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The Sarbanes Oxley Act :: View topic - Medical Collections
Posted: Fri Oct 22, 2010 7:10 am Post subject: Medical Collections
HI
We have three departments billing, posting and collections. The billing manager continues to insist for collection to make changes to the incorrect billed claims and rebill the claims. I don't have a problem rebilling the claim, but I'm not sure if a collector should be making any correction to a claim.
Is a collector allowed to make changes to a billing claim ?
Some companies are so small that breaking out these functions is impractical, and in those cases there may not be the kind of segregation of duties that you would like. When that's the case they must rely on sample spot checks by management, or entity level controls like the reconciliations and variance analysis to help ensure no inappropriate shenanigans.
In your case, it seems like you already have these functions properly segregated, so I don't see why a collector would ever have to re-bill. If a billing adjustment needs to be made and you are fortunate enough to have separate departments, seems like the collector would send an adjustment request to the billing department for them to process and send it out.
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