Why Can’t I Just Be A Doctor?

When it comes to coding, compliance, and documentation, I often hear the following statements:

“How am I supposed to know all this?”

“How am I expected to keep up with all this?”

“Why can’t I just be a doctor?”

There are many requirements we have to fulfill, many skills we need to possess, and much knowledge we need to gain in order to function as a doctor. After becoming a doctor, if we want to practice in the United States, and we sign an agreement to collect payment from a patient’s third-party payer, we are obligated to abide by the terms of the agreement that we signed. Too many providers sign those agreements without even reading them and/or having them reviewed by an attorney. Furthermore, too many providers sign those agreements without attempting to negotiate the terms of the agreement.

If a provider signs an agreement with a third-party payer that states the provider is responsible for knowing and following that payer’s rules regarding coding, compliance, and documentation, then it is the provider’s responsibility to know and follow all of that payer’s rules regarding coding, compliance, and documentation. Signing the agreement and then stating that you want to provide the care and want to be paid, but do not want to have to keep up with and follow the guidelines that govern the provision of care and receipt of payment does not align.

If you need assistance with this system, help is available. For example, the American Podiatric Medical Association provides a robust library of resources regarding coding, compliance, and documentation to its members. Providers may also choose to outsource this responsibility to professional coders, professional billers, and/or professional compliance officers. There are providers whose entire responsibility is to provide the care and create the documentation, then the progress note is sent somewhere else where other professionals handle the coding and check if the documentation has all the components required by a third-party payer. Some providers find this system allows them to serve their patients more efficiently, and in some cases, even see more patients. If, instead, you prefer to handle these duties yourself, you have to learn and follow the rules. That’s the game. That’s what we signed up for.

Dr. Lehrman operates Lehrman Consulting, LLC and is a Certified Professional Coder and Certified Professional Medical Auditor. Follow him on Twitter @DrLehrman