Ammed Direct Upper Mangement turned deaf ear to Medicare/Medicaid Fraud Antioch, Tennessee

28th of Oct, 2011 by User806039

I was hired to increase cash flow and reorganize the billing and EDI department at AmMed Direct. After a few months of auditing accounts I realized there was over $9 million in uncollectable accounts due to incorrect billing, incorrect postings,lack of patient information and general lack of knowledge of the staff. Medicare was contacting the company on a weekly basis trying to collect the refunds due them. They indicated there was no cooperation with upper management, especially Reggie King. The unpaid refunds amounted to over $5 million. The audit showed patients being billed for items they did not order, discounts patient were not responsible for, refunds not credited to accounts, deceased patients, patients that medical diagnosis didn't require the billed items,etc. When confronting Reggie King and Tom Milam with the audited accounts receivable they said it was impossible to repay Medicare at the time and not to discuss the problems with the staff. The company was having cash flow problems and trying to enter into competive bidding.
After several meetings with the President and Vice President I was asked to leave the company and no reason was given. Had I been more prepared I would have kept critical information and turned it over to the OAG..... word of warning...Don't shoot the messanger.
The companies hiring policies were to hire members of families, many had no prior healthcare experience. There was no formal training given on the rules and regulations of Medicare or Medicaid.Many of the more competent employees have voiced their concerns on the state of affairs at AmMed Direct but it has fallen on deaf ears. Due to the economy and lack of jobs employees are treading water until the shoe drops.

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