Health care auditing needs growth

What if clinics could go to a service which would collect all these dribs-and-drabs, then send out a consolidated bill for overages six months after care? At least some of the money going through the system would not be wasted.

an auditorA shortage of auditing costs taxpayers billions of dollars a year.

The numbers finish big, but they always start small.

A recent Medicare study showed $700 million in possible fraud on that program alone.

Despite the shortage of scrutiny, health care providers whose aim is to cut costs report they are having a tough time.

Too bad we can't invest in the auditors themselves.

Of course auditing, by itself, won't make our problems go away. Here is where the story gets personal.

Our daughter had a cancer scare last spring. (She's fine, was fine, all is benign.) Insurance covered most of it, but we're still getting bills, in dribs and drabs, many months later.

This is not unusual, but the waste is in the size of the bills. $4.27. $6.03. $5.34.

Clinics run their bills through insurance, then ask patients to pick up the rest. I get it. But when you mail me a bill for $4.27, and I pay it by credit card, your net is a negative number.

Any good auditor would tell you that.

What if clinics could go to a service which would collect all these dribs-and-drabs, then send out a consolidated bill for overages six months after care? At least some of the money going through the system would not be wasted.

The point is there is an enormous opportunity in the back-end of the medical payments business, in detecting and eliminating wasteful payment procedures.

It's not sexy work, but it could be highly profitable. And computers are good at it.

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