Run Form "leading"

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Justice

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I would like to start off by saying this question is very serious and currently what I do with it could result in termination from my employer.

I have been working for as an EMT-B for the past few years after leaving the Army as a combat medic. Recently my company has started some new Run form policies and procedures that have made me very uncomfortable.

My company has started 'Kicking back" run forms. Now I hold a bachelors in Businees management so I understand better then most in EMS the necissity for a company to obtain payment but this is going beyond that.
If Medicare fails to pay for a transport my company will Kick back the run form and have the employee rewrite it or add more information. Sometimes with a supervisor standing over you instructing you on what to write. I pride myself on excellent documentation and even with that medicare will not pay for some transports so we are forced to rewriet these run forms.

I assumed this was simply to increase the billing rate by better documentation but a few weeks ago I was asked to copy a narrative from another run form where this patient had been transported by "us" as they are a semi weekly patient. All of this information was provided by a supervisor and none of it is in my own words or even how the transport happend to my recolection. I have so far refused to write this form and am currently expecting termination.

am I being unresonable or is this an illegal act of medicare fraud.

Sorry for misspellings I do not wish to download the spellchecker from this site.

Thanks for any help
 
Are they wanting you to copy the previous report word for word, or use it as a template to write yours?

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medicare fraud is wrong, and illegal.

many private IFT companies rely on medicare reimbursements to survive, and as such rely on creative practices to ensure they get paid.

you are not being unreasonable.

you can stand on principle and lose your job, or do what your employer is asking you to do to ensure payment for services rendered.

personally, I would look for a new job out of private IFT, but with the way the job market is lately, there are probably 10 applicants for every position.
 
My supervisors words were "I dont expect you to remember the patients vitals but you can use this run form to rewrite your's for billing".

I dont understand how the entire run form was lost in the first place and I believe they need a new run form because medicare caught on to them resubmitting run forms with the same incident numbers.

As for a job I am currently going back to school under my GI bill to become a PA so I dont need the job that bad but mostly i hold my loyalty to my country and couldnt live with the idea of defrauding it
 
Sounds like a call to the state EMS office and Medicare might be in order at the cessation of your employment with them.

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ffemt8978 said:
Sounds like a call to the state EMS office and Medicare might be in order at the cessation of your employment with them.

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I have been feeling that was the case but having less then 5 years experience in civilian EMS I was just looking for some advice from some people with a better idea of what it a company trying to fight a tough system and down right fraud.

I apperciate both of your advice and anyone else with anything further
 
I agree, most states have a fraud hotline you can call to make a report.

Also, your comment about downloading spell check makes no sense.
 
I'm borrowing someones laptop while mine is getting some programs installed for school so I dont want to download anything as this isnt my computer
 
You believe what they are doing is illegal... probably is if forms are being "lost" and changed for billing purposes. Can you prove it? Do you want to? Cost versus benifit.

Personally, I am too morally and ethically centered to not fight. Back off or go in guns blazing? I always fight if i believe the battle is just, regardless of if I can win. That has gotten me in trouble from time to time. So the question is, again, do you want to fight that fight? And to what level? Passive resistance? Legal action? Go to the EMSA? Comply?

One of the reasons my paperwork nowadays gets copied, scanned, and stored in my personal database. I have been called on the carpet months afterward, and paperwork protects me assuming I did it correct the first time. No one touches my paperwork or alters it.
 
Mountain Res-Q said:
You believe what they are doing is illegal... probably is if forms are being "lost" and changed for billing purposes. Can you prove it? Do you want to? Cost versus benifit.

Personally, I am too morally and ethically centered to not fight. Back off or go in guns blazing? I always fight if i believe the battle is just, regardless of if I can win. That has gotten me in trouble from time to time. So the question is, again, do you want to fight that fight? And to what level? Passive resistance? Legal action? Go to the EMSA? Comply?

One of the reasons my paperwork nowadays gets copied, scanned, and stored in my personal database. I have been called on the carpet months afterward, and paperwork protects me assuming I did it correct the first time. No one touches my paperwork or alters it.
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LOL this mentality has gotten me into some trouble while I was in the Army.
Yes I would love to fight it and have thought of contacting some Law Firms and the state but my concern with this is people losing jobs.

I have seen some companies have to pay the government over 80mil and depending on how deep this goes with my company they could go under and people could lose their jobs
 
Sounds like you are at a “Y” and may have to choose between a job and doing what is right. My first question is could you under oath in a court of law stand on your run-sheet if you need too?

Based on what you are posting here, this is a serious accusation of fraud. Whether you were “forced” to participate or not will mean nothing when it hits the fan as the only thing that will matter is that you signed your name to it. Aside from it just simply being wrong, you place your certification(s) on the line, risk or prison time, and possibly fines. Your fear of losing your current EMS job, places you dangerously close to indefinitely losing your ability to practice as an EMS provider anywhere.
 
EFDUnit823 said:
Sounds like you are at a “Y” and may have to choose between a job and doing what is right. My first question is could you under oath in a court of law stand on your run-sheet if you need too?

Based on what you are posting here, this is a serious accusation of fraud. Whether you were “forced” to participate or not will mean nothing when it hits the fan as the only thing that will matter is that you signed your name to it. Aside from it just simply being wrong, you place your certification(s) on the line, risk or prison time, and possibly fines. Your fear of losing your current EMS job, places you dangerously close to indefinitely losing your ability to practice as an EMS provider anywhere.
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This is another fear of mine. i never wrote the run form, I refused but thankfully I am part time and currently out of work due to injury so I have not been forced to confront the situation yet.
 
wrong, Yes. Illegal, depends on how you look at it. By having you rewrite it they are not altering the documentation, you are, and as the clinician you are allowed to. I would not write anything that I could not recall from my own memory. most likely it is a patient who no longer needs routine ambulance care but the company is trying to get every last dollar they can so they need you to justify the reason for transport. with that said, I would do as the supervisors say but make it clear to them (politely) that you wont write anything untrue. document the incident in your own records including what was said, what was done, and if there where any threats made. include the date, incident number, and supervisors present. if you get fired down the road, turn your records over to the ems agency and medicare. if they do tell you to write something that is not true and you inform them so and they still tell you to write it anyway, do as they say and write it. then go home document what happened and call the ems agency and medicare and inform them of the fraud. if you wrote the false report under duress you cannot be held liable for it, just like a confession under duress is not admissible in court.

good luck. again this is just what I would do. we use a third party EPCR software which saves all changes, you must then justify your change and enter your password on every change. the pcr is saved locally on the computer it was written on for one year, a local county server, and two or three remote data servers for life (or so they say), in addition to the printed copy in the patients hospital records and our paper storage... I dont think any PCRs will be getting "lost" any time soon.
 
Justice, you need to leave that company now, and consider alerting the proper authorities. Dominion Ambulance in El Paso just went down for the same thing, and participation makes you a culpable, guilty party. Resign.
 
this is a pretty scary situation and seeing as how I am investing my time in becoming a PA I need to becarefyl because I could lose my rights to obtain a medical license. Even tho an EMT is not a license, Medicare fraud could lead to never being able to obtain a medical license
 
Also I would like to note that I do not recall this trip at all. I recently sustained a concussion and have been out of work for 3 months. This trip happend 4 months ago. The dates and partner add up but the facility we transported too has a fantastic deli I always stop at when I transport there and I dont remember going there in months. At first I wanted to redo the run form because I felt it was my fault but things arent adding up.

I think seeing as how I dont need the job I might resign to save my future
 
socalmedic said:
...Illegal, depends on how you look at it....if they do tell you to write something that is not true and you inform them so and they still tell you to write it anyway, do as they say and write it. then go home document what happened and call the ems agency and medicare and inform them of the fraud. if you wrote the false report under duress you cannot be held liable for it, just like a confession under duress is not admissible in court....
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Social, I respectfully disagree…unless, of course, you are suggesting that the situation be immediately reported at the first available opportunity. Duress as a defense will not hold up in court if personal documentation as evidence for forced manipulation of medical records is presented after charges are filed. There may be a chance slightly greater then a snowball in hell if solid evidence was presented as well as the personal documentation for the Duress defense if done this way. However, any prosecutor will latch onto, “why didn’t you report this earlier?” I am 99.99999% positive, “I didn’t want to jeopardize my employment” will work as a defense.
 
NAME, it needs to be recreated for billing purposes. There is only one call-the call at ADDRESS. The printed pcr is for informational purposes only. Did you speak to any Supervisor regarding the pcr? The CAD notes that I highlighted stated the pt was going in for a high fever and positive chest xray. I realize you probably won't be able to remember vitals, but other than that the pcr can be completed. Do you still have the info?

I took out my name and the address but this is one of the emails I have gotten from my supervisor.
 
Mountain Res-Q said:
You believe what they are doing is illegal... probably is if forms are being "lost" and changed for billing purposes. Can you prove it? Do you want to? Cost versus benifit.

One of the reasons my paperwork nowadays gets copied, scanned, and stored in my personal database. I have been called on the carpet months afterward, and paperwork protects me assuming I did it correct the first time. No one touches my paperwork or alters it.
Click to expand...

You are personally storing protected health information? That is asking for trouble.
 
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