ponderingturtle
Orthogonal Vector
- Joined
- Jul 11, 2006
- Messages
- 54,796
I'm getting tired of people telling me I'm "confused" because they disagree with me. Short answer: items 1-4 are already being done by the government, via Medicare. Most insurance companies simply use the Medicare numbers as their base, then add on here and there to ensure profitability. Seriously. For those of us who have worked in reimbursement, the first thing a private insurance company says during an appeal is "well, Medicare only allows $X for that procedure".
And what exactly is "completely screwed up" about the "fed's" payments? Medicare payments are electronic now. They're faster, and far more reliable, than commercial insurers. Medicare doesn't indulge in retractions. The providers I worked for loved Medicare, because there was a much better chance of getting the money -- all the money-- owed, whereas commercial insurers liked to play games, sending less than is owed, hoping eventually the providers would give up and write off the difference. It can take three or four years for private insurers to pay up, and often it's after arguments and appeals and refiles.
But think about all the make work jobs for excess college graduates this process provides!