Our small doctor's office simply could not afford to do this. We muddled our way through attempts at having Medicare pay some small amount to patients—after they had paid the doctor—but met roadblocks all along the way. In the two years I worked there, I remember perhaps two nominal payments that patients received.
The coding system that doctors must use for reimbursements is unbelievably complicated. That is why most doctors pick about 20 or so codes and use only those, even though there are surely hundreds of more accurate ones. They know which ones get approved and which ones don't, so they use what works. It's not that they are being dishonest, just trying to simplify things. No one can go through the thousands of pages of codes and figure them all out. The system needs to be simplified. That way, doctors can save money on office staff and time, they can spend more time caring for patients, and Medicare staff and backlog could be cut substantially. Of course, this would cause loss of jobs, but surely there is something better most people can do besides trying to get around the system. Perhaps Medicare could hire staff to investigate fraud!
I would love to see some in-depth, true investigation into the coding system for insurance—including Medicare—and the costs involved in using it. Many people receive expensive treatments and tests when something such as a change in diet, exercise or acupuncture would not only be sufficient, but healthier. Why? Because the expensive treatments are covered and the healthier options are not. For example, patients with back pain can receive numerous tests and surgeries and hospital stays, fully covered, but if they first want to try acupuncture, which has been very effective for many people, it will not be covered.
Simplifying the unwieldy coding system should be one of the first things done in healthcare reform.
Briarcliff Manor, N.Y.
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