RE: the NYT article referenced by Thorvold on the "strategic" medical coding games:
snip:
Roughly $250 billion is moving through those codes, [says Steve Parente, professor of finance at the Carlson School of Management at the University of Minnesota]. On top of that, about 80% of medical bills contain errors, according to Christie Hudson, vice president of Medical Billing Advocates of America, making already-expensive bills higher. Todays complex medical-billing system, guided by hundreds of pages of procedure codes, allows fraud, abuse and human error to go undetected, Hudson says. Until the fraud is detected in these bills the cost of health care is just going to increase. Its not accidental. Weve been fighting these overchargesthey continue to happen and we continue to get them removed from bills. These errors, which are hard to detect because medical bills are written in a mysterious code, can result in overcharges that run from a few dollars to tens of thousands....
...Accounts of medical billing errors vary widely. While the American Medical Association estimated that 7.1 percent of paid claims in 2013 contained an error, a 2014 NerdWallet study found mistakes in 49 percent of Medicare claims. Groups that review bills on patients behalf, including Medical Billing Advocates of America and CoPatient, put the error rate closer to 75 or 80 percent....
...Twenty-five percent of United States hospital spending the single most expensive sector in our health care system is related to administrative costs, including salaries for staff who handle coding and billing, according to a study by the Commonwealth Fund. That compares with 16 percent in England and 12 percent in Canada.
...Whats less understood is the extent to which our current medical-billing system itself is responsible for the high prices patients are charged. There are, of course, many factors that have led to the United States record-breaking $3 trillion health care bill But all of those individual price increases have been enabled indeed, aided and abetted by the complex system of billing and coding that underlies bills like those sent to Wickizer.Whole article here:
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