>>>That is not quite the way it works afaics. The physicians abuse the ICD9 and CPT to charge the most out of a simple procedure. Also unnecessary procedures being done on something to either cover their butt for the miss of information and/or the ability to fill their wallets. I think Bills' post being a example of the practise.
>
>Those are your customers you're talking about. ;) Actually I've been doing this for a long time now, and Medical Necessity, RAC Audits and all the rest of it, make it difficult to "abuse" CPT (and only CPT since no physician is paid on ICD9, which very much is in a supportive role for CPT.)

Yes, they are my customers indeed, but that does not mean that I like what I see. ICD9 is used to check whether the CPT is legitimate, but as you know is that ICD9 is not detailed enough so that for a small procedure you're able to charge big bucks. ICD10 will improve that somewhat. Still left with the problem of performing unnecessary procedures and prescribing expensive drugs.

As for the audits, several clinics have been shutdown because of malpractice in billing. They just went over the line. How many are operating just beneath it?

>>>As for the physicians earnings. It depends. I find that most clinics are bloated with personnel, often work quite inefficient. But that of course is before they got our EMR in place. At that point they often are totally paper-based.
>
>Yep, and there's federal $ to try to overcome that. Actually much of the saving slated for ACA comes from EHR. Which makes you a hero, right? ;-)

I'd say that our software is an EMR rather than EHR which is associated with the main hospital system. We are not positioned that way.

>>>And the victim? Well that obviously is the American citizen who find that their insurance policy does not cover what they need or is just way too expensive.

>You've altered the context. You're also ignoring the massive dividend issue, along with the $1B paid to one insurance executive whose performance in maximizing dividends was stellar.

That of course is a shame as well, but certainly not the only issue, and I argue not the most important one as well. In all cases the end-customers, the insured, are the victims.

>>>To be honest we have the same problem up here, but to a much lesser extend as our insurance companies are regulated to cover a certain level of coverage. On its turn the insurance companies force the healthcare providers to increase quality and drive down the costs.
>
>Shame they don't do it in legal or automotive repair or construction or IT. How about the idea that you charge too much for your EHR, which victimizes patients. Your fees need to be controlled to improve quality and drive down the costs. Nice? ;-)

Note that its the private insurance companies doing this. not the government. There is still big money to be earned here.
In our situation, there are several competitors and fighting on price level. Our EMR is not cheap, but even for us we are not getting rich on this right now. For the things we do we actually are quite cheap. In our case the free market is working (too well IMO), but in the pharmacies and medical services it was not. That was the big difference IMO.