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So, in an unexpected instance of "the system works" would this imply that the frequent flyer hypochondriac who asks the doctor dozens of follow up questions, thereby turning a 15 min consultation into a 45 minute one, will actually end up paying (either directly, or via their insurer) more?
Fuck. That. Noise. So, an army of functionaries use their best judgement to try to translate a doctor's notes into one or more of a series of codes to reconstruct the exact service provided? I thought lawyers billing me in 15 minute increments was bullshit. After the fact reconstruction of what happened layered with overly hierarchical categorization is a new level of theft.
Depending on your perspective it's either far better or worse than you imagine.
The physician's note was historically designed as a record of medical decision making on a patient and we are still primarily trained in this task. However they are now used as a record for billing, a record for legal ass covering, delivered to patients, used for cross staff communication, and as repository of information for research purposes.
As there is the greatest financial interest in doing so you more often see time and effort spent on maximizing billing but it's totally reasonable.
If I see a patient with high blood pressure I'm going to write something like "yo this patient has hypertension get some amlodipine in here stat."
Then the insurance goes oh we aren't going to pay because you didn't establish this patient has hypertension. What do you mean their blood pressure is high and its been high for 20 years and the last doctor had them on amlodipine.
Nope no hypertension.
(Billing staff: psst doc write primary hypertension)
.....Primary hypertension.
OH WHY DIDNT YOU SAY SO HERE HAVE SOME MONEY.
The classic for a long time was the Review of Systems which is sort of deprecated now but had resulted in tens of thousands of doctors being trained that if they didnt ask about renal, dermatologic and reproductive symptoms they couldn't get paid for this trauma patient whose arm fell off.
"The patient was anesthetized!!!!!" "Well just write 'patient declined to answer seven times.'"
It's not charging you for every 15 minutes of time like a lawyer its struggling to get paid for stuff we clearly did.
Yes some fraud and abused exists but essentially every physician has to be constantly thinking "what humps do I jump through to get paid for the basic standard of care thing I did."
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I mean, that's the problem. The system can be issue-based or it can be time-based. But it can't be both.
Bruh, we're at 0.1 hr (6min) increments. And I'm happy enough about it because they do good work and don't waste time. Remember you are paying a professional to deal with arbitrary issues.
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