3 ms·

I believe that standards do indeed exist, and they are called HCPCS codes. I had written a whole comment to your previous comment that got deleted, but please r

I believe that standards do indeed exist, and they are called HCPCS codes. I had written a whole comment to your previous comment that got deleted, but please read the below wiki article to start. Note that the levels described in this article are not the same as your "levels 1-5". Those are CPT codes. For example, a level 5 billing for an emergency room visit is CPT code 99285. https://en.wikipedia.org/wiki/Healthcare_Common_Procedure_Coding_System https://en.wikipedia.org/wiki/Healthcare_Common_Procedure_Co... Edit: also note that CPT codes are part of the HCPCS

epmaybe 9y ago
I'm going to reply to my own comment here as I think something needs to be said regarding my own opinion on this. I think that it's very obscure to patients as to what they might end up having to pay when they enter an ER. These codes are super complicated to me, and I think it takes quite a long time for medical coders to get proficient at their job. It'd be nice if patients didn't have to worry about these sorts of issues when receiving emergent care, but such is the country we live in.
- supercanuck 9y ago
  There isn't a standard between what is a 1 and what is 5. There is a standard that they in fact exist in the first place and charged accordingly. But what one hospital considers a Level 5 and another considers a level 5, is based on the amount of competition the ER has, because there isn't another externality keeping it in check. The article touched on this, and I also discovered this through my own research when I attempted to dispute what in fact a Level 5 was. Add to the fact, that by entering into the hospital you are asked to enter into an arbitration agreement. Compound this with the monopoly nature of an ER, and the only thing keep prices from spiraling out of control is the sheer benevolence of the hospital employees.
  - epmaybe 9y ago
    I think I understand what you are saying now, thank you. The only thing I have to offer is that regulatory bodies such as CMS and DHHS may have the authority to investigate these variations in level breakdowns, besides the sheer benevolence of hospital employees. Additionally, insurance companies would be understandably upset if a hospital was charging them more than they should have been, so potential investigations that shed more light on this could help stabilize this part of the market. I appreciate your insight!
  - goialoq 9y ago
    > sheer benevolence of the hospital employees. and willingness to push back against intense economic pressure from management.

epmaybe 9y ago

I'm going to reply to my own comment here as I think something needs to be said regarding my own opinion on this. I think that it's very obscure to patients as to what they might end up having to pay when they enter an ER. These codes are super complicated to me, and I think it takes quite a long time for medical coders to get proficient at their job. It'd be nice if patients didn't have to worry about these sorts of issues when receiving emergent care, but such is the country we live in.

supercanuck 9y ago
There isn't a standard between what is a 1 and what is 5. There is a standard that they in fact exist in the first place and charged accordingly. But what one hospital considers a Level 5 and another considers a level 5, is based on the amount of competition the ER has, because there isn't another externality keeping it in check. The article touched on this, and I also discovered this through my own research when I attempted to dispute what in fact a Level 5 was. Add to the fact, that by entering into the hospital you are asked to enter into an arbitration agreement. Compound this with the monopoly nature of an ER, and the only thing keep prices from spiraling out of control is the sheer benevolence of the hospital employees.
- epmaybe 9y ago
  I think I understand what you are saying now, thank you. The only thing I have to offer is that regulatory bodies such as CMS and DHHS may have the authority to investigate these variations in level breakdowns, besides the sheer benevolence of hospital employees. Additionally, insurance companies would be understandably upset if a hospital was charging them more than they should have been, so potential investigations that shed more light on this could help stabilize this part of the market. I appreciate your insight!
- goialoq 9y ago
  > sheer benevolence of the hospital employees. and willingness to push back against intense economic pressure from management.