Quote:
Originally Posted by Velvet
To take your example of miscoding, say $270 vs $130 for the type of visit. For one year of over billing $90,000,000 they would have had to miscode 642,857 times in order to make such a difference. So each and every person in TV would have to have this “annual checkup” 4 times a year - every year for 4 years - to come up with the magnitude of the error.
Hmmm.
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Hmmm indeed! So - maybe - just maybe - you should accept that I said this was all hypothetical, an example of what kind of error might be made, and not focus on the dollar amount because the dollar amount clearly doesn't apply in the situation.
Consider the POINT:
A set of codes can apply to similar procedures. A billing error isn't a dollar amount. It's a coded diagnoses, which has a base cost attached to it.
WHATEVER THAT COST MIGHT BE....
Someone put in the wrong code, which came with a higher base cost than the correct code.
The result was an overpayment with no red flags, because the procedure attached to the code was correct, therefore not causing any red flags to go up.