By using this site, you agree to the Privacy Policy and Terms of Use.
Accept
Health Works CollectiveHealth Works Collective
  • Health
    • Mental Health
    Health
    Healthcare organizations are operating on slimmer profit margins than ever. One report in August showed that they are even lower than the beginning of the…
    Show More
    Top News
    physical health
    5 Ways Playing Games Can Improve Neural and Physical Health
    September 9, 2022
    Reasons For Hair Loss and Its Treatment
    Reasons For Hair Loss and Its Treatment
    February 16, 2022
    healthcare organization
    5 Actionable Strategies For Healthcare Organizations
    August 15, 2022
    Latest News
    6 Essential Strategies for Improving Your Medical Practice
    January 25, 2023
    Staying Positive While Living with Mesothelioma
    January 24, 2023
    The Many Health Benefits of Being Outdoors
    January 17, 2023
    How to Assess a Safe Placement of a Nasogastric or Nasoenteric Tube and Its Complications
    January 19, 2023
  • Policy and Law
    • Global Healthcare
    • Medical Ethics
    Policy and Law
    Get the latest updates about Insurance policies and Laws in the Healthcare industry for different geographical locations.
    Show More
    Top News
    Here’s What To Know And Expect About The Future Of Healthcare
    January 22, 2020
    How Your Healthcare Facility Can Ace Their Patient Safety Survey
    February 5, 2021
    Consider These Benefits Of Concierge Healthcare For The Elderly
    July 7, 2020
    Latest News
    Simplifying the Genetic Testing Process: How At-Home Kits are Changing the Game
    January 25, 2023
    9 Hospitals That Have Introduced Green Initiatives
    January 25, 2023
    Why a Health Retreat Can Be the Best Medicine
    January 12, 2023
    Best Money-Saving Tips for Health Managers
    January 12, 2023
  • Medical Innovations
  • News
  • Wellness
  • Tech
Search
© 2023 HealthWorks Collective. All Rights Reserved.
Reading: Upcoding
Share
Sign In
Notification Show More
Latest News
ABA therapist
Everything You Need to Know About Applied Behavior Analysis
Health
Small Lifestyle Changes That Can Have A Big Impact On Your Well-Being
lifestyle Wellness
The Future Of Medicine: How Immunotherapy Is Saving Lives
The Future Of Medicine: How Immunotherapy Is Saving Lives
Technology
medical practice and technology advancement
6 Essential Strategies for Improving Your Medical Practice
Technology
digital dental x-ray
How Does A Digital Dental X-Ray Work?
Dental health
Aa
Health Works CollectiveHealth Works Collective
Aa
Search
Have an existing account? Sign In
Follow US
  • About
  • Contact
  • Privacy
© 2023 HealthWorks Collective. All Rights Reserved.
Health Works Collective > Policy & Law > Upcoding
Policy & Law

Upcoding

JasonShafrin
Last updated: 2011/04/19 at 1:31 PM
JasonShafrin
Share
2 Min Read
SHARE

Would Congressman Ryan’s proposal solve this problem?

Would Congressman Ryan’s proposal solve this problem?

Medicare Part B pays outpatient physicians according to the billed Current Procedural Terminology (CPT) codes, which differ in procedure and intensity….Using nationally representative data from the 2001 to 2003 Medicare Current Beneficiary Survey, this paper…finds strong evidence that these fee differentials influence physician’s coding choice for billing purposes across a variety of specialties. For general office visits, Medicare outlays attributable to upcoding may sum to as much as 15% of total expenditures for such visits.

Likely no. For physicians paid by private insurers, they would still have an incentive to upcode. It is possible that private insurers may be better at policing upcoding, but their extra vigilience may also cause physicians to hesitate from providing necessary services since they fear they’ll be targeted for upcoding. On the other hand, for integrated managed care organizations like Kaiser Permanente, they have the opposite incentive. These providers are rewarded for reducing cost and thus insurers may claim to have providers services they did not in fact perform.

More Read

getting into medical school

6 Tips for Getting Into Medical School

Do You Need Life Insurance? What Does It Cover?
5 Ways New Technology is Revolutionizing Health
Are your Health Workers Properly Protected?
Your Study Path in Nursing: Hardships in Education and How to Overcome Them

Although privatizing Medicare and/or Medicaid could solve some problems, upcoding is not likely to be one of them.

  • Brunt, C. S. (2011), CPT fee differentials and visit upcoding under Medicare Part B. Health Economics, 20: 831–841. doi: 10.1002/hec.1649.

TAGGED: health care policy, insurance

Sign Up For Daily Newsletter

Be keep up! Get the latest breaking news delivered straight to your inbox.
By signing up, you agree to our Terms of Use and acknowledge the data practices in our Privacy Policy. You may unsubscribe at any time.
JasonShafrin April 19, 2011
Share this Article
Facebook Twitter Copy Link Print
Share
Previous Article Triad Group Taints Smith and Nephew Device Company With Recalled Wipes
Next Article Doctor Busted For Patient Information Inadvertently Exposed on Facebook

Stay Connected

1.5k Followers Like
4.5k Followers Follow
2.8k Followers Pin
136k Subscribers Subscribe

Latest News

ABA therapist
Everything You Need to Know About Applied Behavior Analysis
Health January 26, 2023
Small Lifestyle Changes That Can Have A Big Impact On Your Well-Being
lifestyle Wellness January 26, 2023
The Future Of Medicine: How Immunotherapy Is Saving Lives
The Future Of Medicine: How Immunotherapy Is Saving Lives
Technology January 26, 2023
medical practice and technology advancement
6 Essential Strategies for Improving Your Medical Practice
Technology January 25, 2023

You Might also Like

at-home genetic testing method kits
Global Healthcare

Simplifying the Genetic Testing Process: How At-Home Kits are Changing the Game

January 25, 2023
green hospitals
Hospital Administration

9 Hospitals That Have Introduced Green Initiatives

January 20, 2023
benefits of going on a health retreat
Global HealthcareHealth

Why a Health Retreat Can Be the Best Medicine

January 12, 2023
saving money in healthcare
BusinessGlobal HealthcareHospital Administration

Best Money-Saving Tips for Health Managers

January 12, 2023
//

We influence million of users and is the most authentic source of information on healthcare business and technology news.

Quick Links

  • About
  • Contact
  • Privacy
Subscribe

Subscribe to our newsletter to get our newest articles instantly!

Follow US

© 2008-2023 HealthWorks Collective. All Rights Reserved.

Removed from reading list

Undo
Welcome Back!

Sign in to your account

Lost your password?