You are so much a part of the inefficient US system you can't see clearly. You are a part of the problem.
Nonsense.
The systems we install and the ones we compete with are modern, extremely efficient, and allow healthcare facilities to do their jobs better.
Here's the most recent example. Under HIPAA, effective March 23, all healthcare providers are required to use the "National Provider ID" -- the idea for which was a good one -- instead of each insurance company having a separate ID # for every provider, there is a standard ID for all insurance companies to use. Makes sense, right?
Of the 3000 or so private insurances, we have yet to find one that didn't make that didn't make the required implementation date. But Medicare and Medicaid?
Medicare claims are backed up all over the country because the Medicare system can't handle the job for incorporated sole providers. To add insult to injury, most of these providers are having to wait a month to find out they have a problem, because Medicare's antiquated computer system cannot "recognize" they have a problem with the claim on the front-end. In January, I spent 3 hours on the phone with a Medicare congressional go-between trying to explain how big this problem was going to be and she simply could not understand the problem. Not because she was stupid, but because they system is such a nightmare that few actually understand it. BTW, Medicare submitters now must have the NPI number on the claim. So far, so good. The only problem is that they STILL have the same old legacy numbers for internal use so that anytime you deal with them, you're talking legancy numbers. So, now, we have one more ID for every provider.
This problem is easily solved by filing additional paperwork with Medicare enrollment. Great. Except they are so backlogged with requests it is taking MONTHS simply to modify the tax ID they have on file for a particular provider. MONTHS to handle something that could be handled in minutes by fax or email.
Medicaid? Even worse. The implementation failed to take into account that state Medicaids need provider taxonomy data along with each claim. As a result, the "standard" claim is now having to be hacked to allow for a taxonomy code to be submitted in the field that was previously assigned to the legacy #. So, now we have ONE MORE number to deal with for every provider.
The point is that everyone EXCEPT government payors were able to get their work done. The government systems are so inefficient that it will likely be another two years before they straighten this problem out. We are getting phone calls from providers, not our customers, who had no idea they had a problem until they suddenly stopped getting Medicare checks.
I can assure you these guys fully recognize that if the only payor they had writing them checks was Medicare they would be in deep shit today. I don't think they're going to be willing to sign on to government run health care OR government run health insurance.
Again, your knowledge of this subject is below average. If you want to talk about it, fine, but at least find out something about the subject beforehand. |
