Hi
This is how I know. The docs have a high volume office ,spending a few minutes with each patient. They are assessing codes that are timed procedures requiring a minimum of 38 minutes per patient encounter. Since I'm also a patient, I know they just aren't skimping on time, they're simply not doing them at all. And some patients have questioned this as well. They have a nice scripted response for this.
I have had discussions with the docs and managers about proper usage of codes and been told "bill it, you know we'll cover it in our documentation" and "don't question what the docs are coding, just bill it". The computer system is even set up so that the docs select one procedure, but the wrong CPT code is tied to it!!! This allows for billing of an extra code per encounter. The office doesn't even have the equipment required for this code.
I've brought this to the big guy's attention as well, he was only irritated at my discovery, certainly not happy!!!! Since I was let go today--no reason given, with a nice monetary termination package, letters of recommendation and a promise to not contest unemployment, I'd say they are trying to get rid of the liability.
Oh by the way, everyone profits rather nicely from this, people are paid according to monthly income. I have no burning desire for revenge, they will get caught in due time, I just want to make sure that I can't be penalized for NOT disclosing this information.
Thank You--