Wednesday, March 24, 2010

Your Privacy Under Obamacare

 
Quite Rightly brings up something I don't see mentioned very often What Will Big Govt Do With Your Medical Records?

Here's another smart person who is doing some dot connecting:  Over at "A View From the Right", is a very good explanation of how the ICD-9 coding for medical conditions works. Welcome to My (Your) Nightmare - Your Privacy, Gone!

However, let me expand a bit and explore a few other ramifications of the coding system, since I have done a bit of ICD-9 coding.  I worked for a time at a large medical lab.  All denied claims, which were almost always Medicare, were sent to my department.  It was our job to call the doctor's office and see if we couldn't conjure up another code that would be payable.  We couldn't tell the nurse or office person what code to give us since that would be considered fraud, but we could gently lead them in the right direction.  Since we were all,  including the doctors office,  provided books stating what codes would "work" and which ones were not covered, I never understood why these office folks didn't get it right in the first place.  But that's another story.

Ever so carefully because our calls were recorded,  I would lead the person in the doctor's office through the patient's chart.  I remember one particularly dense woman who was just not catching on. In frustration, I finally asked, "Has the patient ever had a headache?"  The answer was affirmative, and the next question was the important one.  "Is it written in the chart?"  Once again we're getting into the fraud area.  The implication was, if it wasn't written in the chart, their job was to get it added to the chart as quickly as possible.  Great! Now we have a code that will provide payment.

As this monstrous bill starts to squeeze the doctor's reimbursement rate, he won't have the money to pay staff to perform this task, meaning his income will drop even more than anticipated. You see, the bottom line here is the government doesn't want to pay your claim.  They will get their jollies from how often they can deny care.  With no one advocating for the doctor and indirectly for you, the doctor's only choice is to fudge the codes; that is, if he has the staff necessary for the job.  How long do you think a doctor is going to want to work under these circumstances?  Not long, would be my guess.  Obama can promise all the health care he wants, but if there are no doctors, it means nothing.


Bob over at The Camp of the Saints has this to say and I completely agree -   They Just Don’t Get It: Mitch McConnell, John Cornyn

Bob also earns the honor of Quote of the Day: 
"This is a battle of survival against the forces of darkness and totalitarianism."
Amen, Bob

1 comment:

Anonymous said...

Fraud...coding fraudulently can cost the doc and the staff. Per incident...thousands of $$$ and jail time. Not me, I won't do that for anybody. If a physician accepts Medicare right now, Medicare can audit all charts at any moment. No request is necessary, they walk right in.