Getting paid is key to medical success

Getting paid is key to medical success

Summary: Perhaps no area of medicine will change as much in the next five years as payment processing, according to a new McKinsey report. (Illustration from the cover of the report.

TOPICS: Health

McKinsey payment processing illustrationPerhaps no area of medicine will change as much in the next five years as payment processing, according to a new McKinsey report. (Illustration from the cover of the report.)

Right now a key difference between a practice's success or failure is having an assistant who can work the system and get you paid. Tossing the bills to a billing company isn't good enough.

That's because, unlike as in credit card processing, there's always someone looking over your shoulder. Getting charges accepted, and paid, is a skill set which goes far outside medicine.

So what would you like to see in a new medical billing system? What's the best way to keep fraud out but keep money flowing in? And how much control of your own billing system are you willing to give up for the benefits?

Discuss, and we'll get this beat started.

Topic: Health

Kick off your day with ZDNet's daily email newsletter. It's the freshest tech news and opinion, served hot. Get it.


Log in or register to join the discussion
  • Procedure vs Condition

    Please raise your hand if you believe we will be able to move from billing at the CPT code level to billing at the ICD-9 level. While I personally believe that both systems impose an artifical taxonomy upon provider and patient, we ought to be able to bill for treating the condition.

    My plumber doesn't bill me for each turn of the pipe wrench. He bills by the hour. I reckon I'd rather have an hourly rate from my doc, rather than an indecipherable EOB from an insurance company.

    My building contractor bills me by the job. He gives me an estimate +/- a small percentage. I can accept that. He knows what materials, time and labor are going into the job. Doesn't my doc?

    Maybe we, in the provider world, balk at ICD-9 billing because we really don't know how a given patient will respond to a given treatment. That's OK. Just tell me, the patient, what the risk of failure is. I'll decide to whether or not to risk my dollars on your proposed cure.

    ICD-9 billing would require the collection of real outcome results. We have the ability to do this. Perhaps, we lack the will.

    There are a few specialty groups who bill at the ICD-9 level, but they are rare exceptions.

    What would it take to get a critical mass of providers to bill at the ICD-9 level?

    I'd appreciate any feedback.


  • Paying up is key to medical care

    A patient needs medical care before he
    worries about payment for the reason of
    medical success.
    Ole Man
    • Is the Hippocratic Oath compatible with Adam Smith?

      The Hippocratic Oath states, first you do the work, then you worry about everything else.

      But the capitalistic system requires that at some point that is what you worry about.

      And these are in inherent conflict.