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re: Financial view of healthcare

Posted on 1/30/18 at 11:04 am to
Posted by the_watcher
Jarule's House
Member since Nov 2005
3450 posts
Posted on 1/30/18 at 11:04 am to
quote:

For a 10min ear tube case I have to:

So you are a physician. Have you ever sat down with an administrator and had them explain exactly how you get paid? That is, the entire process of a coder using your documentation to code for the procedure, then the biller sending off the required forms to the third party insurer regardless of who that third party insurer is? Have you ever seen the actual cash tables (normally in pivot table form) that break out each payer class by amount money charged relative to the amount of actual cash and percentage that has been paid on those claims?

I'm not being condescending at all. Most doctors haven't. What about a case where a claim is denied. Or improperly coded. Or falsely denied. Know what happens then? All of the documentation you hate (and deservedly so I get it) is now the only thing existing that will allow you to get reimbursed.

What about a frivolous malpractice suit? Guess what is going to easily save you ten times out of ten? Detailed documentation. Does it suck that it's required? Of course. But it's better than the alternative. As is having all that documentation available in case of a future medical emergency that you are not present for.
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