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You are the practice manager of Docs R Us, Ltd., a large multispecialty medical practice employing more than 100 physicians. You are conducting a random review of billing for doctors in the practice and you discover that one of the internists in your group who treats mostly Medicare recipients has been checking off the wrong code for her procedures on the billing form. The procedures on the patient record do not match the billing form codes. You pull up her files for the past 3 months and find a pattern of upcoding. When you meet with her to review this miscoding, she becomes very defensive and angry. What do you do?
Three single spaced typed paragraphs (no more) describe what you would do--how you would handle this situation. Use essay form referencing those chapters and concepts that you will use to address the problem. As in previous case studies--frame the problem giving the readera quick overview of the problem. Reference the text using examples and even direct quotes to expand and substantiate your discussion. Before submitting it read it out loud or to someone else to make sure it makes sense.
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