ext_5459 ([identity profile] vvalkyri.livejournal.com) wrote in [personal profile] xiphias 2007-03-15 03:01 pm (UTC)

Yeah. That's one thing that really disturbs me. For the most part Medicare and some of the other big insurers simply state a price they'll pay for any given procedure, regardless of how much it costs the hospital. ("we don't care if he stays in the hospital 2 days or 20 - we're paying X for that surgery") One of the major ROI on my product is it reminds/guides clinicians into using the 'magic words' to document comorbidities. Medicare etc recognize that the guy who had a heart attack 2 months ago is more likely to be in hospital longer after the surgery. But if you just document "Previous MI" but not "Previous MI w/in 6 mos" you don't get the extra cash.

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