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Thread: Coronavirus surge...

  1. #51
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    Quote Originally Posted by boatman37 View Post
    Sorry Rob. Didn't mean to sound like I was making fun of it but the fact is there are people dying from other issues and they are being labeled as COVID related. My step-son is a detective and talks to the coroner a few times a week and that is the practice, at least around here. My best friends pastor is a healthcare administrator and told him they get $37,000 for every COVID patient no matter what the outcome is so when you dangle that carrot I'm sure there are some shady statistics there. Not saying COVID isn't real or shouldn't be respected just that the politics and windfalls from it has kind of made people numb to it
    My wife spent over 40 years in hospital accounting. She says that the penalties for deliberately putting the wrong diagnostic code for a patient are such that any administrator who encouraged such fraud would have to be either stupid or crazy.
    John

  2. #52

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    Quote Originally Posted by J Anderson View Post
    My wife spent over 40 years in hospital accounting. She says that the penalties for deliberately putting the wrong diagnostic code for a patient are such that any administrator who encouraged such fraud would have to be either stupid or crazy.
    Agreed. I've worked for healthcare systems, on the IT side, for over 16 years. I'm not on the clinical side but even I get training on the importance of correct coding for services. We are subject to oversight and audits, unlike many of the politicians who make these idiotic claims. I would encourage people to take the time to research what they hear.
    Last edited by jaypeesmith; 12-17-2020 at 02:21 PM.

  3. #53

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    I had the flu last year. It was pretty terrible. I hope you’ll consider donating to my personal charity fund.

  4. #54
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    Quote Originally Posted by jaypeesmith View Post
    Agreed. I've worked for healthcare systems, on the IT side, for over 16 years. I'm not on the clinical side but even I get training on the importance of correct coding for services. We are subject to oversight and audits, unlike many of the politicians who make these idiotic claims. I would encourage people to take the time to research what they hear.
    I guess I don't have as much faith as you. Our local hospital was shut down a few years ago after a scam involving Jim Biden (Joes brother). I don't remember the details but you can google it. Lots of people I know lost their jobs and worked the last couple of months with no pay. The IRS raided it right after it closed and took all computer systems. I can see the hospital from my living room window.
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  5. #55

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    Quote Originally Posted by boatman37 View Post
    I guess I don't have as much faith as you. Our local hospital was shut down a few years ago after a scam involving Jim Biden (Joes brother). I don't remember the details but you can google it. Lots of people I know lost their jobs and worked the last couple of months with no pay. The IRS raided it right after it closed and took all computer systems. I can see the hospital from my living room window.
    It's not about "faith". It's about what I've experienced and what I know. You mentioned one instance but there are thousands of hospitals around the country. Also, in regards to this incident, this was allegedly tied to loan money being diverted for personal use, not doctors misdiagnosing conditions for profit.
    Last edited by jaypeesmith; 12-20-2020 at 12:32 PM. Reason: Typos

  6. #56
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    Quote Originally Posted by jaypeesmith View Post
    It's not about "faith". It's about what I've experienced and what I know. You mentioned one instance but there are thousands of hospitals around the country. Also, in regards to this incident, this was allegedly tied to loan money being diverted for personal use, not doctors misdiagnosing conditions for profit.
    You might be right. I am not completely familiar with the incident but I'd still bet there are some doing it. Maybe not a large scale but getting $37,000 per patient seems pretty tempting. I mean it would be pretty hard to disprove down the road. But more to my point was if a person has a serious pre-existing condition then comes down with COVID then dies from the original pre-existing condition will it be labeled as COVID related even though COVID may have had nothing to do with it? There is probably no way to know that for sure so maybe 50% of those were triggered by COVID where 50% of them COVID played no part in it other than they had tested positive? I guess that was more of my point. So if that person would have died even if they didn't have COVID will it still be counted as a COVID statistic?
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  7. #57
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    I was reading that it costs 20% more to care for a covid patient. That is why there is a higher reimbursement for covid patients. As long as the hospital has in the patient record that the patient tested positive for covid, they can code it as such for billing. Otherwise, they shouldn't. The article also said there have been very few instances of hospitals improperly coding patients, and the insurance companies are carefully checking claims too.

    I'm not saying there haven't been attempts by hospitals to try to max out their claims, but it would be risky for them to do it. If they do it, and don't have the proper documentation, they would have to reimburse the insurance companies if/when audited and they aren't going to want to get wrapped up in that.

  8. #58

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    Quote Originally Posted by Ryster View Post
    I was reading that it costs 20% more to care for a covid patient. That is why there is a higher reimbursement for covid patients. As long as the hospital has in the patient record that the patient tested positive for covid, they can code it as such for billing. Otherwise, they shouldn't. The article also said there have been very few instances of hospitals improperly coding patients, and the insurance companies are carefully checking claims too.

    I'm not saying there haven't been attempts by hospitals to try to max out their claims, but it would be risky for them to do it. If they do it, and don't have the proper documentation, they would have to reimburse the insurance companies if/when audited and they aren't going to want to get wrapped up in that.
    Not to mention the fines that can come with it. Back in the late 90's, before Rick Scott became the Florida governor and, later a Senator, he was the CEO of Columbia/HCA, a healthcare system. They were found to have falsely coded diagnoses to increase their reimbursement, billed Medicaid/Medicare for unnecessary tests and billed the government for home care visits for patients who didn't qualify to receive them. Columbia/HCA ended up having to pay fines that totaled $1.7 billion, as well as having to admit to committing 14 felonies.

    https://www.politifact.com/factcheck...-medicare-fra/
    https://www.sun-sentinel.com/opinion...002-story.html

    So, it would not be the smartest move for hospitals to try to cheat the system on this.

  9. #59
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    Well, I'm glad to hear Rob survived the ordeal. He's one of the first people I know personally that has had the disease. Actually, second...my ex-wife just got it...but she works in healthcare as a respiratory therapist...so I'm surprised she hasn't gotten it sooner.

    Like my politics, I'm kinda "in the middle" on the Covid debate. I don't consider it a hoax or overblown...but I also am not terrified of it. The statistics show that 85% or more of the fatalities are involving people over the age of 85 or with underlying health conditions. Do I have enough of "underlying health conditions" where I should be concerned? I don't know. Honestly, I could stand to lose some weight...I've smoked some medicinal marijuana in my day...so maybe thats enough to make me vulnerable despite being well below the 85-year threshold. Maybe not.

    But, ya know what...if it is...it is. We're all here for a certain amount of time...and then we're not. This isn't a permanent gig. My life sorta sucks anyways...so, if this is the end...so be it. I'd be more afraid if I just won the lotto or was on the verge of breaking into the PBA50 tour...ya know, just when things start going well...and then, "Boom"...here comes the shaft. But now? As George Burns said in his song, "I'm 3/4 home, from the start to the end..." so...whatever. God'll take me when he takes me. Would be nice to get that first 300-game in beforehand...but oh well.

    Besides...have you watched the TV lately? It's not like this World is really making much of a case for itself. It's one terrible poop storm after another. Everyone hates everyone for all kinds of different reasons...we're gonna die of some hurricane or forest fire or nuclear holocaust. Riots in the streets, shooters taking out people at public gatherings, a national debt so high that I can't even figure out what the number even means anymore, college education out of control, healthcare unaffordable, open borders, inmates being let out of overcrowded prisons, statues of the founding fathers being torn down, etc... And Murder Hornets! For crying out loud! Murder Hornets! There's times I watch TV and think I want to lick somebody with Covid.

    But hey, I bowled a 251 yesterday...so thats cool. That makes me less depressed. Was it worth the risk of contracting a potentially fatal disease? Weighing my risk factors...yes. Had I bowled a 147...no.
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  10. #60
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    The debate going on around here currently is around the businesses that are ignoring the shutdown order and staying open. One side is encouraging it, and vowing to only go to businesses defying the shutdown. The other side is saying those businesses are contributing to a health crisis and telling people to NOT support the businesses. It is the craziest thing. People moan and groan that everything is closing down, then businesses decide to stay open, and those same people are now saying it is wrong and the businesses should shut down. It makes my head hurt.

    My bowling center is staying open during the shutdown. I go once a week and that's it. No unnecessary time spent *anywhere* until things settle down. That's my choice. Others are more comfortable going anywhere at anytime, for as long as they want. That is their choice as well. I personally know three people on my league that got covid. Two are in the hospital (for a few weeks now), the third person recovered and is back to work. There are also people on the league who have members of their own household that got covid. Some of those people continued to come to bowling while their family members were at home with covid (that was probably not smart, but whatever.)

    Do I think the bowling center could do a better job following the guidelines and making their facility safer? Absolutely! However, that just means since they aren't doing much I just have to do what I need to do to stay as safe as possible while I am there. Mask at ALL times, don't touch too many surfaces, keep hands clean constantly, no eating/drinking, no high fiving, no touching my face/nose/eyes, all of that stuff.

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