As more documents go digital there are potential side effects that could cause problems especially in the health industry. A lot of changes have taken place involving the use of Medicare electronic billing for people receiving treatment from physicians. This type of system uses complex medical codes that are provided by the hospitals electronically.
While this can make billing faster and easier in many respects there have been allegations by federal health officials that physicians are using this system to commit fraud. As over half of physicians have already converted to this system there is cause for concern about what it will mean for the patient.
Are Patients Being Charged More
Are hospital patients being charged for more expensive procedures because of this electronic billing system? There has been a noticeable increase in complex billing codes being charged to patients which could indicate that physicians are taking advantage of this system.
The reason that this is a subject that requires some scrutiny is that compared with a typical
Medicare visit charge these complex care codes are nearly double the cost of a regular payment.
If hospitals are falsely applying these types of codes to many different patients’ electronic bills then they are overcharging them for services that they did not receive.
Physicians Arguments Against It
Physicians argue that this type of billing system allows them the opportunity to document what they would not have been able to in the past. This is their reasoning behind the increase in complex codes which they say are more accurate and efficient for hospitals to use. The question is whether the coded billing procedure could also open up the chance for patients to be billed unfairly.
While more hospitals begin using this type of electronic billing and coding system, there are some things that could help prevent this potential problem from growing. There need to be guidelines for professionals to use that could help keep their billing to a minimum.
Shift Toward Electronic Billing
It seems that possibly doctors have taken the shift toward electronic billing as an opportunity to charge more on their bills in the past few years. There need to be clearer guidelines for them to follow so that this does not keep happening and they maintain their normal cost for specific kinds of treatment. Hospitals and physicians argue that these bills are more accurate or that patients are
now requiring more care but the close correlation is too hard to ignore.
It is important for the patients themselves to be more aware of these changes and what they could mean for their own medical treatment. While it should by no means be up to them to make sure
that they are treated fairly it is a good idea for patients to be informed and more able to identify the increase in their bills.
Complex Kinds Of Care
They can possibly determine for themselves whether they really need to be billed for more complex kinds of care. If they have been receiving the exact same kind of treatment but it is suddenly double the cost then this should keep them alert about what is going on. Any patient that suspects that their health care bill is fraudulent should speak up about it and not let it slide.
They are possibly paying for exams or procedures that were never performed on them. Many people believe that these problems are a result of such a rapid change in the health care system to the electronic form of billing that is now being used by so many hospitals. The hope is that eventually there will be more guidelines and awareness to prevent this kind of abuse
from happening on a grander scale in the future.
Kenneth Gray is founder of A-Fordable Billing Solution a Pasadena based medical billing company helping individuals and providers through their medical coding webiste.