Doctors Say 1 in 5 Health Claims Mishandled

June 15, 2010

  • June 15, 2010 at 12:01 pm
    OH Guy says:
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    Sounds like the docs would prefer a simpler system like single payer to me. Billing will be simplified; denials, low reimbursement, slow payments, adminstrative headaches… all things of the past. Can’t wait! LOL

  • June 15, 2010 at 2:42 am
    Calichepit says:
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    To a doctor responding to an AMA survey, the only acceptable system would be one in which ALL bills were paid yesterday for an amount exceeding the bill with no exclusions, deductibles, co-pays, co-insurance. In other words, if I, the doctor, send the insurer a bill, no matter what it’s for and no matter how much it’s for, I should get paid immediately without qualm or quibble.
    That would work great until all the money was gone; probably, by the second day of each calendary/plan year.

  • June 17, 2010 at 9:36 am
    Mike says:
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    Hello,
    I’ve been on both sides of the fence over the last 25 years which include 10 years of handling claims for carriers/TPA’s as well 15 years on the healthcare provider side.
    The system has become so complex that it’s a wonder how any claims get processed/paid whatsoever..
    The interaction between payor rules (each one has different rules), governmental rules (what a nightmare this is!!)and provider systems (too cumbersome and staff often lacks training) has led to a challenging, and constantly changing, system to work with..I don’t know of a better way (certainly not the single payor option) to fix things but the systems is getting worse.
    Mike



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