Anonymous
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Anonymous
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How can you say that the system is not broken?
If you can use old Holter codes to get paid for event monitoring- that is a problem.
When event monitors were originally set up for billing there was ONE hook-up fee, ONE technical component and ONE interpretation done at the end of the monitoring period. Some doctors decided to bill for EACH of the recordings done during the 30 days, so that if a patient used the monitor 8 or 9 times (which was the whole point of letting the patient keep it for 30 days) these doctors were billing for EACH of those recordings instead of billing once at the end of the period when the monitoring session was complete. This is another problem with the system.
I honestly think that some people didn't understand and acted out of a lack of understanding rather than with an intent to do something wrong. But some saw a way to beat the system and took advantage. Doctors and medical organizations abuse the system in the same way that some people stay on welfare for life. If you can do it, then why not?
THAT is a broken system.
I agree with you. However, you are wrong on one point. When event monitoring first came out a physician and service could bill for each transmission. This was soon changed because of the enormous cost to CMS. Given this, why would any company believe they could now start to bill daily just because they place a misleading term like " mobile telemetry" on a device? The sad fact is that there have and are a lot of "end rounds" in the system. What about paying physicians for "education hook ups"? I don't care what your company's legal dept opinion is, for $500/hr, they will say/write anything, it is not appropriate. The fact is this seems to be the only way some companies can distinguish themselves, because if comes down to service,they can't compete.