How much will each stakeholder be affected by your decision? Low Med High You, Clinical Charge Auditor, RN You have to decide what to do about the seemingly deliberate miscoding of a patient’s treatment. Low Med High Quinten Stark, Medical Billing Specialist He has been trained and certified in coding accurately but has knowingly submitted incorrect bills. Low Med High Marisa Bathory, the patient receiving treatment She needs treatment for Borderline Personality Disorder, which her insurance company does not cover. She can’t afford to pay for the therapy herself. Low Med High Dr. Camilla Barrow, the physician providing the service She originally asked the Medical Billing Specialist to find a way to have the treatment paid for by the insurance company. Low Med High Eva Walker, Vice President of Patient Safety and Risk Management She is your immediate supervisor and recently hired you based on your expertise and experience with billing, nursing procedures, and charging practices. Low Med High Marisa Bathory’s insurance company The insurance company is currently paying for therapy they do not normally cover because the treatment has been miscoded.
