A recent federal health official’s declaration brought about happiness in hospital boardrooms nationwide and encouraged the American Medical Association, the country’s largest physicians group, to make public a letter with appreciation for government regulators.
The Centers for Medicare & Medicaid Services informed that there would be a one-year delay in implementing tens of thousands of new medical billing codes, part of an esoteric system that directly influences every patient in the United States.
Medical billing codes have record of a patient’s treatment, stating the amount paid to medical providers and, eventually, who pays it — an insurance company, Medicare Plan or Medicaid, or you. The billing problems are as enormous as medicine itself. Among the many recurrent complaints are: patients being billed for the wrong treatment, receiving double billing for the same treatment, being charged for more than an insurance contract permits or getting a bill for unexpected costs, such as a “facility fee.”
The national sigh of relief over the holdup in the execution of the new codes emphasizes the growing anxiety among health systems and insurers about a billing system that pits providers against payers while leaving patients literally holding the bill.
Payers, including insurance companies and the government, hold that hospitals and doctors use wrong codes because of human error or, sometimes deliberately to get more money.
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