"The blame game!"

...4/16/03: then...Rosanne calls up & says that Hope called her about the usage of a HCPCS code...and that we have included this code in other situations...we explain that Rosanne told us to use T1207 as the code for counselling a family about adoption, but the children are not present for this visit...that was a request from Dr. Hsi...but Rosanne flatly denies that...Cassandra used a code that may be OK to use...but Cassandra E-mailed Rosanne about this situation...but Cassandra is wrong, because Rosanne can't be!...at the end of the day, we received an E-mail from Susan Cordova [Data Entry SUP], mailed to Jackie, Rosanne, Cassandra & myself...this claims that we are sending I/P & O/P charges on the same batch ticket...this compalint came from the PEDS Data Entry people, which includes Hope...I give up!...I E-mailed Rosanne my comment, knowing that it will fall upon deaf ears & blind eyes...4/18/03: Surprise!...the in & out batch is brought to us...Hope entered the incorrect place of service...all the charges were O/P; Hope keyed in I/P...this will be addressed on 4/21/03 (Monday)...just before this, the Easter Bunny (aka Rosanne) came by with bags of chocolates for us to choose...sorry, bribes don't change the way we feel about her!...at coding classes held @TVI, all the UPA managers are raked across the coals for their unprofessional leadership qualities...my next attempt ("hope"fully) for keeping calm will be the "OK" response when someone says I did something...why mince words?...

...work is a little hard to find in our area...but there are piles of untouched billing sheets in the Clinic...Cassandra E-mailed Rosanne if we could use them for audits, or make any necessary corrections...this could also save Data Entry time and eliminate unnecssary routing...even if there were fewer people going to the clinic, there should be enough to give us on a regular basis...we would even pick them up and bring it back to our area...but there was silence for the entire day...the E-mails had been opened but no response from Rosanne...so Cassandra coded E/R claims (which I may do tomorrow)...I had enough work today...GPU doubled in size, and PSAC was relatively full...yet, on 4/21/03: Rosanne wanted me to call her to inform me that people could not read the grey forms I submiited to them...I changed the color of the paper so I could prove that I did the work, and not Data Entry, who makes lots of copies of our batch ticket and staples it to the charges we do not review...this was an important item that I had to call Rosanne when I got back to my desk...sigh!...

...on top of all this, Rosanne was not returning calls, answering E-mails or seeing anyone...she emerged for a short time from her cocoon @noon, then returned to her shell after being asked the cost of training books for advanced Coding courses...and the scheduled 1:30 meeting with surgery?...only Cassandra & myself showed up...even the surgeons did not appear!....there was no E-mail or phone call or anyone stopping by our area to explain why it was cancelled...this is the land where managers have the "because I said so!" attitude...there is also no love lost between Pat (our big boss & Rosanne)...then there was Hope...she called Cassandra and asked if I was there because she had to ask me something...she came, she asked & I asked her why she didn't call me directly...she didn't know what to say & left quickly...that was a moment to remember!...

...contrary to popular belief, our PCs' at work do not have sound cards!...at work, we are not told how to improve our work...we just have to reach goals that we create prior to knowing what the new year will present in terms of new projects or sweeping business changes...if something starts during the year, and we complete that task earlier or better than expected, it does not matter because that wasn't one of our goals!...so why try doing your best on anything except your stated goals!...and everything is based on your boss' opinion!...plus, raises are across the board, and based on the budget, not by standards or quality...found out that Rosie has a desk in Medicine (at the hospital) plus an office at 1650 Univ...we also have some of the oldest PCs', which have been pieced together...plus Rosanne has basically called Cassandra a liar regarding the temporary CPT code...add it all up, and all this resulted in an AM b*tch session for Cassandra & Mike...

...4/24/03: the debate resurfaced on how to code conscious sedation...it can only be coded when listed with another procedure that is not a visit...it is known as a bundled procedure, which means that the dollar value determined for a value for a visit takes into consideration that this may be performed when examining a patient...alone it has no value or RVUs (relative value units)...Dr. Crowley said Dr. Katz wanted to know how much Medicaid paid for the procedure...the answer is $0...but in a previous meeting, Dr. Katz was aware of this fact...tensions started rising...then Becky, Dr. Katz Admin. Assist., came in with a different concern...she is also a former coder, and explained to Dr. Crowley how & when a doctor can be paid for renedering a conscious sedation...Dr. Fahl stopped by, and also agreed with our statements...this is mainly done by nurses, who are paid either by teh clinic or the hospital...Becky copied pages from the CPT book and gave them to Dr. Katz & Rosanne...if there was any problem, we were to contact Becky...and Dr. Crowley walked off...we thanked Becky for her assistance...we heard sad news...Dr. Coleman's husband passed away...she will be on leave until summer, taking care of her 2 daughters...

...it ain't over!...E-mails went back & forth between Rosanne & Cassandra about the missed meeting on 4/23/03...she asked who was there; Cassandra said just the two of us, no surgeons...Rosanne said John had called the meeting...4/24/03: at 11:10 we were told by Rosanne that there was a training session that had started 10 minutes ago...so we went, late, and had a teleconference class...this lasted until 12:30...at that point we were both starved...at 11:40, Jolin came in & told us that the 11:45 meeting had been cancelled...but @11:10, Rosanne told Cassandra that the 11:45 meeting was still on!...then, Rosanne called Cassandra in the PM & apologized for the confusion...but no call to me...oh, I'm sure the excuse is that telling one person was telling both, that the message should be conveyed from one person to another...

"It's a manager thing!"

...now, Data Entry has no work...neither do we, in terms of PEDS Coding...and we all know there is a pile of charges in the Clinic...we received 5 from them on 4/24/03...

...still not the end...Rosanne was still not talking to anyone...more & more of her staff were frustrated with this imposed silence...so, 2 of her employees contacted the compliance manager because there were issued that needed to be addressed about the possibility of fraud being committed...these concerns were in turn relayed to Pat, our big boss...

"It's a blonde thing!"

...almost there!...4/24/03: there is an E-mail sent by Rosanne when we arrive at work...there will be a mandatory meeting @11 on 4/25/03...the topic will be the APC system, another method of determining which CPT codes to use...and, there would be an E-mail from Pat (big boss)...there was, stating the location, and the fact that our attorney would be presents...questions & concerns would be entertained...it was sent to the coders, with CCs' to the managers...but Rosanne's entire name was in small letters...now, remember, Pat & Rosanne do not get along...and, the really big boss, John Razeem, will also be at this meeting...4/25/03: at 10:00 I received a call from Rosanne asking if I was going to attend the meeting, since I had requested leave starting @11 AM...I told her I had planned on being there...4/25/03: not all Coders had to attend...the meeting is on the Point of Service program, which was started in 2000...now, the Coders will have more interaction with the physicians, working with them to acheive a 1-day turnaround time for O/P services...this includes sending the charges to Data Entry, which was not present at this meeting...other people [aka Compliance] will do the audits (written dx...part of this project will start 5/6/03...Geri cannot grasp the concept...all the doctors will have to learn how to level his/her services...both the doctors & the staff will be trained (by, John; good grief!)...Coders will become "coaches"...I can hardly wait...and, remember, if you have any problems, just turn them over to the Compliance area (Ha!ha!ha!)...both Data Entry & the Clinic staff will need more training in what to look for on a billing sheet...

...4/25/03: I told you so!...on 4/24/03, I received a request for forms from NICU...I brought them a large amount, and ordered more...4/25/03: one of their staff told me that these were outdated forms...we did not have, and never did have, the more recent revision...so I wrote again to Shane, explaining that we needed lots of this form and in a hurry...I have to CC a copy to Rosanne...who called me within second after I sent the E-mail...she asked me what did I want now, then paused, and completed reading the E-mail...

...4/28/03: due to Compliance changes, Cassandra is not sure to persue a PEDS certificate...she E-mailed Rosanne, saying that she may not continue her education, explained the reason, and all Rosanne replied was OK!...Cassandra thinks she will be transferred to E/R...Rosanne says that Coders will be placed where they are needed...

...4/30/03: the work day has come & gone...John was upset that I did not know what the topics for discussion were, or where the meeting was being held...he called the meeting & was asking these questions 20 minutes before the start of this class...while waiting for him, we were talking about various subjects, of which he was one...John appeared down the corridor and said I shouldn't stop talking about him because he arrived...I told him I had no intentions of doing so [stopping]...he said I bet you don't...someone had shoved a railroad tie up his butt!...and, as usual, John was not 100% prepared for this review session with the 2 doctors who attended (Dr. Hsi & Dr. Behnken)...and Cassandra & I came prepared with coding manuals...on to the second one...John called this meeting, but had a prior mandatory committment...so he gave us the information to distribute to the doctors...Rosanne, Cassandra & myself sat waiting for 20 minutes...then we left the conference room, after having asked someone to move their work to another location...Rosanne E-mailed the person who called this meeting...the excuse was that no one knew we had arrived...not so! said I...the person looked at Cassandra & I as we were leaving the Surgery area, and she knows who we are!...5/1/03: I was indirectly blamed for not questioning her about the meeting...Rosanne E-mailed her saying it was not our responsibility since we did not call the meeting...

...5/16/03: during these past weeks, Cassandra & I have done audits & analyses of billing charges from Hem/Onc...the doctors code correctly, and Casssandra completes our part of a flowchart explaining if a charge has been entered &/or paid...we showed Dr. Heideman a list of entries that were put on the system 1 month after the services were rendered, and shortly after we began the intensive investigation on Hem/Onc charges...today we were informed that Dr. Heideman spoke to Pat, and still blames us for holding charges!...a meeting will be held with Dr. Katz, Dr. Heideman, Pat, Rosanne (also on the chopping block), John Razeem & us (so far)...no one talks about Data Entry ot the Clinic itself...we may have to code all of Hem/Onc's services, I/P & O/P...we started our search for unpaid services, and found that they belonged to Dr. McKinnell...he has always been the last doctor to submit his charges...many of them have been received beyond the cutoff date...and Cassandra & I have evidence to prove this!...time will tell...this is absolutely frustrating...I would like to know how & why we have held these charges...nobody is helping us or supporting us!...we are also told not to talk with Dr. Heideman, just E-mail any questions or concerns...Mike & Cassandra are on trial again, as the executioner stands on the sidelines & smiles...we will probably have to produce more reports, results, statistics & audits to prove something that no one believes at this time...that we are not holding any billing sheets for long periods of time...we hardly see anything from the Clinic...Doris' desk has a mountain range of services ready to be coded & entered...

...5/19/03: 2:30 meeting in E/R conference room...just Rosanne, Pat, Cassandra & myself...many people helped us retrieve files in Medical Records, we started entering this data prior, and will continue doing so on 5/20/03...we go over statistics & reports, explaining what was missing & ways to improve the billing process. focus was also placed on Jackie (Data Entry) & Doris (the Clinic)...we should complete all charts by a 1:00 meeting on 5/21/03...