Liability and Risk William has been notified that he and Dr. Chen…

Liability and Risk

William has been notified that he and Dr. Chen are being investigated for Medicare fraud due to fraudulent up charging of visits and documentation errors. One such case includes his visit with Charles. William no longer works at Highland Internal Medicine, having left the practice 18 months ago in 2019. William has also been notified by his State Board of Nursing that he is under investigation concerning fraud. Highland Internal medicine used an outside company to help with billing and coding. William does have documentation through email that he agreed to this practice, and he checked the box for automatic update, waiving his right to review the coding before it was submitted for billing. The billing and coding company went back and documented that William also saw Charles for and managed his chronic conditions at the visit on top of his annual Medicare wellness exam. William knows he did not cover or document on the management of these conditions as they were controlled or being managed by other specialists

1. Which coverage plan would you choose?

2. What did William do wrong that left him at risk? What did William do correctly? What would you do differently and how would you avoid this risk in your practice?

3. What type of malpractice insurance would you choose in this situation?

– Claims-Made 

-Occurrence Independent

– Contractor

 

 

 

Explanation & Answer

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