Medical billing hodge podge thread.

arabrab
Mon, 09 May 2016 16:41:30 +0000

As with pretty much any system, once something goes wrong it is hellacious to get it really and truly fixed. The problem is that we tend to have more encounters with medical billing than with any other kind of billing system we deal with, so more opportunities for things to go south. Either things go through correctly the first time or you’ve got a mess on your hands that becomes a tar baby. Personally, I’ve had a lot more trouble with the Pharmacy Benefits Managers like Medco/Express Scripts than I’ve had with insurance companies per se.

Medicare was not so easy, either. It is not single payor – they hire intermediaries to handle claims from different states, and the intermediaries are allowed to make Local Coverage Decisions that vary region to region. Their doctor payments to primary care doctors are shamefully, shamefully low.