Milking The System

SOURCE: Linkedin
I used to work at a Blue Cross in the contracting department making fee schedules. When I saw the creative billings and code-shifting I thought “those dirty doctors. they’re printing money”.

Then I transferred to the payment integrity department. To my great disappointment they we’re letting the claims pay bad. They did not use the data to prevent bad payments for they take 30% of the claim amount for their recovery; and then take a bonus!? #complianceisajoke

What I’ve come to learn is that doctors and hospitals are raising their cost to recover the abrasion #managedcare imposes on them. I’m not absolving them for not managing cost, but the system is broken. The consumer making #direcpayments is the only way to control cost. It is why all of our data is under the #Medxoom platform to create a new #marketplace that treats everybody with dignity and respect.


Leon Wisniewski
Leon WisniewskiFounder Health Cost Labs & Pricing Director at Medxoom