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turbo-1 said:I spent about 5 years as IT manager for a large medical practice. Believe me, the public has absolutely no knowledge of what "payments" and fee schedules are negotiated with medical practices or hospitals. In the case of our practice (ophthalmology, with specialists in plastic surgery, retinal surgery, and vision -corrective surgery) insurance companies often "negotiated" expensive procedures by withholding valid reimbursement claims for a month, 2 months, 3 months... If your receivables get too aged, your bank slashes your line of credit, so you can kiss that new surgical laser goodbye. The insurance companies would reject claim after claim, saying that our staff hadn't coded procedures properly. The last thing the insurance companies would allow is transparency regarding the actual claims rates they pay and how they "negotiate" those rates. It's like making sausage.
Do you honestly believe that "health care reform legislation" streamlines the billing process? Also, why did your staff keep making the same type of coding errors - was the process confusing - do you think Medicare guidelines (and I know the coding is different) had anything to do with the system?
If you want to have a serious discussion about IT and billing - let's do so.
Is anyone familiar with the health IT component of of the American Recovery & Reimbursement Act? The Stimulus Bill appropriates $19 Billionto encourage healthcare organizations to adopt and effectively utilize Electronic Health Records. The second part of the Act calls for $17 Billion in incentives payments to physicians and hospitals.
We might want to start a separate thread to discuss this important topic?