Well this is interesting. Observation re: medical billing
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Archived from the IMDb Discussion Forums — General Discussion
Lilith — 7 months ago(August 15, 2025 05:09 PM)
I just received an EOB with regards to a doctor's appointment. It was billed as "established patient, moderate mdm (30-39 minutes)". I'd like to know how that was even remotely possible when the visit was less than 5 minutes in length. It took about 2 minutes to take my vitals, and I was seen by my provider for, if I am being generous, 5 minutes and quite probably less. She came into the room, asked me if there were any changes, confirmed what prescriptions needed to be refilled, and sent me on my way. There were no conversations, no in-depth discussion, no review of my history. It was just a confirmation that this was a routine check-in, and she said, "Okay, you're good," and said I could leave and to have a nice day. I've been seeing her for I think it's been 2-3 years, and I'm very consistent with no big changes in my life, so I'm an easy and quick appointment. Always. So how do they get away with billing for this quickie appointment as being 30-39 minutes unless they're counting the time I sat out in the waiting room after I checked in before they called me back.
I can't believe they can get away with billing falsities like this. I know for a fact that their appointments are booked 15 minutes apart as well. They would have to be open 12 hours a day seeing patients for this to be legit, but their office hours are only 6 hours per day. The math ain't mathing here.
"Your emotional state is not my responsibility." – Warren Smith -
HollyJollyHanukka — 7 months ago(August 15, 2025 05:23 PM)
It’s the way the biling system is set up. MDM means moderate, multiple problems with some that are chronic and/or acute with a risk of complications. They take into account time it takes doctor to review your records before seeing you. If it was one issue or just to have a prescription refilled, they might have coded it wrong. Or they would not get paid because the coding system changes every year with your insurer.
If you can’t say something nice, say something clever but devastating. -
Lilith — 7 months ago(August 15, 2025 06:42 PM)
It was simply an appointment to get my Rx refilled and nothing else. Nothing has changed. This is a routine visit that I have to maintain to fill my medication. I've been with the same provider for many years, and again, nothing has changed. I hear her outside the door reviewing my chart before she walks in, and she reviewed my chart, that of a patient she's been treating for years, for a few minutes, before walking in, confirming my identity and what I was filling and sending me on my way.
I could understand it if I was there to get new medications or if I was having some other type of health condition that needed to be checked out. But as I said, I'm very consistent and well-managed and everything is always the same. It may well be justified on some level but from my perspective, it feels like an abuse of the billing codes.
"Your emotional state is not my responsibility." – Warren Smith