Responsibility of Bill - Against Physician's Wishes

by Anonymous

This is probably an unusual question. If a provider tells me to not charge a certain patient for an evaluation for whatever reason, can the head billing coordinator and administrator override the provider and make the biller submit a bill against the physicians wishes, even if it is company policy? And lets throw in there, the provider is refusing to sign the bill.


Response:

It certainly sounds like you are caught in the middle. My opinion - for what it's worth - is the billing coordinator and/or administrator shouldn't be leaning on you to resolve this. They are the "management" and paid accordingly to work out these types of issues. You shouldn’t be expected to circumvent the process and they really shouldn't be putting that burden on you.

If the provider is refusing to sign the bill - there's not much you can do other than tell your supervisor - I assume it's the billing coordinator - why you can't bill for this evaluation. You certainly can't force the provider to sign - or concur - that they provided these services. And you ethically can't bill for services a provider doesn't acknowledge were performed.

If the provider is an employee of the practice or business, they may have certain contractual responsibilities regarding these issues - but that shouldn't be the billing specialists (your) problem to work out.

My advice is to tell your supervisor that you can't bill the claim and explain why - that the provider will not cooperate - and let them or their management resolve the issue with the provider.

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