A community of 30,000 US Transcriptionist serving Medical Transcription Industry

TO: Current MM coders NOT TRAINEES - L&L

Posted: Aug 23, 2014

I don't know why people want to rip me a new one over this, but

I would simply like to know if Mmodal treats it current coder employees (NOT ITS TRAINEES) any better than its treats ts MTs.

How may pay cuts have you had in the last 5 years?

How many benefits have you had cut?

What kiind of audit percentage do you have to meet?

Do you have a form of performance manages that cuts your salary in half?

Are you happy working as a coder for Mmodal?

Would you recommend Mmodal to any other coder as an employer?

It's good to see someone finally asking these - questions. Up to now it - sm

[ In Reply To ..]
seemed like everyone just assumes that the Squid will treat its coder employees different than it's treated its MT employees up to now. Somehow I just don't see their past employer history suddenly doing an about-face. I predict they'll crush their coders the same way they did their MTs.

JMHO

given that this is an MT website - not a coding website

[ In Reply To ..]
you are unlikely to have anyone come here and post that is/was not an MT at some time, therefore not able to answer your questions.

Good luck, though.

Agree - sm

[ In Reply To ..]
Exactly ... unless an MM coder had been an MT *and* knew about MTStars, they would not know about this board to come here.

There are few MM coders because their coding business is not very significant, making the likelihood of the above even less.

I have never seen anyone here who said they were a coder for MM. Maybe you will luck out, though.

coding - me

[ In Reply To ..]
Coding is very significant! I don't do the job, but it made a huge difference some years ago... my husband had an EMS ride that didn't get covered by insurance. He was unconscious, had near-stroke, pneumonia, & other problems, so there's no way I could've transported him. The job was coded as "needed a ride to hospital" or something like that. Talked to EMS dept, got the trip report, found out the coding, talked to insurance. They never did cover that ride or any other since then. After 3 uncovered rides, didn't call 911 anymore. Couldn't afford to, would get help loading him into the car, would drive him myself. If bills are coded right, then insurance is more likely to cover necessary care. In our case, it means getting to the hosp faster than I can get him there, but we can't afford $1500 to $2500 that his trips usually cost. Fortunately, he's no longer sick & hasn't needed 911 in awhile.

No one said coding was not significant - Good grief!

[ In Reply To ..]
No one said coding was not significant! The post said MM's coding BUSINESS was not significant , in other words, not very large.

Glad your husband is doing better.

oops - me

[ In Reply To ..]
Guess I got touchy on the subject. That was a very bad, expensive year & only because of coding difficulty. Couldn't get the code changed, so we had bills that were hard to pay. It's become a pet peeve of mine to have records goofed up when it shouldn't be that way. Ok, off my soapbox now. :)

Explanation - for those codes

[ In Reply To ..]
Your situation was unfortunate. It sounds like it was denied on appeal, which tells me the carrier felt the codes were correct. That means this was not a "coding problem."

Policies typically pay only when the service is medically necessary. The ambulance company is obligated to use the codes that correctly reflect the situation. If the patient legitimately needs the service to prevent death or bodily harm, the codes reflect that. If the patient just can't be gotten into the car, the codes have to reflect that.

The ambulance company can't change the codes to get payment. They can be banned by the carrier if they do, as well as being charged with federal crimes.

You, however, can disagree and submit medical documentation in an appeal to the carrier. If the documentation supports your claim, they will pay.

It is exactly the same as going to a doctor with a sniffle and expecting him to code it as pneumonia so your insurance will pay for it.

Fraud is a crime. To you, it might have seemed like just changing some codes to get it paid. To them, however, it was fraud. It was also easily discoverable fraud. The carrier has a right to see the ambulance and the hospital records. If the company changed the codes and the records did not justify it, they would have been charged with a crime.

thanks - me

[ In Reply To ..]
Thanks for the input. His situation was critical. The EMS crew called the hosp & told them his condition. The hosp was too busy with incoming from another hosp & told them to take him to the next one. The crew told them they had to bring him because he might not make it to the next place. The staff treated him in a hallway, but they got to him quickly. I read the crew's report. I was confused about why it got coded it the way it did when the report said his condition was bad & what was going on. He was pretty much unconscious, but he had several things going wrong at the same time. I didn't know changing the code could be interpreted as fraud, & it was never explained that way. Either way, the code was wrong & I got stuck with a huge bill to pay because of it. I couldn't get anybody to understand the situation. It's still a head-shaker to me. Because this happened 3 times in about a year, we made the decision not to call 911 anymore. When he had a stroke later, my teen son & I got him into the car & I drove him to the hosp. It should've been a 911 call, but we can't pay another huge bill like that again. It sucks when you have to make that kind of choice. We have constant medical bills. 911 is a necessary service, but it's the only one our insurance has had a problem with, so it's a service we no longer use. It's too bad. Again, thanks for explaining the situation from the "other side". It does help fill in some gaps of comprehension.

Suggestion - for next time

[ In Reply To ..]
Changing codes to get something paid isn't just "could be interpreted as fraud," it IS fraud.

Does your carrier actually pay for ambulance services? At all? Medicare does pay for medically-necessary transport and requires ambulance companies to accept assignment. That means that they only get what Medicare allows. If they can get Medicare to say it is a noncovered service, then they might be able to charge you a whopping amount more than that. Or maybe the owner's dimbulb daughter-in-law does the billing and just plops the same codes on every claim.

If your carrier actually pays for ambulance services, and if the situation is as you described, you have a valid complaint against the company.

See if there are any coders in your area who do medical bill review. If they think the coding is wrong, file a complaint.

Note: Do not ask them to "change the codes." TELL them to "code it correctly ... this should be xyz." You have to know what the codes should be, because they clearly don't.

covered - me

[ In Reply To ..]
Yes, ambulance rides are covered, had been covered until this one year when the insurance suddenly stopped covering it. Perhaps it would be worthwhile to learn some of the codes in case something like this happens again. I tried to get it changed "to get it paid" because it was a covered event per their own description of eligible events. I have no interest in fraud. Oh well. The bill is paid now & I have no idea if EMS would be covered now for him since we don't call anymore.

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