Dear Leslie,

I have an ethical dilemma at the doctor’s office where I am the receptionist. After working here for three months, I was instructed to start taking payments from patients. While learning this new task, I discovered that the doctor was inflating certain patients’ bills, charging for a higher-level visit and submitting these charges to the insurance companies, to “help” the patient out.

Although they are spending only 15 to 20 minutes with the doctor, she charges them for a 45 to 50 minute visit, charging Medicare and other insurance companies $200 instead of $100 for a 20-minute visit. She gets reimbursed about $60 from the insurance companies and then charges the patient the other $40, so she gets the full $100 for the visit.

This does not seem right to me. I asked her about it and she told me I just don’t understand the billing system. I am looking for a new job. I need to work to help support my family. I feel guilty by association. What can I do to stop this from happening? I am worried about an audit. What can I do while I continue to search for a new job?

Dear Reader,

My advice is to do some further research before jumping ship. It is possible that the doctor is correct, that you do not understand the system. Perhaps there is someone else in the office who can explain it to you. You could also call the Healthcare Billing and Management Assoc. (HBMA), a Laguna Beach, Calif. trade association that represents third-party medical billers, or Medicare or another insurer and pose your questions. A couple of variables raised by an expert at HBMA:

Do you really know how much time the doctor spends on each person’s case? It’s possible that she is investing time doing research, reviewing lab work and other duties unbeknownst to you.

Is she coding her own bills or is a professional coder doing that work?

Medicare and private health insurers are constantly looking for irregularities in billing, which means that if there is an unusual billing pattern, the doctor is putting herself in jeopardy.

Cancer Challenge

Dear Leslie,

I have been in the long-term care industry for more than 20 years but no longer choose to stay in the field. I was diagnosed with cancer in 2002 and am finally on the other side. I am in my late 50s and need to work for another 10 years.

My challenge is explaining the lapses on my résumé. I last worked at the end of 2006. I left my last job because of stress and received a severance package, then unemployment, and am currently on disability through the end of next month. If I say anything about being a cancer survivor, doors close. What should I do?

Dear Reader,

When you have an employment gap largely related to illness it’s important to be brief and upbeat. Mention the gap in a few sentences in your cover letter, so that it’s largely addressed before the interview. Stress your accomplishments and then note that you had to take some time off starting in 2006 to attend to your health. Now you are looking forward to returning to full-time employment. Your interview will be an opportunity to show off your accomplishments and your healthy glow.