Re: ...Billing Service FIRED!...paying health care system

[Guest guest]

Great idea... swipe card, enter last four digits of card, enter billing

code/DSM, enter amount... print receipt, done!

But alas, such a system would remove monies from the insurers faster than

current system. And since the insurance industry has legislatures in their

back pocket (see medicare part D as latest obvious example) there is no

way in the world such a system would be developed.

This is a sad story in the most profound way... expensive health system,

health data not much better (worse in some ways?) than Costa Rica,

providers forced to do extra work to receive payment (any other industry

like that?), 45 million people un-insured, a " safety net " that likes to

cut people and then not pay doctors very well for providing care... etc...

all while the insurance companies and their leaders are doing quite

nicely. How did we Americans let the insurance industry get so much

power?

Supposedly we have the best medical training in the world. Many of the

best international student come here to study. But the actual health care

system is low value (value = cost/unit cost of service). Something is

whacky about it.

I wish I had an answer that had a chance of becoming reality...

Tim

> What do I think, ? I think the insured person should have a card

> like our bank card which we run through a slot in a reciever and the

> payment drops into the appropriate office account. Most of the

> information is repetative.

>

> Joanne from Drain.

>

> Guinn wrote:

> If you've passed any filing deadlines on those insurance claims, you

> may be able to present them in a package personally to a provider

> rep in the company for reimbursement. One physician told me that

> after he fired his billing person and found all these lost claims, a

> couple of the companies agreed to pay him based on the sad story. .

> . Luckily, Medicare has that 18 month limit.

> Do you think we'd all make more money (and contribute less to the

> world) if we all became " billing consultants " ?

>

>

>

>

> From Joanne in Drain, Oregon.

>

> I'm starting to think what you went through is the standard of

> management: my billing expert did the same kind of thing. And,

> realize, everyone keeps saying she is an expert. She remains

> employed by another well known local MD who knows nothing about

> billing and will not be able to correct her. (Yes, I am using the

> past tense when talking about her.)

> So, of the last 60 bills I have cleaned out of my billing

> software as being unpaid and have worked on this week: 7 of them

> should have been billed to medicare and weren't, six should have

> been billed to BC/BS and weren't, and three should have been

> billed to insurances that pay very well and were set up to be

> sent to the patients instead. I have billed out or rebilled

> properly or found lost about $12000 worth of work in the last

> three weeks.

> When you think of it, most MDs never really can know if the work

> they are doing is being reimbursed or being lost in translation.

> We are " cushioned " to the point of being irrelevant to the payment

> process except as well trained hampsters being pushed into running

> through more office calls. The arcane world of the medical

> " billing expert " could be the last refuge of the incompetent and

> no one would ever know.

>

> Joanne

>

> " Naureen A. Mohamed " wrote:

> I did it. I finally teminated with MTBC. I was getting sick of

> their explanations and reasons about why things weren't getting

> paid. Medicaid secondary to Medicare (which does pay in New York

> State) has never been billed properly in over 2 years! Finally, 2

> of my patients were billed when their insurance was active and

> wasn't even billed. That was annoying and the last straw.

> I plan on using EZ claim now and I am really excited (but my husband

> thinks I'm nuts).

> Thanks to everyone for their ideas on this matter. I wouldn't have taken

> the jump if I hadn't seen that so many of you do it already.

> Naureen

>

>

>

>

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