Car Accident Victim: "Hospital tried to force me on a ventilator and convince me I had Covid" (companies, money)
Please register to participate in our discussions with 2 million other members - it's free and quick! Some forums can only be seen by registered members. After you create your account, you'll be able to customize options and access all our 15,000 new posts/day with fewer ads.
A Flagstaff, AZ man claims he suffered minor injuries after a car accident but then ended up drugged with sedatives and woke up in a hospital on a ventilator as the nurses tried to convince him he had Covid:
Reclassifying? Then explain exactly how the hospital does so? The physician on the case documents all the diagnoses. So just how does the hospital reclassify anything?
That is true.
We get hounded all the time by the billing department for being very precise about the diagnosis entered. The billing department CANNOT ENTER A DIAGNOSIS CODE ON THEIR OWN- THE PHYSICIANS DO THAT.
ICD-10 is far more precise than ICD-9 and we are continually asked to be far more precise in accordance with ICD-10 to the point of being annoying. Each diagnosis has specific "sub diagnoses" to make each code very accurate.
Anyways, none of this matters. A positive COVID test doesn't mean someone is dying of or even sick from COVID. They can be dying from something else, and just incidentally test + (whether the test results were a false positive or correct) just like millions of people with no symptoms test + every day.
By the fall of 2020, many if not most directly involved docs could then diagnose Covid 19 clinically. A positive specific Covid 19 test would always be reassuring, but not necessary.
Also in the fall of 2020 before the vaccines, an incidentally positive hospitalized patient was still a more serious matter. Requiring intervention, isolation and such, so that inpatient care became more complex and expensive.
It also easily allows for fraud. Someone vented for bacterial pneumonia requires the same amount of work as someone vented for COVID (minus the requirement to isolate the person for COVID, something we don't need to be doing) but one gets them more money and faster payments with less paperwork.
It also incentivizes testing people with no symptoms so they can be coded as COVID. Their care will be the same, but more money will be attached.
Then hospitals make money from the tests, and a lot of it.
Everyone in such a hospitalized clinical state gets tested for Covid 19.
The end result of the medical misadventure is that falsely positive Medicare patients, admitted for other reasons, get quarantined. And the hospital potentially gains on reimbursement. There is no one along the line looking to push fraud. What happens in real medical life, is that the patients and doctors want proper answers. So those incidentals will have repeated tests. And if the follow ups all come back negative, the doc will reassure the patient and staff, make the properly adjusted documentation, and remove the Covid 19 diagnosis. Then fight with the hospital/medical records. Potentially a very public scene these days. And the hospital has more financial reasons to go along with the doc/clinical documentation, then engage in fraud.
The bottom line is that covid numbers are being manipulated, and are inflated for reporting purposes, as well as reimbursement (bonus) purposes. Hospitals are enriched by covid reimbursements.
This is not a new thing. Since the advent of DRG reimbursement coding during the Reagan years, hospitals have done their best to harvest the clinical record for the most in Medicare reimbursements. Pushing into the gray zones of reimbursements has been common, but outright fraud has not. Because there are too many involved on the documentation end, too many watching, and way too much to lose.
Warren Goldstein was surprised when Austin Emergency Center, in Texas, charged him and his wife $494 upfront for two covid tests. He was shocked when the center billed insurance $1,978 for his test, which he expected would cost $100. His insurer paid $325 for “emergency services†for him, even though there was no emergency.
Many if not most testing these days have an enormous retail mark up price, that virtually no one pays. Most reimbursements for the testings have been preset through negotiation. So a thousand dollar test gets reimbursed at $25. And the lab, the patient and the insurance company all walk away happy.
There are certainly outliers here and there. Usually the unsuspecting uninsured. And they have to then negotiate on their own, or simply bail out and not pay.
No one is saying the hospitals are venting people for no reason, rather reclassifying vented people for other causes as COVID. Get it?
It's like some of you're as slow as snails.
This is where the medical documentation becomes so important. It can certainly be difficult to separate out a bacterial pneumonia + an incidentally positive Covid 19 test in the same patient at the same time. Sometimes it can be done, sometimes not. In the end the best medical guess based on the the clinical data is what we get. But this scenario in 2020 was not common. Much more than likely in 2020, if you had a positive Covid 19 test and ended up in the hospital ventilated the following 2 weeks, far and away it was Covid 19, not simply bacterial pneumonia.
This is where the medical documentation becomes so important. It can certainly be difficult to separate out a bacterial pneumonia + an incidentally positive Covid 19 test in the same patient at the same time. Sometimes it can be done, sometimes not. In the end the best medical guess based on the the clinical data is what we get. But this scenario in 2020 was not common. Much more than likely in 2020, if you had a positive Covid 19 test and ended up in the hospital ventilated the following 2 weeks, far and away it was Covid 19, not simply bacterial pneumonia.
Back in 2020, up to September 1st, you didn't even need the patient to test + for COVID to put them down as a COVID death. Suspected COVID was allowed by the CDC. So if someone had pneumonia back in March 2020, and the hospital never tested them, they were actually all rolled into as COVID deaths so they could get the money. This is why Flu deaths, which were higher than usual back in February 2020, dropped off a cliff in March 2020.
Reclassifying? Then explain exactly how the hospital does so? The physician on the case documents all the diagnoses. So just how does the hospital reclassify anything?
Hospitals have billing people that peruse the charts very carefully looking for more billable stuff. If they find something missed and legitimate they can of course add the charge. But changing or adding diagnoses cannot be done without the approval and consent of the attending doc signing off on the hospital record. And that does happen from time to time.
Everyone in such a hospitalized clinical state gets tested for Covid 19.
No, not everyone. For a while, hospitals stopped testing asymptomatic vaccinated people for COVID19. This is was due to a CDC guideline.
Two individuals I know went to the same hospital around the same time. One was unvaccinated and had a ruptured hernia, he was left in excruciating pain in an outdoor tent, for his tests results, before he could be taken inside for emergency surgery. The other had an unexpected burst of his duodenal ulcer, he was vaccinated and immediately taken into surgery and never tested.
Quote:
The end result of the medical misadventure is that falsely positive Medicare patients, admitted for other reasons, get quarantined. And the hospital potentially gains on reimbursement. There is no one along the line looking to push fraud. What happens in real medical life, is that the patients and doctors want proper answers. So those incidentals will have repeated tests. And if the follow ups all come back negative, the doc will reassure the patient and staff, make the properly adjusted documentation, and remove the Covid 19 diagnosis. Then fight with the hospital/medical records. Potentially a very public scene these days. And the hospital has more financial reasons to go along with the doc/clinical documentation, then engage in fraud.
In the real world, no one suspects a false positive if they have no symptoms and test false positive. They just think they're one of the lucky 20-40% of asymptomatic cases.
Please register to post and access all features of our very popular forum. It is free and quick. Over $68,000 in prizes has already been given out to active posters on our forum. Additional giveaways are planned.
Detailed information about all U.S. cities, counties, and zip codes on our site: City-data.com.
Please register to participate in our discussions with 2 million other members - it's free and quick! Some forums can only be seen by registered members. After you create your account, you'll be able to customize options and access all our 15,000 new posts/day with fewer ads.
