Case Study

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The page below is a sample from the LabCE course Medicare Compliance for Healthcare Personnel. Access the complete course and earn ASCLS P.A.C.E.-approved continuing education credits by subscribing online.

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Case Study

A billing clerk and a medical laboratory professional are having lunch together in the hospital cafeteria. The billing clerk mentions that she saw a bill go through the system for a biopsy performed on one of her coworkers. The billing clerk asks the laboratory worker to please check the pathology report and let her know the result because she is concerned about the welfare of the coworker. How should the laboratory professional respond?
Correct Answer: Refuse to look up the result of the biopsy for the clerk and remind the clerk that it is a violation of compliance policies to do so, or to ask another person to do so.
Discussion: The laboratory professional has a responsibility to report violations of compliance policies, and the friend has put her in a difficult position. For that reason, it is not enough to just refuse the clerk's request. If the laboratory professional does not inform the billing clerk about the compliance policy, there is a possibility that the clerk would ask another employee to check the biopsy result.