Saturday, December 24, 2011

Hello Old Friend

Since you are a world renowned author and authoring another book, I thikn.  I ike to take this time and say it was nice to know you when you were just a lowly shrink. Best of Luck my old frined in all you do.

God Bless,

Wednesday, December 7, 2011

Physician Coders, Pearl Harbor Annniversary and other issue

Well I passed my Billing and Coding Exam for the AAPC, the American Association of Professional Coders. That is sort of the world that gets physicians and facilities sometimes paid. Every bill to a third party provider that is Medicare of a Private Insurance Company has to have a Diagnostic Code and a Procedural Code. There are thousands and thousands of codes, with several digits. For example the diagnostic code for PTSD is 309.81. In the billing and coding world if you don't bill the right and correct code and have the proper documentation it is a reason and an excuse for an insurance company to not pay the doctor or a facility, or at least delay payment. It is not like medicare or insurance companies have money sitting around and just can't wait to pay doctors. When you can delay payment or simply not pay a doctor and hope that no one notices, that money sits somewhere, typically it is gaining a bit of interest. So to delay payment or not pay is cost effective for the insurance company no matter whom it is. Most people that work in billing and coding do not understand this part. Moreover most people think doctors get paid lots of money anyway, way too much and this makes people angry, this attitude actually provides support to a system designed not to pay doctors if they don't have to.  Most people are oblivious too it.
Now there are tens of thousands of people that work in billing and coding. Keep in mind they have families they have to support and feed. The money to pay them comes from somewhere. It is considered a health care cost.
I took the certification exam because I wanted to understand this world. Most doctors coming out of residency and medical school don't even know a thing about billing or coding. We rely on others to do it for us. Of course without physicians there would be no billing or coding jobs. There are only a handful of physicians in the country that are certified coders. I suspect some or most of them are good business people. I know nothing about business.
Billing and Procedural Codes have nothing to do with the practice of Medicine, most coders don't believe that. The exam was 5.5 hours long. I had to go to the bathroom during the test, but could not allow myself the time, since the clock does not stop. To pass the test and become certified you need a 70%.  I was sure I flunked. Lots of people flunk. I got a 90%. I was happily surprised. I am turning fifty in one day and I worry that I am not as cognitively sharp as when I was 20 years old. However this test that lots of people flunk reassured me a bit- that I still got it.
The test is hard and chaotic like the world of billing and coding. You actually sort of have to think more like an attorney than a doctor. Find those hairline splits of the black and white dogma and make an interpretation. Remember lots of lawyers wanted to be doctors, but very few lawyers "settled" for medical school. Medical School is harder. The coding certification test was really hard. Maybe as hard as a test in medical school.
I take care of patients all day, every day. regardless of how I feel or how I am doing. I get to give 110% every day to patient care. Call it a responsibility, a burden or a privilege, it is what it is and I probably won't quit my day job anytime soon to be a coder. If many people and entities have their way, we can maybe drive most doctors out of the practice of medicine and make it so arduous to practice medicine that no one wants to go to medical school. Then nurses, technicians and computers can practice medicine, the masses of people will be so dumbed-down by society, that they maybe won't know the difference. Some think this will save money. It won't. I dont' know if this will happen in my lifetime, but I am happy to be a bit more versatile with a certification in coding, should physicians practicing medicine become obsolete. I may have a marketable skill.+++

Now take a moment to remember in your hearts and in your prayers those Veterans of Pearl Harbor and WWII. It happened seventy years ago today. The last great generation, the last War the United States flat out won. I've visited  Pearl Harbor and I've been to Hiroshima. Both are incredibly moving places. There are not so many WWII veterans living anymore, they would be in their 90's, many of them. Thank God for them, because there is a good chance that I would not be writing this blog and you would not be reading it, if it was not for them. 

Talking about the book with the Lake Superior wind....... a calm day