Healthcare Compliance - Ethical Dilemma

Topics: Quality assurance, Health care, Management Pages: 2 (636 words) Published: March 3, 2013
A couple featured in Time Magazine talks about a medical billing dilemma. Sean Recchi, 42, was diagnosed in March 2012 with non-Hodgkin’s lymphoma and went to MD Anderson Cancer Center in Houston for treatment. He is in remission now, but he was left with an $83,900 bill, including $48,900 for a six-day consultation stay before treatment started. They took action when Stephanie Recchi, Sean’s wife, was researching billing practices and sought out Medical Billing Advocates of America in the process. Brill contacted the group about another MD Anderson patient when he found out the Recchis and called them in June 2012. I think that MD Anderson facility has not complied with Code of Ethics of the Association for Healthcare Documentation Integrity ("AHDI") in all laws, regulations, and standards governing the practice of healthcare documentation including the Health Insurance Portability and Accountability Act of 1996, the American Recovery and Reinvestment Act of 2009, and the Health Information Technology for Economic and Clinical Health Act. I think they have violated Sean Recchi’s rights and have been overcharged by MD Anderson. I think the dilemma appeared to be inadvertent because a well know; reputable organization and their ethically trained employees will not consciously be careless. They are trained to check everything precisely and accurate because an intentional error could be disastrous. I think this will affect the institution in an ethical matter because they have not complied with the standard code of ethics and may affect the reputation of the healthcare facility. Action Plan:

In the complicated world of medicine, medical billing mistakes can happen. In this case the coder may have put the wrong code on the insurance claim, resulting in the insurance company to not cover the provided services. I think these mistakes are usually innocent and may not be outright Medicare billing fraud, but in this case it definitely cost the Recchi’s money....
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