Healthcare Pricing for Leftist Dummies

[dogtowner]

The doctor has been in business for decades. It has nothing to do with him not knowing the codes. It's the new system and the new codes he was talking about. The coding system has now increased a thousand fold. Instead of 200 codes for billing that he has in his head, he now has to use a computer to find the correct code out 200 thousand. He said that is what is taking all of his time.

The same thing happened to me on my last Dr. visit, so I understand perfectly what this F&F doctor was talking about. I was in the exam room three times longer than normal while the doctor was dickering around on his laptop. I've also heard that hospitals and insurance companies, etc. are having a terrible time training their personnel on the new system.

Since when has the government ever done anything efficiently? I used to do DOD billing. The invoices where three pages long on legal sized paper. You would have to make nine copies to send off to different addresses, and some of them had to include the damned contract. Then you were lucky to see a payment from the government in 6-9 months.

point is you cannot pin the new ICD10 on the govt.moreover if your tv doc had 200 codes to remember he wont have 200k to consider, maybe 1000. and why a doc is spending time generating claims is beyond me, thats whathis insurance person is for.

last paragraph is why you have software with EDI. and its not that expensive. moreover, a good system has intellegence that maximizes the billing to get the doc the most. and its a LOT cheaper than hiring your own crack certified coder.

 

[Cruella]

Senator Coburn wh0 is also a doctor and surgeon, said that the new coding system is complicated. He believes that physicians will “devote more time and energy toward coding, which may detract from patient care.” Claiming there are uncertain benefits to implementing the vastly more detailed code set, he writes that “it is hard to imagine that increasing the number of codes from 18,000 to 140,000 would simplify billing and reduce errors. To the contrary, it would seem very plausible that more coding options coupled with greater coding specificity would foster tremendous confusion amongst busy providers, which would likely increase – not decrease – the amount of miscoded and rejected claims.”

While it’s unclear why Sen. Coburn believes that physicians aren’t mentally up to the task of accurately documenting the diagnoses that they are making anyway, he takes the common tack of mocking some of the more obscure ICD-10 codes, such as being struck by a turtle or being injured while on flaming water skis. “The adoption of 140,000 billing codes fraught with nuances, superfluous intricacies, absurdities, and redundancies could serve as a major distraction to physicians and other providers who are trying to provide the best care possible,” he says.
http://ehrintelligence.com/2013/05/24/icd-10-elimination-bill-introduced-in-the-senate/



Rand Paul, also a doctor, has said similar things about this new system.

It's also estimated that the implementation of the new system will cost in hardware, software and training, anywhere from $80k to $2.5 million depending on the size of the practice.

 

[Centrehalf]

Senator Coburn wh0 is also a doctor and surgeon, said that the new coding system is complicated. He believes that physicians will “devote more time and energy toward coding, which may detract from patient care.” Claiming there are uncertain benefits to implementing the vastly more detailed code set, he writes that “it is hard to imagine that increasing the number of codes from 18,000 to 140,000 would simplify billing and reduce errors. To the contrary, it would seem very plausible that more coding options coupled with greater coding specificity would foster tremendous confusion amongst busy providers, which would likely increase – not decrease – the amount of miscoded and rejected claims.”

While it’s unclear why Sen. Coburn believes that physicians aren’t mentally up to the task of accurately documenting the diagnoses that they are making anyway, he takes the common tack of mocking some of the more obscure ICD-10 codes, such as being struck by a turtle or being injured while on flaming water skis. “The adoption of 140,000 billing codes fraught with nuances, superfluous intricacies, absurdities, and redundancies could serve as a major distraction to physicians and other providers who are trying to provide the best care possible,” he says.
http://ehrintelligence.com/2013/05/24/icd-10-elimination-bill-introduced-in-the-senate/



Rand Paul, also a doctor, has said similar things about this new system.

It's also estimated that the implementation of the new system will cost in hardware, software and training, anywhere from $80k to $2.5 million depending on the size of the practice.

The bolded portions are a lot less powerful than they should be due to the presence of words like "could" and "may." Doctors don't, for the most part, do their own coding.

Coburn and Rand are politicians and have an axe to grind. I'd like to know how much of the estimated costs from Rand include HIPAA compliance upgrades which would have needed to have been done even without the ACA. To put that estimate in perspective, $80K is less than the annual cost of one nurse and the practice gets to spread that cost over a period of years in many cases; it's a small percentage of the practices total overhead.

 

[Cruella]

The bolded portions are a lot less powerful than they should be due to the presence of words like "could" and "may." Doctors don't, for the most part, do their own coding.

Coburn and Rand are politicians and have an axe to grind. I'd like to know how much of the estimated costs from Rand include HIPAA compliance upgrades which would have needed to have been done even without the ACA. To put that estimate in perspective, $80K is less than the annual cost of one nurse and the practice gets to spread that cost over a period of years in many cases; it's a small percentage of the practices total overhead.

That's where your wrong. First of all I have two doctors and a nurse in my family. The doctors do code.

It just recently happened to me at my doctors office. Instead of his pre-coded sheet that's attached to my file for that visit, he had a lap top and did a lot of poking around while I sat there in the exam room. I was also in that room three times longer than I normally am, while he was doing it.


What makes you think a nurse in a small office makes $80k? Do you really think the computer company, the software people and the labor required is going to be spread out over time.? Hardly.

 

[Centrehalf]

That's where your wrong. First of all I have two doctors and a nurse in my family. The doctors do code. "

I have a barber, a baker, and an Indian Chief in my family. Prove that I don't and who cares about anecdotes anyway. Medical coding is an industry all to itself and if your view were reality, it wouldn't be.

It just recently happened to me at my doctors office. Instead of his pre-coded sheet that's attached to my file for that visit, he had a lap top and did a lot of poking around while I sat there in the exam room. I was also in that room three times longer than I normally am, while he was doing it."

As far as you know he was playing angry birds. One visit does not a pattern make. Still anecdotal.

What makes you think a nurse in a small office makes $80k? Do you really think the computer company, the software people and the labor required is going to be spread out over time.? Hardly".

Reread what I said. I didn't say the nurse makes $80K, I said the nurse costs $80K, at least.

 

[Centrehalf]

Cruella, just so you know where I'm coming from on this bit about the nurse:

A $10 per hour employee is not really a $10 per hour employee. From the point of view of the employee, they're a roughly $7.50 per hour employee because that's roughly what they take home.

From the point of view of the employer, they're a roughly $20 per hour employee because that's what they cost. That's how much total money is spent directly due to the employment. This is for full-time, part-time is different and the numbers may be different in other states but the principle remains the same.

 

[Cruella]

Cruella, just so you know where I'm coming from on this bit about the nurse:

A $10 per hour employee is not really a $10 per hour employee. From the point of view of the employee, they're a roughly $7.50 per hour employee because that's roughly what they take home.

From the point of view of the employer, they're a roughly $20 per hour employee because that's what they cost. That's how much total money is spent directly due to the employment. This is for full-time, part-time is different and the numbers may be different in other states but the principle remains the same.

What? So you think I need lessons on employee costs? Just so you know, I've worked in accounting for 20+ years.

A full time employee that earns $20 per hour, costs the employer approx. $46,034 per yr, not including medical benefits, if they get any, as most most medical people work 30 hr weeks or less. I also don't see small offices paying union wages/benefits, but in that case the costs would be considerably higher.

 

[Iolo2]

Your nutty system costs twice as much as the NHS and lets the poor die. Aren't you MUGS!

 

[Centrehalf]

What? So you think I need lessons on employee costs? Just so you know, I've worked in accounting for 20+ years.

A full time employee that earns $20 per hour, costs the employer approx. $46,034 per yr, not including medical benefits, if they get any, as most most medical people work 30 hr weeks or less. I also don't see small offices paying union wages/benefits, but in that case the costs would be considerably higher.

Feigned outrage? This is where we are now? You did the same thing to me in another thread regarding Obamacare, you gave me a primer on Obamacare, assuming I didn't know, instead of just answering a simple, straightforward question put to you. Based upon your earlier comment to me it was not unreasonable for me to post what I did. Given the experience you've just claimed you should have had no difficulties understanding what I said and what I meant by it. If you really want to go this route that's unfortunate.

 

[Iolo2]

You deny the existence of the outside world to obey your masters. Everywhere civilized has a better system. You are nutters.

 

[Cruella]

Feigned outrage? This is where we are now? You did the same thing to me in another thread regarding Obamacare, you gave me a primer on Obamacare, assuming I didn't know, instead of just answering a simple, straightforward question put to you. Based upon your earlier comment to me it was not unreasonable for me to post what I did. Given the experience you've just claimed you should have had no difficulties understanding what I said and what I meant by it. If you really want to go this route that's unfortunate.

Feigned outrage?

 

[Cruella]

You deny the existence of the outside world to obey your masters. Everywhere civilized has a better system. You are nutters.

The Force be with you.

 

[dogtowner]

You deny the existence of the outside world to obey your masters. Everywhere civilized has a better system. You are nutters.

then why do people come here when they need the best care ?

 

[steveox]

Your nutty system costs twice as much as the NHS and lets the poor die. Aren't you MUGS!

Yes im on MUGS

 

[cashmcall]

For years I've been saying that the job losses of 2008, catapulted our country into a complete health care melt down. Young, healthy people lost millions of jobs with benefits and they quit spending money, money they didn't have anyway, on healthcare. With the loss of billions of dollars in premiums, the insurance and health care oligarchies went into panic mode. Their margins were getting crushed and they ratcheted existing member premiums through the roof.

The only way to get all of that lost money back in- was to shove healthy people back into the health care system via the force of law- so that they could subsidize the costs of the unhealthy and improve profit margins. That is all that Obamacare boils down to- a law that compels and takes money from the young and healthy- and delivers it to the healthcare oligarchy on behalf of the elderly and sick.

The entire left hemisphere has bought into the ridiculous notion that the ACA is some benevolent program devised by their loving government to help them. I absolutely giggle at the naivete' of people who believe things like that. It's always about money. If you don't give it to them voluntarily, they'll just pass a law and take it from you anyway.

So here's the justice part. The same people who re-elected Obama in 2012 (the young) after the ACA was passed are now going to have to pay the premiums for Obamacare. I read a story this week that said the average 25 year old pays about 800 bucks a year for healthcare right now. Under Obamacare, those making 40,000 a year are going to be asked to pay premiums totaling 5000.00 per year. (silver, gold plans)

So the same demographic that voted for this buffoonery is the same demographic that will have to pay for it. Now that might be some measure of justice but it gets better...

Young people are not going to buy in. Why? Because the penalties are far cheaper than the worthless coverage. Here's the best part. Young people may not have to buy it at all...until they get sick! Remember that pre-existing clause? There is literally nothing stopping anybody from not purchasing health insurance until they actually get sick. Which is precisely what most will do. http://www.economist.com/blogs/democracyinamerica/2013/06/implementing-obamacare

Should young people buy in? No. That's what this article says. This article makes two excellent points. There are SIXTY pages of questions to sign up for Obamacare. Wow. Welcome to government. This article also give an example of a 27 year old, making 30 grand a year and having to pay 300 a month for Obamacare. That is the basic plan. The "you almost don't have insurance" bronze plan. I hate it when articles don't identify costs by plan. The silver or gold plan would cost more. I don't think people will take the bronze plan. The out of pocket expenses render it almost useless. http://www.nationalreview.com/article/351661/young-people-should-say-no-obamacare-john-fund

So in addition to the young Obama voting demographic being on the hook for this mess- giving far more in premiums than they will be receiving- I really don't think they'll buy in. I am referring to those people making a decent wage. The people making 20 grand or less will get their healthcare for free essentially. So they'll sign up. This will ultimately cause an even bigger problem than the one they sought to avoid. Health care costs will shoot through the roof some more as the pent up demand of that class of people who previously had no health care receives attention- while the people making a livable wage continue to opt out only until they get seriously ill and at that point opt in and add to our systemic losses.

The healthcare industry needs sweeping reform from top to bottom. The ACA will be a financial disaster. Not for political reasons. It just won't work. People are broke. They can't afford this. Nobody is going to make a payment the size of a house payment for something they will very likely not need for 30 years. Maybe we needed the ACA for all of the wrong reasons. Maybe it will lead to a serious effort to reform a bloated, thieving industry, where virtually every player is gouging the American public for the absolute maximum amount of money. If a catastrophic failure occurs with the ACA, perhaps that will lead to intelligent reform. The unintended consequences of bad legislation may actually lead to something much more palatable or cost effective.

The people in this country are broke. The ACA fixes nothing. It just steals more money from the haves and redistributes it to the have nots. The system is coming apart at the seams and the ACA is no fix. Not even short term.

We have a real problem in this country. We cannot tell the true from the false. The Affordable Care Act is a lie. It is not affordable nor does it care who it hurts. It is simply a tax which forces in the young and healthy and takes their money.

I keep thinking people will get tired of being lied to. But not yet. Justice has a way of settling these things. I hope it doesn't take too long.