Non-systems (Professional Responsibilities)

Question 1

Colleagues are billing using individual current procedural terminology (CPT) codes, despite the fact that patients are participating in group activities. The therapist is troubled by this since insurance companies and many patients are likely to incur unjustified fees. What is the MOST appropriate therapist action?

1.Confront the involved therapists and remind them of the need to follow established billing procedures
2.Inform the director of rehabilitation about the billing irregularities
3.Contact the involved insurance providers and patients about the noted events
4.Report the information to the state licensing agency

Answer 1

• Inform the director of rehabilitation about the billing irregularities

obligated to discuss the situation with the director of rehabilitation. If there was sufficient evidence to indicate that the director of rehabilitation was aware of the billing irregularities and did not take action, it may be appropriate to take more formal action.