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The cheaters are the minority but they rob medicare and medicaid of millions. I am the appointed compliance officer at my job. I have rejected many CMNS for durable medical equipment that were generated by home health agencies and never approved by the doctor. The DME companies send the requests hoping that the doctors will blindly sign. My favorite was for a vacuum erection device for a 90 year old patient who also needed incontinence supplies.
I guess many make it up through Medicare/Medicaid fraud, otherwise how would you account for $60 billion fraud in the medical industry that the government is fully aware of?
The insurance companies do not work with the insured. In my file (medical clinic) I saw a bill that was submitted to my insurance carrier that was padded. I called the carrier and asked for a copy of the bill the doctor submitted be sent to me, or at least tell me the charges over the phone. I was told they could not provide me with that information as it would violate the doctors privacy. This wasn't a Medicare/Medicaid claim, it was private insurance.
Actually fewer docs are accepting medicare these days...
You make it seem like docs and carriers are in bed together- it quite the opposite.
How did you know the bill was padded (and I'm not saying it was or wasn't)
But there's the submitted charges and what's actually reimbursed. Two different things.
Private insurance- you can definitely as for an itemized list of charges- Keep in mind that depending on what it was for- say a facelift- there's charges from the doc, anesthesia, the facility, labs...
Some docs are snots, few are dirty. Alot are just guys/gals that spent their 20's in crummy hospitals, now doing their best to take care of their patients in an increasingly hostile environment.
The cheaters are the minority but they rob medicare and medicaid of millions. I am the appointed compliance officer at my job. I have rejected many CMNS for durable medical equipment that were generated by home health agencies and never approved by the doctor. The DME companies send the requests hoping that the doctors will blindly sign. My favorite was for a vacuum erection device for a 90 year old patient who also needed incontinence supplies.
The minority?? $60 billion a year?? That's alot of minority.
Thank God not every doctor feels that way. Doctors create jobs. I am glad I am close to retirement age because I see the trend is to force doctors out of private practice.
I would say it is not too far from the truth...
I do not know a single physician that has encouraged their children to follow in their footsteps... no one, at least in the last 25 years.
That has to say something about where the profession is headed.
So many of the young Docs are foreign born... many are excellent at what they do.
Being in any business with employees is a tremendous undertaking and then add the complexities of one that is so highly regulated as the practice of medicine and you get the picture.
A single physician typically has at least 4 employees... you need a biller, scheduler, two medical assistants plus additional staff to cover for vacations, illness and medical leave... on Doc was so frustrated because for the last 6 years he always had an employee out on maternity leave... one employee was 3 weeks on jury duty...
Actually fewer docs are accepting medicare these days...
You make it seem like docs and carriers are in bed together- it quite the opposite.
How did you know the bill was padded (and I'm not saying it was or wasn't)
But there's the submitted charges and what's actually reimbursed. Two different things.
Private insurance- you can definitely as for an itemized list of charges- Keep in mind that depending on what it was for- say a facelift- there's charges from the doc, anesthesia, the facility, labs...
Some docs are snots, few are dirty. Alot are just guys/gals that spent their 20's in crummy hospitals, now doing their best to take care of their patients in an increasingly hostile environment.
It's not just "doctors". It's widespread across the medical field.
I know the bill was padded because the receptionist left my file open and I saw the bill.
Cosmetic surgery is NOT covered under any medical insurance or program.
If you look at statistics, it is fraud related to durable medical equipment and physical therapy. That is not the majority of doctors.
I said it was widespread across the medical field.
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