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Must Have IV & Monitor "Because Management Said So"


engine173351

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well It's been a while for me, but we used to fill out charge forms.  150 for transport fees,  Iv STart charge, Iv fluids fee, monitor charge, ET fee etc etc  and yes, the patient is charged for all that individually.  So that is definately the issue here.  

Based on the OP's information it definitely appears as though company policy is encouraging both fraud and unethical practice then. As others have already mentioned I would steer clear of this potential disaster, document the hell out of everything, and be prepared to speak to the appropriate authorities.

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Based on the OP's information it definitely appears as though company policy is encouraging both fraud and unethical practice then. As others have already mentioned I would steer clear of this potential disaster, document the hell out of everything, and be prepared to speak to the appropriate authorities.

I think if I worked for this company and I was forced to do this, I would do the following.

1.  Refuse to start any IV that I did not feel was clinically appropriate.

2.  Refuse to put on any monitor that was not clinically appropriate.

3.  Document reasons in my report for 1 and 2 above

4.  Keep a private journal with run numbers (NO PT names) that I transported and if monitors/IV's were appropriate or not.  

5.  make a informal visit to the medical director to get his/her opinion of this practice

6.  Call CMS and ask their opinion, initially as a anonymous report but if they begin to discuss fraud and criminal penalties, ask them about whistleblower protection for myself and if they would offer it then and only then would I give any more information to them.  

 

But then at number 6, you get into the weeds I think,  you have already opened that can of worms,  you have told them a story, they have said it's fraud,  and you now have a decision,  do you give them your companies name and subject yourself to penalties for not telling them in the first place or do you give them the information, have whistleblower protection and then become a pariah in the industry in your area for turning in your company for medicare/insurance fraud.  

I don't know many companies who  if they find out you turned your previous company in for medicare fraud that will hire you for fear of you doing the same to them.  So rock meet hard place.  Hope you like the middle.  

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  • 4 weeks later...

If I were you, I would do a good assessment on every single patient & document your findings & your treatment. I also would ask for a copy of the policy & I would refuse to do any procedure which was not medically necessary. If the company is indeed billing for services at a higher level of care than is medically necessary, they could face an audit, fines & fraud charges.

 

Edited by 1EMT-P
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If I were you, I would do a good assessment on every single patient & document your findings & your treatment. I also would ask for a copy of the policy & I would refuse to do any procedure which was not medically necessary. If the company is indeed billing for services at a higher level of care than is medically necessary, they could face an audit, fines & fraud charges.

 

And let me add,  if you knowingly go along with this STUPID policy and requirement, you might even be a party to the audit, fine and fraud charges.  

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