https://www.medpagetoday.com/primarycare/generalprimarycare/109083?xid=nl_mpt_DHE_2024-03-10&eun=g2225995d0r&utm_source=Sailthru&utm_medium=email&utm_campaign=Daily%20Headlines%20Evening%202024-03-10&utm_term=NL_Daily_DHE_dual-gmail-definition It is always best to keep your business in house when you do private practice. There are currently 19 states, with 6 states being in the biggest hot water, for illegally overbilling and overdiagnosing Medicare patients in order to get higher reimbursements paid to them. What is not entirely clear is did the providers and their offices KNOW this was happening or not?
I never considered third-party medical billing to be a party to corruption!
As soon as their income became variable due to "proper" billing, the race was on.
No wonder costs are skyrocketing!
The irony is, if third-party billing were eliminated, and doctors went back to cash or barter, the medical system would collapse and people would probably live just as long.
Medicine has become the third-rail of politics.
Unfortunately, our government is trying to make it impossible to OPT OUT.
I'm not sure if they still run it as they did in the beginning but I always likes "Atlas MD" in Wichita. It was simple basic care that most anyone could afford. I always thought it was the PERFECT model for a plan for about 80% (or more) of Americans. It was very reasonably priced. That plan and a catastrophic policy would suit most and free up specialist to help people who are in greater need.
Obamacare is such a mess and appears to really help no one at a far greater price with fewer services.
The strain of illegals entering the system (for free) will break the systems. Anyone tried to locate a new doctor these days? In my area there are tons of "walk-in/emergency care offices popping up. Is our health care system heading to the McDonald's marketing structure?
Heaven help us if we get sick and need a good diagnostican. 😕
Billing and coding has become so difficult and ever changing that you need a degree in coding to survive.
What is worse are the private companies auditing Medicare records!!!!
They get a percentage of what they find “immediately” and have been guilty of using new rules on old claims, randomly denying claims and just making rules up.
Yes the doctor / hospital can appeal, but must repay Medicare plus a huge fine first!!!
Congress wants to go after Medicare because they say it’s too costly. They should instead go after the fraud inside it, but then they wouldn’t get their kickbacks would they?
I turned in the doctor i worked for because of fraud and unnecessary surgeries. They let him off. Eventually he was sued for assault and battery, but after his insurance paid the fine he went on to build a free standing surgical center. Who says that crime doesn’t pay?
Oh yeah and then there was the fraud congress gave hospitals to kill patients instead of keeping them alive. How much did that cost Medicare?
Just more reasons to NOT trust doctors as a matter of principal. Remember 95% of them spewing the mantra, "Take your shot it is safe and effective"? I am guessing 80% are still spewing away.
As with most problems today, if you chase it far enough you end up at a root cause of Government involvement. While this article identifies the Medical Offices and Third Party Billing Company as big parts of the problem, what about the Feds who are funding all of this? Might the actual underlying law and resultant regulatory language ENCOURAGE fraudulent billing practices? Do you suppose it is possible that the billing submitted by the former high ranking government official might get a little less scrutiny than the Joe Bagodonuts Medical Billing Company? Such a suspicious mind I have.
As I have detailed before, the entire medical insurance thing happened as a result of intrusive and over reaching government. This would not have happened had the Roosevelt centrally planned economy (The New Deal) not imposed wage freezes. Simultaneously US industry began ramping up to supply the obvious approaching war in Europe. Companies needed engineers, chemists, and other professionals. The problem was they could not offer more money to attract the people they desperately needed. So they went around the salary problem with "benefits". Company car, company house/apartment, paid medical, etc. Because the manufacturing companies were created to build things, not administer healthcare, they took the obvious next step and hired healthcare administration out. Thus the insurance companies were born. The rest is history that is not taught anymore.
My rambling point is that the Government is up to its eyeballs in this mess and has no interest in resolving the situation. When people depend on you, you have power over them. The only currency the Government recognizes is power. Don't expect the Government to give up any power they have.
Wow.
I never considered third-party medical billing to be a party to corruption!
As soon as their income became variable due to "proper" billing, the race was on.
No wonder costs are skyrocketing!
The irony is, if third-party billing were eliminated, and doctors went back to cash or barter, the medical system would collapse and people would probably live just as long.
Medicine has become the third-rail of politics.
Unfortunately, our government is trying to make it impossible to OPT OUT.
It's so tiresome not being able to trust anyone.
I'm not sure if they still run it as they did in the beginning but I always likes "Atlas MD" in Wichita. It was simple basic care that most anyone could afford. I always thought it was the PERFECT model for a plan for about 80% (or more) of Americans. It was very reasonably priced. That plan and a catastrophic policy would suit most and free up specialist to help people who are in greater need.
Obamacare is such a mess and appears to really help no one at a far greater price with fewer services.
The strain of illegals entering the system (for free) will break the systems. Anyone tried to locate a new doctor these days? In my area there are tons of "walk-in/emergency care offices popping up. Is our health care system heading to the McDonald's marketing structure?
Heaven help us if we get sick and need a good diagnostican. 😕
Welcome to “Obamacare”!!!
Billing and coding has become so difficult and ever changing that you need a degree in coding to survive.
What is worse are the private companies auditing Medicare records!!!!
They get a percentage of what they find “immediately” and have been guilty of using new rules on old claims, randomly denying claims and just making rules up.
Yes the doctor / hospital can appeal, but must repay Medicare plus a huge fine first!!!
Massive coding scandal. Sounds like the Biden mafiosos may have something on Ms. Cohen.
I never used these third-party billers. They need to add value, right? I guess you discovered it here.
Congress wants to go after Medicare because they say it’s too costly. They should instead go after the fraud inside it, but then they wouldn’t get their kickbacks would they?
I turned in the doctor i worked for because of fraud and unnecessary surgeries. They let him off. Eventually he was sued for assault and battery, but after his insurance paid the fine he went on to build a free standing surgical center. Who says that crime doesn’t pay?
Oh yeah and then there was the fraud congress gave hospitals to kill patients instead of keeping them alive. How much did that cost Medicare?
Just more reasons to NOT trust doctors as a matter of principal. Remember 95% of them spewing the mantra, "Take your shot it is safe and effective"? I am guessing 80% are still spewing away.
As with most problems today, if you chase it far enough you end up at a root cause of Government involvement. While this article identifies the Medical Offices and Third Party Billing Company as big parts of the problem, what about the Feds who are funding all of this? Might the actual underlying law and resultant regulatory language ENCOURAGE fraudulent billing practices? Do you suppose it is possible that the billing submitted by the former high ranking government official might get a little less scrutiny than the Joe Bagodonuts Medical Billing Company? Such a suspicious mind I have.
As I have detailed before, the entire medical insurance thing happened as a result of intrusive and over reaching government. This would not have happened had the Roosevelt centrally planned economy (The New Deal) not imposed wage freezes. Simultaneously US industry began ramping up to supply the obvious approaching war in Europe. Companies needed engineers, chemists, and other professionals. The problem was they could not offer more money to attract the people they desperately needed. So they went around the salary problem with "benefits". Company car, company house/apartment, paid medical, etc. Because the manufacturing companies were created to build things, not administer healthcare, they took the obvious next step and hired healthcare administration out. Thus the insurance companies were born. The rest is history that is not taught anymore.
My rambling point is that the Government is up to its eyeballs in this mess and has no interest in resolving the situation. When people depend on you, you have power over them. The only currency the Government recognizes is power. Don't expect the Government to give up any power they have.
Massive coding scandal. Sounds like the Biden mafiosos may have something on Ms. Cohen too.
I never used these third-party billers. They need to add value, right? I guess you discovered it here.
I just read the source material. This is huge.