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| Re: Gibbs Can't Name Countries Where Government Health Care Works Better (467376) | |||
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Re: Gibbs Can't Name Countries Where Government Health Care Works Better |
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Posted by BMTLines on Fri Jun 26 23:58:15 2009, in response to Re: Gibbs Can't Name Countries Where Government Health Care Works Better, posted by Orange Blossom Special on Fri Jun 26 22:24:58 2009. Sometimes they bill for things they didn't even do. Reminds me of a stat that said most hospital bills are full of errors. I assume it's those long tedious itemized bills, the ones they send to the insurers aren't always that long as they lump the catagories at times. Well aside from a horrific car accident bill anyway.I worked in the industry for many years and I can tell you that there was a time when the itemized bill really didn't matter. At one time hospitals were reimbursed "perdiem rates" by the major insurers such as Blue Cross, Medicare and Medicaid. The remainder of the bill was written off as a "contractual allowance" So it really didn't matter if the hospital billed for 10 lab tests or 20 lab tests - they would only get a perdiem rate of $200 per day no matter what was done. The patient would get a letter from Blue Cross stating that "if you did not have BC your bill would have been $40,000 (for example)" what BC did not tell their member is that they only paid the hospital $2000 which the hospital accepted as payment in full under the contract. Today all hospitals have contractual agreements with HMO's and other major insurers which also reimburse according to similar formulas although I believe they are related more to the diagnosis as opposed to the length of stay. Either way the itemized charges do not factor into the equation at all. The primary reason hospital bills were "wrong" was simple carelessness in the way the charge tickets were processed. When I did that work it was back in the day of batch processing and punch cards - how accurate do you think we were when we had thousands of "tickets" to process and less than a second to read a doctor's or nurse's quantity count and item code. Lets just say guestimates ruled!! Since it affected billing and not patient care - no-one really cared - speed had priority over accuracy! Today's improved computer systems should have resolved many of those billing issues. |
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