So here’s the good for medicare: they are recouping more over payments than under payments.<\/p>\n
“Approximately 96 percent ($992.7 million) of the improper payments were over payments collected from providers, while the remaining 4 percent ($37.8 million) were under payments repaid to providers.”<\/p>\n
Every time a Doctor admits a patient to the hospital they follow certain guidelines.\u00c2\u00a0 These guidelines are written by the hospital to accommodate all insurances that they accept.\u00c2\u00a0 These guidelines are often strictly enforced by the hospital because they will not get paid if not followed.\u00c2\u00a0 Now that Medicare is broke, they are pushing harder and harder to recoup as much as they can.\u00c2\u00a0 This entire process has put a very dire outlook for Doctors who admit to hospitals.\u00c2\u00a0 Doctors have nothing to hide and operate in a very documented profession.\u00c2\u00a0 As standards change, Doctors change with it.\u00c2\u00a0 That is why the approval process is there, that if the Doctor feels the patient needs something then they have to make sure the insurance will cover it.\u00c2\u00a0 Really not the best thing for the patient, but that is the way it works.<\/p>\n
Now after years of a bad approval process, they are going back to try to recoup any over payment.\u00c2\u00a0 A simple example could be from a patient that was seen two years ago and one of the “RAC” scavengers finds that even though at the time the person was being admitted or taken care of in the hospital according to the guidelines of the hospital which was set forth my Medicare, that something was not done according to some new audited standard.\u00c2\u00a0 So they Medicare screws up in their approval process two years ago that resulted in overpayment to either the hospital or a Doctor.\u00c2\u00a0 Now two years later, Medicare is coming back to recoup payment plus interest for that hospital\/doctor.\u00c2\u00a0 The approval process was put in place to find make sure that medicare would pay for said procedure, but now they are turning around and changing their minds.\u00c2\u00a0 This is kind of like and IRS audit several years later.\u00c2\u00a0 This is creating more headaches then it is worth.\u00c2\u00a0 What I think has to happen here is that Medicare has to become more efficient on the initial approval process not try to go back years later to recoup where they screwed up.<\/p>\n
I wish I could do this when I make a bad trade.\u00c2\u00a0 I bet any business person who makes a bad decision on marketing or partnership wish they could just take it back two years later.\u00c2\u00a0 I guess when you are big government you have the ability to correct any mistakes at any time.\u00c2\u00a0 Of course this comes when hospitals and Doctors are already facing a 21% pay cut from Medicare.<\/p>\n
How many Doctors do you think will continue to accept these government run programs without being forced through licensing?<\/p>\n
![\"\"](\"http:\/\/www.cheapiv.com\/wp-content\/uploads\/nationalhealthexpend.jpg\" "\\"nationalhealthexpend\\"")
<\/a><\/p>\n