Question: Case Study Scenario: You are the practice manager of Docs R Us, Ltd., a large multi-specialty medical practice employing more than 100 physicians. You are

Case Study Scenario:

You are the practice manager of Docs R Us, Ltd., a large multi-specialty 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 Internal Medicine doctors 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 code forms. You pull up her files for the past three (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? How could you have prepared better for the meeting with the physician?

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