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Politics : Formerly About Advanced Micro Devices -- Ignore unavailable to you. Want to Upgrade?

To: Alighieri who wrote (741173)	9/23/2013 1:19:13 PM
From: i-node	1 Recommendation Recommended By TimF Respond to of 1577019

>> There is no way to know that....private insurance is not immune from it. Besides, private insurance manages a much simpler demographic. Private insurance isn't immune but they do a far better job, and have for years, of claims adjudication. While private insurance companies don't advertise fraud when it happens, the fact that Medicare finally bit the bullet and implemented the same fraud detection software that private insurance companies use says something. Unfortunately, it hasn't thus far been successful with Medicare. The problem is the bureaucracy doesn't understand how to prevent fraud. For example, for a provider to get enrolled with Medicare is a months-long process that includes 100s of pages of paperwork. The idea is that this enrollment process somehow prevents fraud. Yet, private insurers do not require enrollment at all -- you file a claim, and if it is a valid claim, it is paid. No bullshit to deal with. So, why does Medicare still have a fraud problem measured in the 100s of billions? Because their emphasis is in the wrong place. It isn't provider enrollment that generates fraudulent payments; it is fraudulent claims. This has been obvious for a decade or more, yet they can't fix it. As to a "simpler demographic", that's nonsense. Private insurance has EVERY demographic. Medicare has OLD PEOPLE. What could be simpler? You're just talking, Al.