• Report: #822817

Complaint Review: Central Ohio Primary Care

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  • Submitted: Sat, January 14, 2012
  • Updated: Mon, January 16, 2012

  • Reported By: Anonymous — Columbus Ohio United States of America
Central Ohio Primary Care
570 Polaris Parkway Suite 250 Westerville, Ohio United States of America

Central Ohio Primary Care AKA COPC Medicare Code Fraud Westerville, Ohio

*UPDATE Employee: Medicare Fraud Allegations Against Central Ohio Primary Care

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Central Ohio Primary Care billing located in Cincinnati Ohio changes Medicare and/or medical codes to read "routine" knowing in advance that Medicare will refuse payment based upon the code or designation "routine".  Central Ohio Primary Care and/or the billing office thus can charge and collect anything they wish while by-passing Medicare assignment.

I visited my doctor and five months later learned I had a very large unpaid bill.  The unpaid bill represented laboratory work done by a Central Ohio Primary Care facility.  The work was all coded as routine and Medicare refused to pay any part of a bill marked "routine".  The Dr. said he corrected the coding, but the billing office refused to accept the corrections.




This report was posted on Ripoff Report on 01/14/2012 01:45 PM and is a permanent record located here: http://www.ripoffreport.com/r/Central-Ohio-Primary-Care/Westerville-Ohio-43082/Central-Ohio-Primary-Care-AKA-COPC-Medicare-Code-Fraud-Westerville-Ohio-822817. The posting time indicated is Arizona local time. Arizona does not observe daylight savings so the post time may be Mountain or Pacific depending on the time of year.

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REBUTTALS & REPLIES:
0Author 1Consumer 0Employee/Owner
Updates & Rebuttals

#1 UPDATE Employee

Medicare Fraud Allegations Against Central Ohio Primary Care

AUTHOR: Director of Coding and Compliance - (United States of America)

Central Ohio Primary Care Physicians, Inc., takes very seriously the allegations made regarding potential Medicare fraud.  We do not "by-pass Medicare assignment" guidelines by billing patients for diagnostic tests at full price. 

When a Medicare patient has diagnostic testing performed at COPC and the diagnoses submitted to Medicare do not qualify for "medical necessity" we are required to have the patient sign a form, an ABN (Advanced Beneficiary Notice) - without this form signed prior to the service, by the patient, the patient cannot be held responsible.

Also - we cannot change coding that is already present within a physician's progress note - so if the physician has not documented chronic illnesses to cover the diagnostic testing - we cannot change the coding just to have it paid by Medicare.

Patients do  need to be aware that a complete "head-to-toe physical exam" is never covered by Medicare and will always be patient responsibility.  It is important to know what service you are expecting to have the physician perform when you schedule your appointment.

I would ask the person that made this allegation to call the Compliance Department at 614-326-2672.
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