Run Form "leading"

[Mountain Res-Q]

You are personally storing protected health information? That is asking for trouble.

90% of the paperwork I refer to is non-medical.

For the stuff medical in nature:

Only if that info is released. No diff than using an ePCR system where the info is stored in the laptop and than other databases. It is my paperwork that I am storing. However, in my case it should be noted that I no longer work ambulance (never did keep paperwork back then), but in three gigs, two where I am actually responsible for maintaining the paperwork files, i.e. the paperwork from others comes to me and I make sure records are stored in hard and digital forms. I just double up my paperwork and make sure that digital format can never be lost. As far as person info, my system makes it more secure, as I am the only one who knows where it is and has access, as opposed to allowing none-medical owners, billers, etc to see it the way the OPs paperwork is viewed and rejected by people who want it changed for billing reasons.

Note: I am a paperwork nazi because it has saved my bacon several times (medically and not), so I and complete with it and 100% protective of it.

 

[RocketMedic]

If this had been an immediate rewrite, possibly legit
But with the delay the OP mentioned, it sounds like its been rejected by billing.
No Buenos.

 

[Aidey]

You are personally storing protected health information? That is asking for trouble.

Most of the ePRC software I have seen have an option to print off PCRs without the personal information. I print those off on calls I want to keep a record of. The run number is still on the report, so if for some reason I need the pts name (for follow up usually) I can still find it.

 

[medicdan]

Op, would you feel more comfortable if Billing/Management gave you a "rubric" of language that is appropriate for billing, for you to use at your discretioon? Reports continue to be yours, and you use "preferred" billing...?

Sent from my DROID2 using Tapatalk

 

[mycrofft]

As a former EMT AND a former case manager...
1. If the information on the run form is being basically altered (acuity, type of problem, location, etc) then it's bad.
2. If they are jostling you to use certain terminology but the substance is intact, then it is ok. There were times I sent forms back with a leading question , such as "Would you say THIS was the issue?" because we both knew the case was good to fund, but a specific wording had to be met to get the money.
3. Considering the quality of grammar on many of our posts (we'll except this thread so far), I can see run tickets being bounced back for that alone.

 

[Justice]

As a former EMT AND a former case manager...
1. If the information on the run form is being basically altered (acuity, type of problem, location, etc) then it's bad.
2. If they are jostling you to use certain terminology but the substance is intact, then it is ok. There were times I sent forms back with a leading question , such as "Would you say THIS was the issue?" because we both knew the case was good to fund, but a specific wording had to be met to get the money.
3. Considering the quality of grammar on many of our posts (we'll except this thread so far), I can see run tickets being bounced back for that alone.

My typing on an internet forum gets the effort of a text message.
On my Run forms I cross my t's and dot my i's.

This isnt an issue of down playing a genuine medical condition.

I am being asked to recreate an entire run form that #1 I dont recall
and #2 using information I do not know to be accurate.

Tomorrow morning I am going to call a fraud alert line and see what it turns out to be. updates to follow

 

[RocketMedic]

That's definitely shady, Justice. Good on you.

 

[firetender]

If, due to an injury, which is why you seem not to be working now, you actually cannot recall what happened, then:

#1) You don't remember enough to make a judgment on whether your employer is fudging the books and commiting fraud. In that uncertainty, perhaps you can relax a little more about that. We can't fill in the blanks for you.

#2) You have absolutely NO obligation to write up anything regarding the call. You would be within your rights to refuse to document anything that you cannot recall. One thing that MUST be documented is that you suffered TEMPORARY amnesia to make sure your future is not negatively impacted.

#3) Whistleblowing, though righteous, is something that is best done AFTER you fully assess your target's ability to make your life miserable. I'm not speaking against honesty as much as speaking for discernment in the battles you choose to fight. Where do you choose to put your energy and attention?

 

[Justice]

If, due to an injury, which is why you seem not to be working now, you actually cannot recall what happened, then:

#1) You don't remember enough to make a judgment on whether your employer is fudging the books and commiting fraud. In that uncertainty, perhaps you can relax a little more about that. We can't fill in the blanks for you.

#2) You have absolutely NO obligation to write up anything regarding the call. You would be within your rights to refuse to document anything that you cannot recall. One thing that MUST be documented is that you suffered TEMPORARY amnesia to make sure your future is not negatively impacted.

#3) Whistleblowing, though righteous, is something that is best done AFTER you fully assess your target's ability to make your life miserable. I'm not speaking against honesty as much as speaking for discernment in the battles you choose to fight. Where do you choose to put your energy and attention?

It wasn't direct amnesia, Just a minor concussion and extreme pain from a shoulder dislocation. So I have just had so much going on I honestly can't remember that specific transport.

My biggest concern is everytime I have ever had a pt in my ambulance I have at the very least started a run form, Where did my original go. this is the 3rd time I have been asked to recreate a run form. The other times I had no problem recreating them as they were regular patients and i transport them frequently. This "lost" run form thing has become suspicious.

Lastly thank you, i agree that whistleblowing might not be the best for me.

 

[Jon]

Wow.

Interesting discussion.

I'll reiterate the big point - Documenting more or less than the full story of the call, for the sake of Medicare paying the claim, is, at minimum, skirting fraud.

I work for a VERY large company that has had multiple run-ins with the Medicare auditors in recent years. Guess what - I've been told, in no uncertain terms, to notify the Comm Center if the patient doesn't meet Medical Necessity. We might still do the run - but we'll flag it for further review, and might just eat the trip, rather than get it bounced by Medicare.

Your situation, Justice, sounds shady as heck. That said, I only see your perspective... but your situation is by no means unlikely.

As has been said - document the truth. If they ask for clarification for some things, that's OK... so long as it's still the truth, and your original chart remains part of the record.

As for being a whistleblower - as you've noted, it might be easier, in the short and long term, to just walk away.

 

[Justice]

Wow.

I work for a VERY large company that has had multiple run-ins with the Medicare auditors in recent years. Guess what - I've been told, in no uncertain terms, to notify the Comm Center if the patient doesn't meet Medical Necessity. We might still do the run - but we'll flag it for further review, and might just eat the trip, rather than get it bounced by Medicare.

I have had the same thing happen but this is something different.

 

[RocketMedic]

"Different " isn't really a good way to function when it comes to charting and whether or not the call happened.

 

[Justice]

"Different " isn't really a good way to function when it comes to charting and whether or not the call happened.

The call date/time/Partner add up but i honestly just cannot remember doing the call or not. I have looked over all the paperwork they have on the call and I can't remember it at all.

 

[Justice]

Poor me, I was fired

Ya they tossed me out like yesterdays trash. Kinda hurt since they didnt even offer a gold watch. :sad:

Went to get my mail and in it was a termination letter.

Under the termination letter was a letter from my Attorney General saying a silent investigation was already under way.

He thanked me and called me Patriotic:blush:

 

[Mountain Res-Q]

Ya they tossed me out like yesterdays trash. Kinda hurt since they didnt even offer a gold watch. :sad:

Went to get my mail and in it was a termination letter.

Under the termination letter was a letter from my Attorney General saying a silent investigation was already under way.

He thanked me and called me Patriotic:blush:

Not sure how you feel about that termination, however, personally I can say that my principles are more important than anything. It is all I have. I would be fine with it. "Patriotic"? Dunno. Moral and ethical? In my book, yep... Repercussions be damned for me; but that opinion is subjective.

Here's one on the house... :beerchug: ..."Justice" has been served...

:blink: Sorry... bad pun... I am tired...

 

[Justice]

Not sure how you feel about that termination, however, personally I can say that my principles are more important than anything. It is all I have. I would be fine with it. "Patriotic"? Dunno. Moral and ethical? In my book, yep... Repercussions be damned for me; but that opinion is subjective.

Here's one on the house... :beerchug: ..."Justice" has been served...

:blink: Sorry... bad pun... I am tired...

I am fine with being let go.

Patriotic because when I submitted my evidence with what was taking place, I also included a signed letter stating no matter the amount found I do not wish to have any part of the "reward" and if there is one it could be anonymously donated to CFSRF ( Childern of Fallen Soldiers Relief Fund)

And I like the Pun.

Thanks gonna go crack one right now

 

[Justice]

Union stepped in and I am no longer being let go.

Now I am told i can write "This run form is for billing only and I cannot attest to the information in this report"

Seems safe but I wanted to cover my bum so i called a Lawyer who has experience in Medicare fraud. He told me to run away from the situation as fast as possible.


He said billing practices like this are currently under review with Medicare.

Any thoughts?

 

[ffemt8978]

Union stepped in and I am no longer being let go.

Now I am told i can write "This run form is for billing only and I cannot attest to the information in this report"

Seems safe but I wanted to cover my bum so i called a Lawyer who has experience in Medicare fraud. He told me to run away from the situation as fast as possible.


He said billing practices like this are currently under review with Medicare.

Any thoughts?

Listen to the lawyer. If any agency I worked for tried that, I'd be nothing more than a vapor trail leading out of there.

 

[Justice]

Listen to the lawyer. If any agency I worked for tried that, I'd be nothing more than a vapor trail leading out of there.

Thanks this was my thought but I guess I needed to hear it from someone with a bit more experience

 

[DrParasite]

Listen to the lawyer. If any agency I worked for tried that, I'd be nothing more than a vapor trail leading out of there.

allow me to respectfully disagree with you on this. I would be looking for a new job immediately, but not out the door.

It is much easier to get a new job when you already have one, vs being unemployed and looking for a job.

Keep your paper trail and documentation, because when the medicare fraud investigators come knocking at your door (and they will come knocking), you have have all the documentation that you tried to do the right thing, and were threatened with termination if you did.

but definitely be looking for a new job immediately.