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Mr. Sullivan was discharged from the acute care unit and admitted to the hospital skilled nursing unit on June 29 for rehabilitation after his hospitalization.
Mr. Sullivan was discharged from the acute care unit and admitted to the hospital skilled nursing unit on June 29 for rehabilitation after his hospitalization. The charges on the account for Mr. Sullivan's admission were over $400,000. Coders at Springfield General have always been under a great deal of pressure to keep the inpatient unbilled accounts under $750,000. Prior to Mr. Sullivan's discharge, the unbilled accounts report was at $925,000, and when he was discharged, the amount grew to over a million dollars. The following morning, the coding supervisor, Carma Davis, was called to meet with Fernando Sanchez, the Chief Financial Officer of Springfield General. He told her that he expected the Sullivan account to be coded and billed before the end of the day because this was a critical financial time for the organization. She assured him that she would personally take care of it. Carma was well aware of the hospital's financial situation. Weekly analysis of the organization's accounts receivable had recently been replaced with daily analysis and midday reporting of coding productivity. Rumors of layoffs were spreading like wildfire. Carma, being in a lower management position, was in constant fear of her position being eliminated. Carma felt the need to not only get the account coded, but she also felt she needed to prove her abilities and worth to the organization to Mr. Sanchez. She tracked down the chart immediately after her meeting with Mr. Sanchez and planned to get the chart coded
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