Doctor patient relationship and bills

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doctor patient relationship and bills

Once a physician-patient relationship has been established, the physician is Perhaps a patient routinely fails to pay bills without offering an. Let's talk about the doctor, patient, and insurance relationship. happen to you or a member of your family, and how would you afford the bills?. Many laws have undermined the doctor–patient relationship — mandating that Arizona Senate Bill , however, threatens to undercut the doctor–patient.

doctor patient relationship and bills

Needless to say, my patient, an elderly gentle retired professor, was stunned and left to fret and stew through the long weekend and well into the next week when the two met again. This time the conversation took a very different tact.

First, the urologist apologized for his inexcusably bad manners and rudeness late the previous Friday.

doctor patient relationship and bills

Then he settled down to explain what was going on and mark out a plan for what "Professor D" might expect in the next few days and weeks: First a biopsy or two to determine the type of cancer, a search for evidence of spread beyond the kidneys and with the evidence at hand, explore the options and outlook and talk about the future, taking into account any questions the patient and his wife might have then and later.

Story continues below Days later I talked to the urologist.

Billing and up coding: What’s a doctor-patient to do?

He explained that Friday had been a terrible day both in and out of the operating room. One of his patients died "out of the blue" in the recovery room from a massive pulmonary embolism from a blood clot in one of his legs. That, an overbooked outpatient clinic, numerous interruptions from the ward and one look at the CT scan and urologist was at wits end. He lost his patience and manners. I might add that matters worked out well for "D. And best of all there has been no evidence of recurrence and the two, patient and surgeon, became golfing friends.

Opinion | Nurturing the doctor-patient relationship |

However, this story does highlight the issues of how and what doctors tell us. Sometimes physicians have their eyes glued to the computer screen to look up lab results or previous visits but seldom look at their patients.

doctor patient relationship and bills

TH then asked about the lengths of visits and the extent of examinations, and learned that both complicated and simple visits were coded the same way. TH was concerned that this practice was acting in an unethical manner by upcoding.

doctor patient relationship and bills

At this point Dr. Discussion Professionalism in the field of medicine has dictated that physicians operate under a unique code of ethics, which is different from most businesses due to the primary duty to be dedicated to the welfare of patients and our professional imperative for self-regulation of our peers.

These principles can appear to be at odds with the modern-day practice of medicine where monetary business concerns are inextricably linked to the ability to interact with and subsequently treat patients.

Nurturing the doctor-patient relationship

It is important to note that fraudulent billing is illegal as well as unethical. This case highlights a contemporaneous issue facing the medical profession: To the outside observer, the distinction between fraudulent coding and unintentional upcoding may not always be clear Wynia et al.

Some may believe this is a harmless act since there is no detrimental outcome for the patient. However, overbilling from any scenario, whether intentional or not, has a damaging impact on the health care system as a whole and is not a victimless event.

There are a finite number of resources available, and overutilization or overcharging ultimately shortchanges monies needed for other areas and infringes on the core tenet of justice in medical ethics. No matter the reason, the practice of fraudulent coding is unethical, unjust, and maleficent. The patient, if knowledgeable of such a violation, has an obligation to help stop unethical or fraudulent behavior.

Category: Doctor-Patient Relationship

The challenge for patients in this scenario is expressing their concerns in a non-threatening manner to the physicians. Being found guilty of an upcoding fraud can, and should, lead to dire consequences for the physician Hannigan, Even if the physician is not guilty and there is just a misunderstanding, the accusation can lead to considerable financial cost and emotional turmoil and as such, accusations of impropriety should not be taken lightly.

In this case, the physician-patient confirmed with the practice manager that something was amiss before jumping to conclusions based on her own personal experience.

Medicare auditors and other third-party payers routinely identify billing outliers and refer many such cases for further focused review. Audit investigations include on-site visits and interviews with patients. Ideally, the burden of regulating ethical behavior of physicians should fall on the members of our medical profession and not on our patients.

In our case, the roles of patient and physician are intertwined and complicate the ethical dilemma. Proper coding touches upon many of the principles that form the framework for medical ethics but beyond these issues, there is a more distinct principle of professional integrity and moral excellence. For physicians and non-physicians to trust their care to medical professionals, we must be certain of their integrity.

Analysis of case scenario When reviewing our case, a balance must be struck between overreacting to suspected behavior and curtailing fraudulent behavior given the ramifications of reporting Kantor and Rapini, However, since the upcoding by the physicians in our scenario was consistent and repetitious, this case brings to bear the uncomfortable possibility of addressing unethical or possibly fraudulent behavior among colleagues.

TH remains their patient. TH would then have to build new relationships of ethical confidence with new caregivers.

doctor patient relationship and bills

Option B, discussing the issues with the physicians, is the most direct and personal approach and has the distinct benefit of allowing the physicians involved to explain their justifications for the coding directly to the concerned party. This approach may offer the best chance for Dr. TH not only to address her concerns about the coding practices, but also to find out whether the physicians in question are indeed resorting to fraud.