Upcoding Crackdown: Federal Efforts Fail to Benefit Private Insurers

For more than a decade, taxpayer-funded health care programs have seen a steady uptick in higher-paying billing codes. Office visits, outpatient services, and emergency room care have all been billed at progressively higher reimbursement codes, raising fees by billions of dollars. Many providers contend the shift is the result of sicker patients coupled with the

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EMRs: The Law of Unintended Consequences

The government has been pushing for electronic medical record keeping for many years.  The thought was it would drive efficiencies, reduce costs and improve care.  Billions in incentives have been spent trying to get hospitals and providers to upgrade their systems to allow for electronic medical record keeping.This New York Times article shows that Medicare

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We Are Creating Another Problem

I have often written about the issues caused by our medical industry with opioids.  We are creating addicts that in turn create unsatiable and recurring demand. As society sees the issues and takes action, some people will clean up and some will search for a way to satiate the addiction.One well-known and affordable source of

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Transparency in Medical Bill Review

Here’s a Rising article published in WorkCompWire. It’s on the importance of transparency in a bill review program. Transparency is about trust. It’s amazing to me how often I find programs with hidden or misleading data, and the client tolerates that behavior.  At Rising, if our partner isn’t transparent and open, then that partner is

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Some Appreciation for Coding

Most of us have looked at our medical bills with confusion.  I did when I had medical bills piling up.  It is a separate language and art form to understand healthcare billing in our society.  It is critical that someone look at your billing.  It is a sad fact that many medical providers are more

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