The Cellar: a friendly neighborhood coffee shop, with no coffee and no shop. Established 1990.
1 of 1- Diaphone Jim
- Not Ignoring You.
Offline - Registered: 10/13/2020
- Posts: 1,446
Billing for health
It seems that enough of us here in the Cellar are receiving health care to ask this:
After a medical appointment, do you carefully read what is available from the provider, such as office visit summary and after visit orders?
I do and I always find things that I am being billed for that simply did not happen.
The basis for these fictitious encounters is what is called "up coding," otherwise known as fraud.
It seems to be ubiquitous and simply ignored in the world of medical insurance, including Medicare.
I have more on it if there is any interest.
- Diaphone Jim
- Not Ignoring You.
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- Registered: 10/13/2020
- Posts: 1,446
Re: Billing for health
Sure is quiet.
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Thread Starter- fargon
- life is good
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- From: Viroqua Wi.
- Registered: 10/13/2020
- Posts: 1,368
Re: Billing for health
Yes, I read everything.
I Love my country, I fear the government.
- griff
- A Magical Woodland Creature
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- Posts: 3,165
Re: Billing for health
We’ve never caught an “error “ but as we hit our complicated years things could get messier. I’m amazed that an administration defrauding taxpayers at this pace has time to look at petty fraud.
If you would only recognize that life is hard, things would be so much easier for you. - Louis Brandeis
- tw
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- Registered: 10/16/2020
- Posts: 1,814
Re: Billing for health
I don't see fraud. I see numerous mistakes due to wrong code numbers. Many medical facilities, to cut costs, do not have people who fully understand those many codes. Cheaper employees will increase profits (they claim). I am amazed how many times a claim is resubmitted until the medical office finally gets a correct code.
We have a problem in this country. To many come from a bean counter mentality. Not from where the work gets done. Well over 50% of master's degrees are MBAs. People who are taught to increase profits. How the work gets done is only an expense. Need not be learned.
Need we cite GM for the past 50 years? Or everything in Boeing designed after MBAs took over in 2001. Or a Mission Accomplished war that was somehow suppose to be won by throwing trillions of dollars at it. After all, Cheney's attitude was quite obvious. "Reagan proved that deficits don't matter."
They could not find even one engineer who said it was safe to launch Challenger. Being trained in management (not reality), they could not understand what every engineer was saying. Murder of seven astronauts.
In every case, the boss could not be bothered to learn how the work gets done. Even in medical facilities that have excessive costs. With employees (who costs less) who do not know what are correct codes for medical claims.
- Diaphone Jim
- Not Ignoring You.
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- Registered: 10/13/2020
- Posts: 1,446
Re: Billing for health
At my last exam I got results for the two foot pulses, dorsalis pedis and posterior tibial.
Without removing my shoes.
Actually, removing my shoes would not have helped because he never touched my feet.
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Thread Starter- Anon
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- Registered: 10/25/2021
- Posts: 843
Re: Billing for health
What we have here is a podophilia parapraxis.
I don’t know of a separate billing code for it; so, consider it a freebie.
- Diaphone Jim
- Not Ignoring You.
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- Registered: 10/13/2020
- Posts: 1,446
Re: Billing for health
What bothers me is that the clinic reported results for this exam test and others that were NOT performed.
They do become part of the main $ coding for time of appointment.
Fraud is a legal term. What I find with every appointment is dishonesty and fictional medicine.
And I have been told "Everybody does it," as if that is a justification.
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Thread Starter