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Committing Insurance Fraud as a Scribe...

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hello1234!

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I would only mention positive things about the scribing experience at interviews ..

... and as an undergrad, u are not really able to accurately judge what is going on in a clinical situation, but it’s good u left a situation where u felt uncomfortable
 
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854555

This is a very difficult scenario to process. Mentioning something like this can come off in various ways and it kind of depends on how a screener or interviewer takes it. Some might take it in a good way in terms of you displaying integrity and not wanting to do the wrong thing. Some others might take it in a bad way. However, it's very common for applicants to not put something in the application and mention it in the interview... so what you could do is just bring it up organically during interviews and make your points about it more solidly and gauge the interviewer's response and tone to clarify further.

Aside from all this is the whole heavily debated shabang about whether or not exaggerating patient charts for insurance reimbursements is actually unethical. Some argue that this is to counteract unfair and unethical practices of insurance companies so technically it balances out (their words not mine). I personally still think it's not ok because it is dishonest.
 
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Robin-jay

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    I don't know if I'd bring up anything negative in an interview.
     
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    Shedding light on the positive is almost always better than highlighting negative. In interviews, I’m sure you can talk about positive and ethical interactions you observed. 300 hours is sufficient. This isn’t a job interview; they typically don’t ask why you left. List it on you AMCAS and talk about the good. If asked in an interview, I’m sure you can tactfully address how you saw the increasing burden of paperwork and documentation.

    In my experience from the interviews I have done, interviewers and adcoms have wind of this and sometimes they try to 'squeeze' it out of you in a sense. Each experience has it's difficult and annoying moments. Identifying and addressing them shows maturity. Some applicants try to be completely positive and pretend that nothing went wrong, and that may not necessarily turn out in their favor.

    Then again, I agree with you as far as using social filters and not bringing up inappropriate downsides and addressing downsides professionally. But I don't think OP's example is necessarily lethal to bring up in an interview.... especially since it is a common occurrence to exaggerate patient charts.
     
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    Doc_Ock

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    a) you did the right thing
    b) list it in your experiences
    c) if asked about time you had to make a difficult decision or something like that in an interview, use this.
     
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    PeleHonuaMea

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    - I would still list it in your ECs.
    - I'm assuming the "challenge" essays include: "what did you do about it?" Or "how did you overcome it?".
    - As for the ERs billing practices, most insurances have Utilization Review departments. They comb through the patients entire chart to make sure they're not being overcharged. If so, they will deny the claim for payment.
    - I dont know the entire story, but if it's really that disturbing, the facility should have a hotline posted somewhere for employees (including ex-employees) to call anonymously to file a report. I cant imagine this organization as a whole would endorse such risky behavior. Hopefully it's only a departmental issue?
     
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    Robin-jay

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    We also use only paper charts, which is just weird considering how much money the ER has and how much more efficient computerized systems are.

    This ER is top-notch. They have two massage therapist on the clock at all times so that patients can get a massage before they are seen.

    Weird.
     

    Lucid_Dream

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    Places that paperchart are often corrupt. I used to work at an LTAC, and we only had papercharts. They told us "Were low on blue pads and diapers, so tell your patients to quit going through so many. Once we're out, we're out". Right. Because incontinent patients and vegetative patients can help it...

    We often ran out of pretty much any supplies, and the administration was very corrupt. We took many patients far too sick to be at an LTAC, and some people that had nothing wrong at all.

    Also some nurses didn't give all of the medications and just crossed them off the MAR, and this particular place, you had 7 patients, and were required to chart narratives, with no by exception charting. You wrote at least a page and a half on each patient per shift. All of the patients had numerous wounds (and wound vacs that would come off with incontinent episodes), and many antibiotics due, and you had to draw all of your own blood via PICC or butterfly needle. There was simply not enough time in the day. Those of us who were sticklers about doing everything right would arrive at 6:30 and never leave before 8:30. They would run you off for "incidental overtime". At my new facility I'm never here past 7:10, and if we must stay late they give us no trouble. And we chart on Iphones and its by exception and it takes almost no time.
     
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    Robin-jay

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    Places that paperchart are often corrupt. I used to work at an LTAC, and we only had papercharts. They told us "Were low on blue pads and diapers, so tell your patients to quit going through so many. Once we're out, we're out". Right. Because incontinent patients and vegetative patients can help it...

    We often ran out of pretty much any supplies, and the administration was very corrupt. We took many patients far too sick to be at an LTAC, and some people that had nothing wrong at all.

    Also some nurses didn't give all of the medications and just crossed them off the MAR, and this particular place, you had 7 patients, and were required to chart narratives, with no by exception charting. You wrote at least a page and a half on each patient per shift. All of the patients had numerous wounds (and wound vacs that would come off with incontinent episodes), and many antibiotics due, and you had to draw all of your own blood via PICC or butterfly needle. There was simply not enough time in the day. Those of us who were sticklers about doing everything right would arrive at 6:30 and never leave before 8:30. They would run you off for "incidental overtime". At my new facility I'm never here past 7:10, and if we must stay late they give us no trouble. And we chart on Iphones and its by exception and it takes almost no time.

    My advice is always to work in a clinic/hospital for a solid 6-12 months and then work retail until you get accepted to medical school. Entry level clinic/hospital jobs are almost never worth the trouble passed showing ADCOMs you worked there for a decent amount of time. I would encourage volunteering any day. However, scribe jobs, etc. are now run by some corrupt entities.
     
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    Lucid_Dream

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    My advice is always to work in a clinic/hospital for a solid 6-12 months and then work retail until you get accepted to medical school. Entry level clinic/hospital jobs are almost never worth the trouble passed showing ADCOMs you worked there for a decent amount of time. I would encourage volunteering any day. However, scribe jobs, etc. are now run by some corrupt entities.
    Never worked retail, don't plan to. But I am a glorified wait staff. RN= Refreshments and Narcotics
     

    freedoctor17

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    I don't know if I'd bring up anything negative in an interview.
    My interviewer at the school I'm currently accepted at had a bunch of "negative" stuff we talked about. Talked about a mistake I made and what I learned from it and one of the challenges I had faced and what I would have done differently now. I think it's fine to talk about negative things as long as you can clearly show you learned something or you can reflect on it honestly.
     

    cj_cregg

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    Yeah, I would include this on your application but truly steer clear of saying anything negative about it in essays or your interview. Saying something negative about other healthcare providers/facilities in an interview tends to reallllly rub people the wrong way, even when it's justified.

    To do this, obviously, you'll need to have some thoughts in mind about what you can say without wading into issues of borderline incriminating yourself lol. Things you should be able to discuss about the experience (with a positive spin) are:
    - A few things you learned from it (maybe you saw a doctor educate a patient about something, saw a doctor handle a difficult patient/family member well, etc.)
    - An ethical issue you saw - a normal one lol, not an insurance fraud (a patient who needed a translator but there wasn't one available? a minor who wanted care without a parents' consent? a patient who didn't want to consent to the type of care they needed?)
    - A challenge you faced (getting accustomed to the quick pace? interacting with patients, nurses, or doctors? etc.)

    My interviewer at the school I'm currently accepted at had a bunch of "negative" stuff we talked about. Talked about a mistake I made and what I learned from it and one of the challenges I had faced and what I would have done differently now. I think it's fine to talk about negative things as long as you can clearly show you learned something or you can reflect on it honestly.
    I think there's a big difference between being asked about a mistake/weakness/challenge and responding, and saying something negative about a professional colleague or healthcare facility. The first is fine and expected, the second is concerning. Currently doing residency interviews and we were told by our advisors over and over again not to say anything bad about classmates, residents/attendings, other programs, etc. Aside from it just being a bad look, medicine is a small world and OP's interviewers might know someone at that hospital. And specifically for OP, I don't see it this way but for a grouchy adcom it's not a far jump to "this kid was involved in insurance fraud and didn't report it"
     
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    healingandsuch

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    I was thinking that the tip should be submitted to the major insurance carriers in the area. Let them look into it. Too bad they don't take gov't insurance... there are some very generous rewards for tips that root out fraud against the government.
    That's what I thought as well. OP would've collected a major reward!
     
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    Robin-jay

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    My interviewer at the school I'm currently accepted at had a bunch of "negative" stuff we talked about. Talked about a mistake I made and what I learned from it and one of the challenges I had faced and what I would have done differently now. I think it's fine to talk about negative things as long as you can clearly show you learned something or you can reflect on it honestly.

    I've had my fair share of interviews. I always felt the vibe much better when the conversation was more laid back and focused on either positive things, or optimistic things. Negative and pessimistic conversations only go so far. However, of course there are tons and tons of factors besides this regarding interview topics.

    But if you told me I had to choose between discussing a positive/optimistic (realistic optimism) conversation vs a negative/pessimistic conversation, I would have to go with the former positive/optimistic topic any day.
     
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    allantois

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    I had a somewhat similar experience being a scribe; I quit it as soon as I realized the shadiness of the practice but in interviews I only discussed the medical aspects of the job..
     
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    Doc_Ock

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    I had a somewhat similar experience being a scribe; I quit it as soon as I realized the shadiness of the practice but in interviews I only discussed the medical aspects of the job..

    Same.


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    Ribonucleic Acid

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    I was thinking that the tip should be submitted to the major insurance carriers in the area. Let them look into it. Too bad they don't take gov't insurance... there are some very generous rewards for tips that root out fraud against the government.

    I didn’t win the billion-dollar Powerball. I could really use the money right about now.


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    Doc_Ock

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    Hey guys, thanks for the responses. I just had my exit interview with one of the doctors who is also a partial owner of the ER. Basically, our conversation turned into a debate on whether what they are doing is insurance fraud. I brought up many of the points I mentioned in my original post and talked about how many of the providers said it was insurance fraud. He was justifying it by saying that insurance companies are screwing over patients with high premiums and all he is doing is fighting back. I told him that whether he is benefitting the patient or not, which he is by saving them money and providing extensive treatment, it is still stealing. One argument I made, while I was still attempting to get him to admit it was insurance fraud, was that the private ER nearby is doing so poorly. He said that it was because they are charting wrong and so patients don’t want to come back because they are getting charged so much.

    Anyways, I thought that was interesting. My friend, who also quit at the same time I did, was in the interview with me. In total, it was about an hour long. I suspect that normal exit interviews are not done by the owner of the company and they usually don’t take an hour long.

    In the end, he said to call him any time and feel free to come back. Honestly, he was legit trying to justify and cover up everything the whole time and mitigate the situation. I really wasn’t having his BS.


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    Start calling the major insurance companies. BCBS, Aetna, etc. Hell i'm sure there's an investigative journalist there who would take this story.
     
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