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0-5 years of experience
Supporting billing operations and maintaining exemplary accuracy rates by skillfully coding for over 30 radiology clients including hospitals, groups, and individual physicians.
- Accurately processed coding for over 400 patients per day while also managing and resolving over 350 denials on a daily basis
- Increased reimbursement success rates through highly accurate billing/tracking with an acute focus on completeness, specificity, and appropriateness according to services rendered
- Recovered millions of dollars in lost revenue by reviewing remittance codes from EOBS and Accounts Receivable and correctly processing associated appeals
- Worked closely with internal departments and physicians to resolve billing/coding issues for a wide range of insurance types including Medicare, Medicare HMOs, VA, and commercial insurances
- Successfully identified errors/omissions, corrected issues, and mitigated risks by performed detailed audits on problematic accounts
- Increased accuracy, improved data integrity, and streamlined coding processes by implementing coding best practices
0-5 years of experience
Analyzed and coded 450+ Outpatient/Inpatient procedures performed monthly by 13 OB/GYN Physicians and 1 Urologist using ICD-9, CPT-4 and HCPCS codes
- Pre and post payment reviews of billed charges for Family Practice, Internal Medicine, Pediatrics, OB/Gyn and Urologists
- Assisted in denial process by writing appeals to the Insurance carrier
- Conducted in-house audits and consulted with Senior Management of findings, and determined corrective action needed.
- Trained Physicians and/or support staff on documentation, coding and billing issues
- Completed data entry and compilation of statistical reports on Mysis program
- Assisted in development and training of bubble scanned encounters for each department.
0-5 years of experience
Abstracted/audits and/or assigned appropriate CPT-4 and ICD-9 codes by utilizing the Current Procedural Terminology & International Classified Disease Clinical Modification coding classification for professional serves
- Assigned appropriate modifiers, and follow the Correct Coding Initiative guidelines, as indicated through the Limited Coverage Diagnosis (LCD), as well as the National Correct Coding Initiative (CCI)
- Reviewed TES for coding edits in IDX to provide resolution of TES editing
- Maintained all CEUS for Certification of AAPC (American Academy Procedural Coder)
- Updated and revised all demographics and insurance information into IDX system for accurate billing of charges
- Identified documentation issues in patient records, queried physician for clarification of documentation issues and requested record addendum to complete clarification
6-10 years of experience
Expert in CPT & ICD-9 Coding for accurate and optimum reimbursement
- Effective Collector with knowledge of insurance guidelines, laws & statures for various carriers, including No-Fault and Workers Compensation. Reported revenue of 96% paid claims.
- Authorization Specialist for referring doctors of all specialties to expedite patient’s scanning for various carriers and their network affiliates including the referring MD’S Business Agreement.
- Interviewed new candidates for front office and medical collection, and checked prospective candidates’ references.
- Trained new employees on computer system.
- Prepared Payroll and Banking deposits.
- Assisted the Marketer with leads to new referring doctors and maintaining the relationship and arranging breakfast/lunches for the offices.
0-5 years of experience
Downloaded and organized charts from hospital’s website into Laserfiche before coding.
- Coded and analyzed 230 + accounts in the AS400 for the ER services for different hospitals.
- Verified eligibility for Medicare, Medical, HMO, PPO and government insurances by phone and online.
- Assisted with accounts receivable, returned mail, health insurance claim forms, and patient letters.
- Updated patient demographic and created new accounts in AS400.
0-5 years of experience
Temporary remote E/M chart auditing for Workers Compensation & Mental Health Clients
- Utilized CPT coding books
- Assessed charts to determine documentation is correct for the assigned billing codes
- Obtained prior authorizations and investigated unpaid claims
- Prepared various reports regarding missed coded charts
0-5 years of experience
Provided coding services of emergency department charts for physicians professional
services and facilities on a daily basis; also coded for Urgent Care facility
- Ensured proper medical coding, preparation and accountability of the emergency
- Compiled all components and ensuring that all E/D charts are obtained and fully
- Exceeded productivity expectations of 25 charts per hour on a consistent basis
6-10 years of experience
Accurately compile, code, and enter office charges and post payments to accounts.
- Observed and practiced current coding and billing practices utilizing national trend data including ICD-9, CPT and HCPCS Level II Coding resources.
- Ran monthly reports for claim accuracy, and miscellaneous reports as requested for quality assurance.
- Reconciled daily banking system to provide accurate accounting information. Assisted other departmental employees as needed. Successfully interacted with co-workers, patients and vendors. Multi-task and attention to detail in all areas.
- Acted as technical liaison for all software problems and work with support to resolve the issue in a timely manner to minimize monetary loss.
- Communicated with Misys/Allscripts resources regarding system software/hardware support issues and maintenance.
- Accurately created and maintained seven physicians’ schedules in multiple systems by adhering to established written rules and protocols.
- Developed procedures and protocols for physician schedules.
- Accommodated physician and Practice Manager requests according to rules and protocols.
- Prepared scheduling reports in Excel for physician and manager review as requested.
0-5 years of experience
- Oversaw and trained staff on documentation guidelines and coding principles
- Developed formal audit reports containing findings and recommended solutions
- Abstracted ICD-9 codes and CPT codes for the Department of Medicine
- Created presentations which educate providers on coding for E/M and Procedures
- Educated physicians on documentation guidelines as related to accurate E/M assignments
0-5 years of experience
Provide quarterly review for outpatient and inpatient coders from multiple facilities for appropriate DRG assignment. Accurately code inpatient and outpatient encounters for contract coding coverage as needed.
- Independently worked with third-party vendors to consult on areas of documentation compliance, auditing and other current industry best practices in multiple revenue settings to include HCC/Medicare risk adjustment and private payer standards.
- Educate and propose process improvement and implementation for third party vendors.
- Create policy and procedure for new projects and provide training to internal employees on new projects.
- Audit and report to VP results on internal coder accuracy rates for all active company projects.
- Created and implemented new internal policy for coding compliance, training requirements and auditing for all HMI employees.
- Created & presented physician outpatient education sessions on correct diagnosis and procedural documentation including Psychiatric, GI, and general practice.
6-10 years of experience
Maintained the patient’s information, reports, income reports and statistics with balancing the daily schedule.
- Posted and reconciled insurance and patient payments.
- Sent secondary claims upon processing of primary insurance.
- Researched and resolved incorrect payments, EOB rejections, and other issues with outstanding accounts.
- Answered customer queries, complaints and problems on phone.
- Set up new patient accounts.
0-5 years of experience
Performed physician coding for the Department of Anesthesiology with over 100 providers, including MD, residents, CRNA’s and SRNA’s.
- Reviewed the Surgeons operative note from the EMR (Epic) to code for Anesthesia services from cross specialists including, Obstetrics, Cardiology, General Sugary, and Radiology.
- Coded the surgeon’s entire operative note by selecting the appropriate ICD-9, and choose the highest corresponding anesthesia CPT using the ASA crosswalk.
- Returned incomplete or illegible medical documentation to the provider for further clarification or an addendum.
- Prepared for ICD-10 transition by selecting operative reports and assigned the appropriate ICD-10, to provide feedback to the providers for accurate medical documentation.
- Data entered all coded charges into the IDX billing system.
- Worked daily edits and denials from IDX to complete the revenue cycle.
- Duties also included importing data from Epic and IDX to complete statistical reports that were missing required fields.
0-5 years of experience
Performed timely investigation and resolution of medical necessity, experimental procedure, and administrative appeals.
- Abstracted and assigned appropriate E &M, CPT, HCPCS and CPT codes per physician encounter.
- Provided resolution for claim denials.
- Responsible for follow-up, appeals, and claim status ranging from 800-1000 inquiries to third party payors per month.
- Effectively communicated with external and internal medical professionals.
- Communicated with management any issues that prevent clean claim issuance.
6-10 years of experience
Outpatient coding for a variety of specialties including OB/GYN, Ophthalmology, GI, Podiatry, Orthopedics, Family Practice, Internal Medicine, Pediatrics, General Surgery, Plastic surgery, Urology, Same Day Surgery and Inpatient Professional Services
- Ensured clinics were prepared for HIPPA and JCAHO reviews
- Key player in department achieving JCAHO accreditation
- Excelled within a deadline intensive environment consistently meeting on time completion of projects
- Trained all new employees on using the computer software and clinical coding specifications
- Wrote coding process for the Inpatient Professional Services that was adopted by MEDCOM for the Army as the coding process for all DOD facilities.
0-5 years of experience
Reviewed medical records and assigned pertinent diagnosis and procedure codes based on patient’s medical record
- Reviewed medical records denied by third party payers and resubmitted for billing
- Reviewed diagnosis and procedure codes submitted by physicians
- Reviewed EOB’s (Explanation of Benefits) to determine accuracy of insurance companies payments
- Investigated unpaid patient accounts, co-insurance amounts and presented to director for re-billing
0-5 years of experience
Handling a wide variety of medical claims including physical therapies, ENT, primary care, Internal Medicine, surgeries, Podiatry, Urology, Dermatology, Cardiology and E&M
- Effectively conduct medical record reviews of the coding and documentation of diagnosis and procedures codes to ensure the providers are appropriate coding the visit
- Utilize the Correct Coding Initiative (CCI) edits for accurate assigning of code and make use of the Local Coverage Determinations for medical necessity.
- Review charts for correct admit/discharge dates and entered proper surgery dates
- Actively maintained current working knowledge of CPT and ICD-9 coding principles, government regulation, protocols and third party requirements regarding billing
- Accurately post and reconcile payments to patients account, at the same time research and resolved any incorrect rejections, and other issues with outstanding visits
0-5 years of experience
Coded for Gastroenterology, Biatric Surgery and General Surgery.
Coded for same day surgeries for ambulatory surgery center.
Worked with 3M coding software to assist with denial and submit appeals
- Worked account receivable reports based on payers
- Generated weekly status reports in Microsoft Excel to meet with physicians and management to communicate pertinent information regarding payer trends and physician issues
- Coded for Bariatrics, General Surgery and Gastroenterology
- Coded for the Ambulatory Surgery Center
- Generated tracking reports in Microsoft Excel and used eClinical daily for billing processes
0-5 years of experience
Medical Coder responsible for 10 multi-practice facilities and over 80 health care providers
- Experienced Coder for Podiatry, Pain Management, Orthopaedics and Bariatrics
- Accurately assign ICD-9-CM and/or CPT-4 code(s) and sequence diagnosis and procedures per patient medical record
- Performs targeted coding and documentation record and claim reviews; correct any deficiencies and prepare report on findings and recommendations. Ensure that all reviews and audits are based on current federal regulatory
- Successful track record of analyzing and problem solving complicated assignments and complex coding errors
- Create and document effective assessments to record progress and identify areas of improvement
- Efficiently manage significant work load under pressure. Consistently meet established deadlines with minimal supervision
0-5 years of experience
Accurately assign ICD-10-CM, ICD-9-CM and/or CPT-4 code(s) and sequence diagnosis and procedures per patient medical record
- Assure the assignment of complete, accurate, timely and consistent codes by the medical coding unit
- Reconcile clinical notes, patient encounter form, health information for compliance with HIPPA rules.
- Provide coding and documentation advice to the coding unit, clinical and professional staff.
- Analyze billing to improve coding data accuracy for Medicare compliance reimbursement
- Ensure coded data accurately reflects service provided, based on documentation, guarding against fraud and abuse.
0-5 years of experience
Manually enter data with an extremely low error percentage
- Handle time-sensitive material like confidential, urgent packages
- Review large litigation cases and identify key information for each document
- Preparing documents by disassembling and reassembling documents
- Performing quality control checks
- Assembled parts based on specifications
- Accurately read blue prints
- Collected and organized parts in assembly area
0-5 years of experience
All aspects of medical billing and coding for inpatient and office services and procedures
- Daily balancing of charges and payments
- Troubleshooting denied claims and completing insurance company requests
- Currently billing for Neurology West, Thoracic Surgery and Taylor Station Primary Care
- Chosen as Super User for ICD 10 from Coding and Compliance and currently working on ICD 10 modules
- Fill in as Certified Medical Assistant/Medical Practice Representative on an as needed basis
0-5 years of experience
Provide on-site ICD-10 education for providers and staff located nationally. Present to a wide array of populations including coding, clinical, support staff and senior leadership. Educate these populations in a large number of topics including introductions to the ICD-10-CM/PCS systems, documentation specificity required by ICD-10, documentation improvement, general ICD-10 awareness, ICD-10-CM/PCS coding, and other ICD-10 topics. Research, design and develop education content and write articles/papers/thought leadership when on-site education is not scheduled. Work with other ICD-10 Education Consultants to look for process improvements, streamline programs, maximize efficiency, and ensure all deliverables are met Job Requirements.
- Strong skill set in classroom and webinar education
- The ability to conduct compelling presentations for coders, physicians, nurses, and other clinical populations in a style that will lead to successful adoption and knowledge transfer
- Confidence in dealing with multiple populations and handling a wide variety of questions especially about ICD-10
- Conduct coding audits for new and existing clients to determine training needed.
- Assist with mapping ICD-9 codes to ICD-10 codes.
0-5 years of experience
Responsible for running queries and complies for weekly work files
- Verified electronically transmitted claims submissions and processing edits
- Researched insurance carrier issues, follow ups
- Posted and appealed insurance denials
- Identified claim specification issues
- Trained staff and Doctors for upcoming ICD-10 changes Coding Operative Reports from same day surgery, ER coding, Diagnostic Coding, Coding infusions treatment for our CF patients
- Posted private and insurance payments
- Researched canceled check information, and Financial Counseling with patient as needed for surgery or insurance issues
6-10 years of experience
Maintained all coding functions for Emergency Department
- Maintained all E&M and I&I coding functions for both facility and physician coding processes
- Attend monthly HIPAA Hospital Team meetings
- Attend monthly Coding Team meetings, presenting coding and ICD-10-CM updates
- Attend monthly Revenue Cycle Team meetings
- Attend monthly JCAHO Team meetings on behalf of Director of HIM
6-10 years of experience
Protect the security of medical records to ensure that confidentiality is maintained.
- Release information to persons or agencies according to regulations.
- Enter data, such as demographic characteristics, history and extent of disease, diagnostic
- Assign the patient to diagnosis-related groups (DRGs), using appropriate computer software.
- Resolve or clarify codes or diagnoses with conflicting, missing, or unclear information by consulting with doctors or others or by participating in the coding team’s regular meetings.
- Post medical insurance billings.
- Protect the security of medical records to ensure that confidentiality is maintained.
0-5 years of experience
Accurately coded inpatient and/or outpatient ICD-9-CM and/or CPT-4 code(s) and sequence diagnosis and procedures per patient medical record
- Assure the assignment of complete, accurate, timely and consistent codes by the medical coding unit
- Reconcile clinical notes, patient encounter form, health information for compliance with HIPPA rules and JCAHO standards.
- Provide coding and documentation advice to the coding unit, clinical and professional staff.
- Analyze billing to improve coding data accuracy for Medicare compliance reimbursement
- Ensure coded data accurately reflects service provided, based on documentation, guarding against fraud and abuse
- Conduct training, in-service and other education regarding diagnosis, procedure code assignment, regulatory requirements, and use of AHLTA, CHCS I, CCE for compliance and data quality
- Educate physicians on documentation requirements and guidelines requires to receive the appropriate reimbursement for the services they render
10+ years of experience
Responsible for CTP, HCPCS and ICD-9 (ICD-10) coding utilizing Local and National Coverage
Determinations and National Correct Coding Initiative edits
- Perform data entry and billing for Medicare, Medicaid and commercial insurance carriers
- Meticulously research coding and billing issues utilizing all available resources to ensure compliance
- Implement and monitor Physician Quality Reporting System (PQRS)
- Effectively perform insurance follow-up and appeals
- Apply auditing processes to ensure coding and billing compliance
- Assist patients with conflict resolution, customer service
- Provide supervisory coverage in Business Manager’s absence
0-5 years of experience
- Interpreted medical documentation for coding procedures, diagnoses and related conditions for the clinician-patient visit in the Emergency Department of regional hospitals.
- Applied knowledge of coding principles of the Corrective Coding Initiative (CCI).
- Attended monthly meetings with an ED physician for continual education of ED coding.
- Maintained awareness of trends for National Insurance Regulations and Guidelines.
0-5 years of experience
Using AccelaSmart to gather all patient charges from date of services and linking ICD-9 cpt to payable procedure codes following insurance protocol.
- Use Allscript to lookup procedure code and supported documentation for insurance purposes.
- Submit all claims in Centricity to correct insurances, check Realmed for rejection on claim for incorrect diagnosis code and insurance information.
- Audit logs daily for missed charges.
0-5 years of experience
Responsible for accurately coding medical claims to obtain reimbursement from various insurance companies and governmental health programs.
- Ensure healthcare providers meet specific documentation requirements that are essential in proper recordkeeping and claim reimbursement.
- Record, store, and report medical coding information to create statistics of healthcare encounters.
- Code for Wound Care, PT/OT, Lab, Cardiac/Pulmonary, and Diabetes rehabilitation departments.
- Serve as a liaison between the healthcare providers and Billing Department.
- Compare account charges with documentation to ensure it is correct for final claim submission.
0-5 years of experience
Abstracts clinical diagnoses, procedure codes and documents and other pertinent information obtained from the EMR
- Perform ongoing analysis of medical record charts for the appropriate coding compliance
- Providing coding feedback and training to physicians resulting in improved coding and documentation.
- Prepare both electronic and paper medical billing claims for payers and patients
- Follow-up unpaid insurance claim, and patient A/R collections.
- Enter all reimbursements from EOB forms into the Practice Management system.
- Follows up with collections as needed
0-5 years of experience
Review the coding for surgeries and correct any errors and Handle Insurance Refunds.
- Responsible for making sure the claims are being paid at the maximum reimbursement from insurance companies and Assist the doctors and patients with collections.
- Carry out the duties of filing and researching insurance claims; work with insurance companies and customers to collect money.
- Submit claims electronically and follow up to make sure they are paid in a timely manner.
- Maintains general accounts, Assists with the preparation of budgets
- Supervises the collection of the information
6-10 years of experience
Preformed documentation reviews for coding guidelines and medical necessity requirements
- Met with physicians to educate on current coding guidelines
- Coding multiple specialties including Gastroenterology, Urology, OB/GYN surgeries, Oncology office visits, chemotherapy, infusion and radiation charges
- Review current policies and documentation to avoid coding denials
- Work with physicians keeping them current on coding guidelines and policies
- Manage written appeals, file corrected claims, and work non-pays
- Posted charges and payments
0-5 years of experience
Coded trauma, orthopedic, spine and pain management, and physical/occupational therapy visits.
- Accurately applied payments to patient accounts.
- Read doctor dictations and coded patient charts accordingly.
- Coded patient charts using CPT and ICD-9 books.
- Electronically submitted claims online.
0-5 years of experience
Analyzed and interpreted patient medical and surgical records to determine billable services.
- Communicated with medical transcriptionists regarding patient medical records.
- Assigned additional diagnosis codes based on specific clinical findings (laboratory, radiology and, pathology reports as well as clinical studies) in support of existing diagnoses.
- Strictly followed all federal and state guidelines for release of information.
- Examined diagnosis codes for accuracy, completeness, specificity and appropriateness according to services rendered.
- Accurately entered procedure codes, diagnosis codes and patient information into billing software.
- Reviewed diagnostic and procedural terminology for consistency with acceptable medical nomenclature.
- Ensured compliance with medical/legal requirements and JCAHO standards.
- Consistently ensured proper coding, sequencing of diagnoses and procedures.
- Quickly responded to staff and client inquiries regarding CPT codes.
0-5 years of experience
Responsible for reviewing provider documentation to ensure correct level of acuity relating to diagnoses and ensuring claims are properly coded and submitted to the patient’s health insurance plan.
- Clarify discrepancies in documentation and coding.
- Complete appropriate paperwork and documentation regarding claim/encounter diagnosis information.
- Extract pertinent information from clinical notes, radiology reports, laboratory reports, specialty forms and other reports to ensure highest level of HCC diagnosis assignments.
- Perform analysis from chart reviews for provider education training.
- Review hospital notes and code appropriately.
0-5 years of experience
Coding of medical records using CPT-4, ICD-9 and HCPCS guidelines
- Sent claims to insurance companies both electronic and hard copy.
- Sent statements to patients utilizing Bill Flash.
- Prepared surgical estimates for patients and collected deposit for procedures.
- Posted payments both electronically and manually from insurance companies as well as patients.
- Worked denials/rejections to maximize reimbursement for providers.
- Updated physicians PQRS and maintained credentialing for said providers.
- Prepared month end reports.
- Attended seminars and classes to maintain the highest degree of knowledge available in CPT and ICD-9 coding.
- Serve as the “in-house” IT coordinator,
0-5 years of experience
- Coded Rehabilitation and Chiropractor procedures
- Posted Daily Super bills and Sent Claims Electronically and by Mail
- Updated Patient Demographic Information and Health Insurance
- Reviewed and Edited Denied Claims
6-10 years of experience
Analysis of death certificates for Illegible causes of death.
- Contact medical facilities regarding rare causes of death.
- Data entry for death certificates into Supermicar (Mortality Medical Data System).
- Assign proper icd10 mortality codes to death certificates.
- Responsible for sending out of state death transcripts to other states.
- Responsible for sending quality control death certificates to the National Center for Health Statistics (NCHS).
- Interpreter for Spanish customers for paternity issues and explaining paternity laws and the legal processes. Processing acknowledgments of paternity to identify father’s.
0-5 years of experience
Insurance verification for outpatient ER visits for multiple hospital locations (Online and Telephone)
- Entered insurance keys using internal system codes (AS400)
- Met hospital end of the month deadlines for verification of insurance
- Kept date of service logs (7 Hospitals)
- Posted ER charges and demographics to CPU Computer System
- Reviewed hospital charts and face sheets for verification
- Verified Worker’s Comp Insurance and Billing Information
- Internal hospital code setup in Remote Insurance Coding Application (RICA)
- Communicated with IT Team and supervisors in eliminating discrepancies, increasing RICA accuracy and effectively improving system operations
0-5 years of experience
- Looked over patient’s electronic health records for missing information and errors
- Applied the correct codes for encounters and submitted claims
- Reported any errors and missing information
0-5 years of experience
Review, code, and abstract medical records according to specified guidelines.
- Performs miscellaneous job-related duties as assigned (various coding projects)
- Utilize documentation in the medical record to assign the appropriate codes: ICD-9-CM,
- Abstracting for HEDIS CBP only.
- Use medical reference resources to research and resolve any coding issues.
0-5 years of experience
- Collect, manage, and input radiological hospital report files and translate them through the program Reflections
- Interpret and code on average of up to 800 interventional and diagnostic radiological reports using current and up-to-date CPT, ICD-9, Dr. ZHealth, Medicare’s LCD and CCI edits standards and guidelines
- Determine appropriate billing amounts for Oncology Cancer Center bases on procedures, physician time, and patient consultation
- Daily interaction with health care providers to identify applicable coding procedures to ensure correct payment is received
- Diagnosis and resolve denied claim issues and re-bill insurance for proper reimbursement
- Aggregate multiple data points through the hospital’s EPIC system in order to register patient accounts
- Pro actively monitor Epic, Cerner, Star and Ultravisual on a case by case basis in search of additional patient information
0-5 years of experience
Demonstrated the ability to appropriately use the code guidelines to code to the highest Specificity
- Worked with Specialties’ as well as General Practice using ICD-9 as well as other industry wide manuals
- Understood and followed the HIPPA Standards
- Computer Literate with the knowledge of the programs Word, Excel, Outlook, and the ability to use the internet
0-5 years of experience
Audit patient records to submit properly-supported diagnoses to Medicare for risk adjustment
- Apply ICD-9 and AHA Coding Clinic guidelines to ensure compliant coding
- Provide feedback to providers to enhance documentation and coding practices
- Achieve daily production and accuracy requirements through time management and organization
0-5 years of experience
Code (CPT & ICD-9) for a radiology group for the following modalities: MRI, MRA, PETSCANS, CT, CTA.
- Prepare all charges with correct demographics to ensure correct billing to insurance companies and other entities.
- Payment posting, review EOB’s for accuracy of re-imbursement.
- Mail paper claims with required information attached.
0-5 years of experience
- Assigned ICD 9 CM codes to pain center series patients, lab patients that have receive orders from their physicians for certain diagnosis and diseases, Physical/Occupational Therapy, outpatients clinic visits for internal medicine including dialysis, podiatry, chronic kidney disease, diabetes, hypertension, asthma, glaucoma, pediatrics, OB-GYN, vaccinations, ambulatory pre/post assessments
- Reviewed orders/ requisitions and physician notes and assign the proper coding guidelines with the correct diagnosis.
- Reviewed charges for all associated diagnostic test services for the encounter from all the departments.
- Maintained quality and productivity standards
- Communicated with different departments about invalid diagnosis