Alexandria Ocasio-Cortez

[AM64]

Well that's just a lie. It isn't the ACA that is causing these problems. A lot of it is the expense and labor that goes into billing and getting paid by a half a dozen insurance companies, that use their own coding, and cause massive headaches.

Single payor would eliminate that and billing would be uniform in coding DRGs.

By single payor do you mean the multiple contractors that governments use to fulfill programs like Medicaid and TriCare. You mean that kind of consistency???

 

[AM64]

You are ****ing full of ****.

Absolutely right; you'd be amazed at some of the creative DRG coding that Blue Cross did in paying TennCare claims. Many were paid correctly and then "reviewed" and "recalculated" with big takebacks and smaller payments. When auditors get bonuses based on savings, they get really creative in reordering the CPT codes that get dumped into the DGR grouper ... somebody wasn't admitted for a broken leg - it was obviously that he was a smoker that required the hospitalization.

 

[T-TownVol]

By single payor do you mean the multiple contractors that governments use to fulfill programs like Medicaid and TriCare. You mean that kind of consistency???

He will have to check the talking points and get back to ya.

 

[hog88]

Well that's just a lie. It isn't the ACA that is causing these problems. A lot of it is the expense and labor that goes into billing and getting paid by a half a dozen insurance companies, that use their own coding, and cause massive headaches.

Single payor would eliminate that and billing would be uniform in coding DRGs.

Completely false. Billing codes are universal.

CPT - CPT Codes - Current Procedural Terminology - AAPC

 

[AM64]

Completely false. Billing codes are universal.

CPT - CPT Codes - Current Procedural Terminology - AAPC

They are, hog. And they are set in an order as primary and a series of secondary codes. The procedure is pretty much foolproof ... until someone decides to re-rank the CPT codes. Reordered codes will chance the DRG. It's a system that makes a lot of sense until somebody diddles with it.

 

[T-TownVol]

They are, hog. And they are set in an order as primary and a series of secondary codes. The procedure is pretty much foolproof ... until someone decides to re-rank the CPT codes. Reordered codes will chance the DRG. It's a system that makes a lot of sense until somebody diddles with it.

One can purposely use the wrong code to manipulate coverage/payments, but NO ONE makes up their own codes........well, except for the ones that make up just about everything they post on VN.

 

[lawgator1]

Doctor Shortages Explode Thanks To ObamaCare
https://www.investors.com/politics/editorials/doctor-shortages-obamacare-ehr/
Aug 20, 2018 - Health Reform: A year before ObamaCare became law, an IBD/TIPP Poll warned that it would lead to doctor shortages because many would quit or retire early. ... Another survey found that nearly two-thirds ofdoctors feel burned out, depressed or both. This is already having a significant effect on patient access to doctors.

Great source you have for that.

In July 2009, an editorial in Investor's Business Daily claimed that physicist Stephen Hawking "wouldn't have a chance in the U.K., where the [British] National Health Service (NHS) would say the life of this brilliant man, because of his physical handicaps, is essentially worthless."[19] Hawking was British, lived in the United Kingdom nearly all of his life, and received his medical care from the NHS. IBD later removed the editorial's reference to Hawking in its online version and appended an "Editor's Note" which said, "This version corrects the original editorial which implied that physicist Stephen Hawking, a professor at the University of Cambridge, did not live in the UK."[20][21] Hawking himself responded, "I wouldn't be here today if it were not for the NHS. I have received a large amount of high-quality treatment without which I would not have survived."[22]

So they insulted the man and falsely claimed that socialized medicine would not have helped him. Then, when caught, they deleted the claim and lied about why they took the reference out of their editiorial. Shameful publication, especially on this subject.

 

[lawgator1]

They are, hog. And they are set in an order as primary and a series of secondary codes. The procedure is pretty much foolproof ... until someone decides to re-rank the CPT codes. Reordered codes will chance the DRG. It's a system that makes a lot of sense until somebody diddles with it.

I get that DRGs are the same, but don't different insurers use different systems to actually submit the billing?

 

[T-TownVol]

Great source you have for that.




So they insulted the man and falsely claimed that socialized medicine would not have helped him. Then, when caught, they deleted the claim and lied about why they took the reference out of their editiorial. Shameful publication, especially on this subject.

Sad that you only use this logic on articles that you disagree with. All have had stories that were wrong, does not mean all their stories are wrong.

 

[hog88]

I get that DRGs are the same, but don't different insurers use different systems to actually submit the billing?

Don't know that answer but so what? Almost all of our clients have gone to one form or another of electronic invoicing and they most definitely don't use teh same codes. Most businesses have to deal with that.

 

[lawgator1]

 

[LouderVol]

i love when numbers actually get thrown out.

we currently spend 583 billion on medicare. its already 14% of our budget. you want to grow that by more than 5x? Medicare would be 70% of our budget then. Good job saving us money.

you are also double dipping on your savings. 1.5 on premiums & 1 on admin costs. where do you think those admin costs get paid? its part of the premium.

further, there are no savings. instead of paying insurance.com for our coverage we are paying insurance.gov with our taxes.

also just for S&G 3 trillion over our entire population works out to be just over 9k per person. I can only speak for myself but that would be a HUGE increase in my spending for healthcare. and then you have to factor in that not everyone, kids, elderly, unemployed, aren't paying into this and you are increasing the tax burden on middle America by more than 10k per person. probably ends up costing us a lot more.

there are apparently 141 million tax payers. 3 trillion a year would cost us $21,276 each, if we are fair and equal.

tell me again how this is saving us money?

bump for @lawgator1

he must have missed this. I am sure he has a ready response.

 

[AM64]

I get that DRGs are the same, but don't different insurers use different systems to actually submit the billing?

I'm not quite sure what you are asking, and it's been several years since I was involved in auditing the insurance underpayment issue, so there are likely many changes since then with respect to claim submission and payment. The system shouldn't matter though; the result should always be the same. Years ago 3M wrote the program (don't know if they still do) and most users apparently bought that; Blue Cross of TN wrote their own program using the standard criteria. It's a pretty straight forward process that should always yield the same DGR when the CPT codes are input in the proper order.

 

[LouderVol]

imagine a party that believes the fix is a political idea that has ensured that .1% of the population controls all the wealth, while the 99.9% are more or less literally enslaved to them.

 

[C-south]

That 1% is dims. The wealthiest of the wealthy are predominantly libs yet they throw money at things to promote division and globalism instead of the things their pawns cry for.

 

[Orange_Vol1321]

He's right.

The only thing I've heard mentioned so far that is not totally out of the question is "Medicare for all." Mind you, I don't think it will pass all at once. But it makes sense to gradually expand the groups that participate and pay for it along the way with Medicare taxes to self-sustain.

The cost to fund it for all would be approximately $3 trillion/year. Currently, we spend $1.5 trillion on premiums, and the savings from administrative costs alone would be over $1 trillion. So we can come close just in nixing premiums and cost savings.

And that means no uninsured problem and no deductibles or copays. So there would be substantial savings there, as well.

I don't expect this to happen any time soon. The companies making a TON of money off the current system will fight it and portray it with so much negativity that it just can't pass. But slowly expanding it would. So that's the way to go.

Nope.

 

[T-TownVol]

You post some stupid crap.........

 

[0nelilreb]

There are Drs and nurses on this board , why don’t you ask them what the differences are in dealing with Gov. Insurance vs private . Get the info from people who actually deal with it everyday and it’s their job to know ? I bet the answers will shock you , or maybe not if you don’t believe them .

 

[Weezer]

I see similarities. Does this make Trump Bullwinkle?

 

[lawgator1]

There are Drs and nurses on this board , why don’t you ask them what the differences are in dealing with Gov. Insurance vs private . Get the info from people who actually deal with it everyday and it’s their job to know ? I bet the answers will shock you , or maybe not if you don’t believe them .

I was hoping some would weigh in.

 

[nuclearjunky]

I was hoping some would weigh in.

Hold on while I create a DRvolhater troll account and I’ll get back to you

 

[1972 Grad]

I was hoping some would weigh in.

delete

 

[CABVOL]

Well that's just a lie. It isn't the ACA that is causing these problems. A lot of it is the expense and labor that goes into billing and getting paid by a half a dozen insurance companies, that use their own coding, and cause massive headaches.

Single payor would eliminate that and billing would be uniform in coding DRGs.

The ACA caused a huge portion of doctors to leave their practices and join hospitals. This was due to the huge amounts requirements the ACA placed on physicians and their practices. They simply could not afford the new EHR software and the staffing requirements needed to accommodate the ACA guidelines.

Anyone notice how much time goes into answering all the same questions every time you see a physician? And I mean before you ever see the physician? These are requirements of the ACA. Did you know if they don’t ask you those questions and meet all the requirements by the ACA, Medicare will swoop in after an audit and start docking the payments (very little already). How much they dock is based on how many of their requirements you failed to meet.

Also, not all hospitals get paid by DRG. Critical access hospitals are on a completely different pay scale.

 

[AM64]

Alexandria Ocasio-Cortez and Elijah Cummings prepare to battle Trump with re-energized House Oversight Committee

This should be good.

 

[joevol33]

Can you all please get back to posting memes of my girl saying stupid stuff?