That’s part of the problem, for sure, but I’ve noticed an even bigger problem at the “ground level” of hospital billing and coding: almost everyone in hospital finance / revenue cycle is a moron.
Most billing mechanisms are hilariously poorly designed, poorly maintained, and at the highest levels are essentially held together with superglue and duct tape. The system as it exists is almost exclusively due to a sort of “blind watchmaker” mechanism.
I don’t know if anybody here has read Zach & Kelly Weinersmith’s new book (of SMBC fame) Soonish, but there’s a hilarious cartoon in it where there’s an amateur biologist saying something like “Nature is a wondrous tapestry!” contrasted with a professional one saying “It’s a goddamn cobbled-together nightmare of idiocy!”.
If people looking from the outside at the medical billing are the amateur biologist seeing a greater design in the whole mess, then I guess I’m the specialist saying “Nope, it’s a blind idiot with a meat cleaver all the way”.
A system structured like this is, if you think about it, really not ideal for either doing business or for making anyone superlatively rich - it just incurs insane overhead/administrative costs. I could easily design a “malicious” system, designed to extract tons of money for shareholders without delivering any extra value to patients, that’s much more efficient than this. No, the current system is was simply “failed into”, as a sort of ground state of incompetence.