Medicare denies more claims than all private insurance combined

[Kasz216]

ManusJustus said:

Kasz216 said:

ManusJustus said:
IRT, this topic is horribly ignorant, and its obvious that the aritcle and topic creator have no idea how health insurance works in America. Private insurance companies are very clear about how much they can pay, for instance the doctor knows that they will pay 80% of the operation after a deductible of $500, so thats how much you bill for. Medicare will pay for almost anything, which is why doctors bill them for everything and even scooter saleman will file a claim on a patients behalf.

 

Medicare doesn't "Pay for anything". 

They only pay for nessesary services... and what they pay for and don't is clearly laid out.

These claims are "after service" claims.

Which is actually what those "scooter" guys do.  They look at the info you've provided and the medicare standards... and see if you qualify.  The only reason they only do it for medicare is that medicare is by far the largest provider.

Something being necessary or unnecessary for a patient isn't clear.  Also, you can't expect doctors to know the nuances of medical billing.  Why not bill if you aren't sure?  Why not bill for more if they are going to pay a percentage of what you ask?  Why not bill them for things you didn't do to make up for what they wont pay?  On top of that, many Medicare patients dont pay their bills.  My hospital doesn't even send a due date with the bills they send out because they dont expect people to pay them.  If the patient you just saw isn't going to pay for anything, why not bill Medicare and recoup some of your loses?

Medical Billing is horrible, if they put more people on salary less people would see Medicare and other insurance providers as a cash cow.

I can't expect doctors to know the nuances of medical billing.

I CAN expect the doctors to know the nuances of Medicare billing.  The LARGEST insurance provider in the country... which you need to adopt in to and is supposed to have one of the most straight foward billings and claims process out there.  If your a medicare doctor... chances are medicare is a large amount of your buisness.

Your arguement is that they make more claims on the system that is most used, they come across the most and is supposed to be one of the most straight foward.

That defies common sense.