Derek Thompson
๐ค SpeakerAppearances Over Time
Podcast Appearances
Tim, the term that we've used today is upcoding, and contained in that term suggests the idea that there is an optimal code that we should use for people, and that Medicare uses the right code, and Medicare Advantage upcodes, therefore uses the wrong code.
Tim, the term that we've used today is upcoding, and contained in that term suggests the idea that there is an optimal code that we should use for people, and that Medicare uses the right code, and Medicare Advantage upcodes, therefore uses the wrong code.
Is it possible, actually, that Medicare is undercoding, or that historically we've been undercoding, and that in a way, what we're talking about as waste is actually a lot of doctors and insurance companies recognizing the true illness of patients rather than exaggerating their illness.
Is it possible, actually, that Medicare is undercoding, or that historically we've been undercoding, and that in a way, what we're talking about as waste is actually a lot of doctors and insurance companies recognizing the true illness of patients rather than exaggerating their illness.
Is it possible, actually, that Medicare is undercoding, or that historically we've been undercoding, and that in a way, what we're talking about as waste is actually a lot of doctors and insurance companies recognizing the true illness of patients rather than exaggerating their illness.
Mike, I'm thinking about this as like blame pie. In the little play that we did where I was the pre-diabetic 80-year-old patient, it seemed like the insurance company got the biggest slice of the blame pie. In some cases, maybe it's the doctors who have the bigger slice of the blame pie. They're the ones doing the upcoding. But I was reading some journalistic reports of diagnostic codes.
Mike, I'm thinking about this as like blame pie. In the little play that we did where I was the pre-diabetic 80-year-old patient, it seemed like the insurance company got the biggest slice of the blame pie. In some cases, maybe it's the doctors who have the bigger slice of the blame pie. They're the ones doing the upcoding. But I was reading some journalistic reports of diagnostic codes.
Mike, I'm thinking about this as like blame pie. In the little play that we did where I was the pre-diabetic 80-year-old patient, it seemed like the insurance company got the biggest slice of the blame pie. In some cases, maybe it's the doctors who have the bigger slice of the blame pie. They're the ones doing the upcoding. But I was reading some journalistic reports of diagnostic codes.
And I saw that many doctors say that they are advertised software programs that promise to make them more money. And those software programs essentially do the upcoding of the patients themselves, right? The software developers are like, we promise that we'll make you a physician more money. How do we make you more money?
And I saw that many doctors say that they are advertised software programs that promise to make them more money. And those software programs essentially do the upcoding of the patients themselves, right? The software developers are like, we promise that we'll make you a physician more money. How do we make you more money?
And I saw that many doctors say that they are advertised software programs that promise to make them more money. And those software programs essentially do the upcoding of the patients themselves, right? The software developers are like, we promise that we'll make you a physician more money. How do we make you more money?
We essentially take every pre-diabetic and we code them as type two diabetic and voila, you end up getting a larger payment to your clinic. How big of the blame pie here should go to the software that these companies are using?
We essentially take every pre-diabetic and we code them as type two diabetic and voila, you end up getting a larger payment to your clinic. How big of the blame pie here should go to the software that these companies are using?
We essentially take every pre-diabetic and we code them as type two diabetic and voila, you end up getting a larger payment to your clinic. How big of the blame pie here should go to the software that these companies are using?
This is the problem with you economists. I keep wanting to cut up the blame pie with economists when I talk about healthcare. And they always say that we don't believe in moral systems. Well, I believe in moral systems. So pretend you're me and give me an approximation for the blame size pie percentage.
This is the problem with you economists. I keep wanting to cut up the blame pie with economists when I talk about healthcare. And they always say that we don't believe in moral systems. Well, I believe in moral systems. So pretend you're me and give me an approximation for the blame size pie percentage.
This is the problem with you economists. I keep wanting to cut up the blame pie with economists when I talk about healthcare. And they always say that we don't believe in moral systems. Well, I believe in moral systems. So pretend you're me and give me an approximation for the blame size pie percentage.
Tim, you and Michael first started looking at upcoding about 10 years ago. How much more prevalent has this practice got in the last 10 years?
Tim, you and Michael first started looking at upcoding about 10 years ago. How much more prevalent has this practice got in the last 10 years?
Tim, you and Michael first started looking at upcoding about 10 years ago. How much more prevalent has this practice got in the last 10 years?