Upcoding

emr

Ready for the new controversy in healthcare?  Before electronic medical records took over there was a criticism of doctors that they didn’t put enough information or  documentation in the patient’s chart for each visit.    This was really for billing and coding purposes and in no way reflected reality or the work doctors did with a patient.   Doctors were punished for this by not being able to bill as much for each visit.   With the advent of the EMR or EHR there came an advantage to the new technology.  It made it easier to code each visit and get an optimal reimbursement.    Of course, no advantage can ever go to the physicians so that will have to stop as well.  In a new American Medical News article, they list how the Centers for Medicare & Medicaid Services are now scrutinizing the accuracy of physician documentation who use the features of electronic health record systems to support their billing. “Auditors and lawmakers have suggested that recent increases in the rates at which doctors bill costlier, higher-level services could be attributable to the enhanced billing capabilities provided by EHRs.”  We are damned if we do and damned if we don’t!   The whole thing is a stupid cat-and-mouse game anyway.  Coding and billing and auditing are creations of the insurance companies who want to screw docs out of payment.   Any benefits given to the physicians will soon be removed by the all powerful insurers.   And the worst part is that none of it means anything to patient care.  That is why a “monthly membership” model without billing a third-party would remove all this.  Without the risk of auditing the only thing that would be placed in the chart is the basic SOAP note and those things pertinent to the patient’s care.

 

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