they are short-staffed. When you arrive you are asked to perform various bookkeeping services such as single-entry accounting, charges, payments, and adjustments that require posting on patient accounts. While there you are also responsible for collecting copayments. Shortly after starting you begin to find errors.
Review the text for types of bookkeeping errors as well as this article: Five Common Accounting Mistakes and How to Avoid Them https://www.thegibsonedge.com/blog/five-common-accounting-mistakes-and-how-to-avoid-them
Investigate several ways bookkeeping/accounting errors can be located.
Include the following aspects in the discussion:
Expand on what types of errors can occur. Find at least five.
Discuss what your first action should be when you find an error.
Summarize how you would implement ways to reduce the errors.
Part 2-
Health Care Fraud
As we explore billing and coding in the small office, it is important to consider the issue of fraud. Most errors are just that, errors, but occasionally you might end up working for a small health care facility that engages in billing practices that are incorrect, are known to be incorrect, and collect payments that are not legal under the law. This is fraud, and the consequences are serious. You do not want to be involved in fraud involving payers or the federal government.
Read this article: Health Care Fraud
https://www.whistleblowersinternational.com/types-of-fraud/healthcare/
Read the summary of this article: False Claims Act
https://downloads.cms.gov/cmsgov/archived-downloads/SMDL/downloads/SMD032207Att2.pdf
Outline your risk of violating the False Claims Act.
Include the following aspects in the discussion:
The Act covers more than deliberate fraud. It includes “acts in deliberate ignorance …”. How will you assure that you submit correct information as ignorance of billing and coding rules is not an excuse?
What does “acts in reckless disregard of the truth … of the information” mean to you, and how will you avoid being accused of this?
Discuss if you would be comfortable being a “whistleblower” if you uncovered fraudulent practices.
