Recent articles in the NYTimes have indicated that inflated and inaccurate billing is happening across hospitals.
The Obama administration has issued a strong and much-needed warning to hospitals and doctors about the fraudulent use of electronic medical records to illegally inflate their billings to Medicare. Attorney General Eric Holder Jr. and the health and human services secretary, Kathleen Sebelius, cited “troubling indications” that some providers are billing for services never provided and vowed to prosecute. They sent a letter to five major hospital trade associations on Monday, two days after an article in The Times described in detail how greater use of electronic records might be making it easier for hospitals and doctors to submit erroneous payment claims.
A Times analysis of Medicare data compiled by the American Hospital Association found that hospitals received $1 billion more in Medicare reimbursements in 2010 than they had in 2006, at least in part by changing the billing codes they assign to patients in emergency rooms.
The findings involved two kinds of potential abuses. One is “cloning,” in which a doctor cuts and pastes information from a patient’s electronic record to suggest that the services were performed again at the later date, or possibly uses the same documentation for other patients as well. The other is “upcoding,” in which hospitals may exaggerate the intensity of care provided or the severity of a patient’s condition to justify higher billings.
Continuing to deal with the incompetency of Kaiser, I can vociferously tell you that not a single employee at the hospital will champion your cause. They do not care. They do not have time. It’s not their responsibility. There is zero accountability. Something has got to change, but it won’t happen until there’s serious litigation and Kaiser has to pay out millions. Isn’t it sad that I want my own hospital to undergo litigation? That I want it to be screwed because otherwise they’ll continue to overcharge patients?
Why would I get charged differently for the same procedure? When I bring this up, the receptionist says, “That’s what the code says. You can certainly sort it out later with billing.” And essentially I can’t see the doctor unless I cough up the money and just pray that it truly will get sorted out later. But almost a full year later, I am still trying to fucking figure out my health care costs? DIE-DIE KAISER!