Medicaid Billing Case Study
In the workplace, it is important to know how professional values and personal values interact when confronted with ethical issues. Some people confront the ethical issues directly while others struggle. Nevertheless, a few years ago I was working with a Medicaid billing program providing case management service which included coordinating services based on a psychosocial model to meet the needs of individuals and families. Moreover, along with those duties I was responsible for billing Medicaid three hundred minutes a day or 25 hours per week. The overall quota for the department was to bill $55,000 monthly. I would often struggle to complete my documentation and weekly billing because the amount of time allotted was not realistic. The staff
was required to bill five hours a day and two hours to complete required documentations, which was quite extensive. I wanted to be fair to the clients by accurately capturing their story, therefore, I did not rush when completing documentation. Consequently, during my weekly supervision late documentation and low billing was a reoccurring topic on the agenda. My supervisor came up with different strategies to help me improve in the areas I was deficient. However, her suggestions were against my personal values. For example, she wanted me to take work home and alluded to billing for services that I did not provide. I am a person that values integrity, therefore that strategy contradicted my beliefs. For me, the quality of service was more important than meeting the required billing requirements. I knew if I confirmed I would breach my personal values and that may harm my reputation and status with the organization. In addition, I would be put in a position to cheat clients who are already at a disadvantage because of their socioeconomic status.
I was written up a few times for the aforementioned which was also reflected in my evaluations. Each time I received a write-up I rebutted the memo. I eventually requested a meeting with the program director to express my complaint about the memos I received and my beliefs about providing quality service to the clients. I did not receive much support from the director as she appeared indifferent to my complaint. However, she did reiterated the billing requirement for individuals and the department. Her comment solidified that the agency’s value superseded mine and there is no middle ground.
Thereafter, I noticed the supervisor’s behavior was punitive towards and she started treating me differently. For example, when she wanted to get my attention she addressed me by my last name instead of my first name which is how we all address each other, in the office. She communicated with me in writing; denied vacation request. Eventually, her behavior towards me soften after an independent auditor evaluated the program and my work was recognized for best practice.
was required to bill five hours a day and two hours to complete required documentations, which was quite extensive. I wanted to be fair to the clients by accurately capturing their story, therefore, I did not rush when completing documentation. Consequently, during my weekly supervision late documentation and low billing was a reoccurring topic on the agenda. My supervisor came up with different strategies to help me improve in the areas I was deficient. However, her suggestions were against my personal values. For example, she wanted me to take work home and alluded to billing for services that I did not provide. I am a person that values integrity, therefore that strategy contradicted my beliefs. For me, the quality of service was more important than meeting the required billing requirements. I knew if I confirmed I would breach my personal values and that may harm my reputation and status with the organization. In addition, I would be put in a position to cheat clients who are already at a disadvantage because of their socioeconomic status.
I was written up a few times for the aforementioned which was also reflected in my evaluations. Each time I received a write-up I rebutted the memo. I eventually requested a meeting with the program director to express my complaint about the memos I received and my beliefs about providing quality service to the clients. I did not receive much support from the director as she appeared indifferent to my complaint. However, she did reiterated the billing requirement for individuals and the department. Her comment solidified that the agency’s value superseded mine and there is no middle ground.
Thereafter, I noticed the supervisor’s behavior was punitive towards and she started treating me differently. For example, when she wanted to get my attention she addressed me by my last name instead of my first name which is how we all address each other, in the office. She communicated with me in writing; denied vacation request. Eventually, her behavior towards me soften after an independent auditor evaluated the program and my work was recognized for best practice.