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Politics : Formerly About Advanced Micro Devices
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To: bentway who wrote (523524)10/26/2009 12:12:37 PM
From: i-node1 Recommendation  Read Replies (1) of 1583001
 

The figure was just off the top of my head. But, a figure could easily be arrived at. Once an operation had been certified as legitimate, the restriction could be removed.

Idiot. An "operation" that hasn't been certified as "legitimate" (which is what the enrollment process is all about) can't bill in the first place. The entire process of provider enrollment is supposedly to insure that illegitimate providers aren't able to collect.

Problem SOLVED! At least THAT wholesale fraud avenue.

Exactly. You have no f*cking idea what you're talking about. Your solution to the problem is the same as hers -- more of the same crap that's failing now.

It isn't rocket science. Commercial insurances don't do enrollment, and don't have these massive frauds perpetrated against them. Enrollment isn't the solution.

Reasonable adjudication of claims is. Any commercial insurer knows that they have to look at what is being billed in a commonsense manner. Medicare never has, never will.

There is something wrong when a patient calls in, week after week, for six years, saying, "You're getting billed for services I didn't receive", that it keeps happening.

A person has to be pretty stupid to support MORE involvement in healthcare by government having seen this segment.
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