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Was involved in medical billing software. Any individual bill is generally fine on its own. Actual fraud was taken seriously. But the system is absolutely d
by treeman79 4y ago
Was involved in medical billing software. Any individual bill is generally fine on its own. Actual fraud was taken seriously.
But the system is absolutely designed to milk the government for every dollar possible. Basically, how much can we bill for without it crossing the line into fraud.
Perhaps much worse. Is there is zero incentive to reduce cost for treating people.
- HillRat 4y agoIronically, one of the more effective ways to reduce billing waste was when health systems (or their PE owners) decided to slash costs by laying off their coders (for everyone else who didn't live revenue cycle, a "coder" in this case is someone trained to translate medical procedures to billable CPT codes) and having nurses do billing. Suddenly there was zero incentive to optimize for reimbursement, since nurses are understandably nervous about getting sent up for inadvertent Medicare fraud.