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I’ve worked in healthcare revenue cycle management for over a decade. If you don’t accurately tell the insurance company what you’re doing and why you’re gettin
by thallium205 4y ago
I’ve worked in healthcare revenue cycle management for over a decade. If you don’t accurately tell the insurance company what you’re doing and why you’re getting denied. Doesn’t matter if it’s health, auto, home, etc. There are thousands of codes, millions of combinations, and all being mostly hand coded by minimum wage workers. There are constant fuck ups most of which don’t require anyone but a computer to review to know it’s wrong. But okay cool conspiracy.
- borissk 4y agoEven if we assume you're right, the way that the system is setup and the fact that there are constant fuck ups, but no effort to fix them are not accidents. Yes, there are conspiracies out there (surprise, most people are not angels) and the US health system is definitely one. Check out the insurance companies profits. Those are directly linked to denied customer claims. Claims are not denied en-mass, by accident obviously - unless you're a complete fool.
- thallium205 4y agoThe constant billing and coding fuckups are because the government forces providers to use them. HIPAA requires the use of the x12 standard which is woefully broken. Speech between provider and payer is completely regulated. Nobody is doing anything to address it because they are prohibited by law. Oh and by the way: health insurance company profits are essentially capped by the government via medical loss ratios. They don’t make more money the more they deny otherwise they will be forced to send rebate checks (like what happened during Covid)