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The Fermi problem: Estimation of potential Billing losses due to Undercoding of Florida Medicare data. | LitMetric

The Fermi problem: Estimation of potential Billing losses due to Undercoding of Florida Medicare data.

Explor Res Clin Soc Pharm

University of Florida College of Pharmacy, 1225 Center Drive, Gainesville, FL 32610, United States of America.

Published: March 2023

Billing issues are more commonplace than most healthcare professionals, including pharmacists, even realize. Undercoding-or billing outpatient visits for a lower level of service than may be justified-leads to decreased reimbursement, but almost no data captures what is being sacrificed, especially at the state level. Using publicly available data from the National Ambulatory Medical Care Survey and Centers for Medicare and Medicaid Services, we attempt to approximate just how much Medicare reimbursement is lost annually to undercoding in Florida. We also discuss the hidden dangers of undercoding, including how it could hinder the ability of clinical pharmacists to build sustainable clinical services and contribute to the broader healthcare team.

Download full-text PDF

Source
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC10026023PMC
http://dx.doi.org/10.1016/j.rcsop.2023.100238DOI Listing

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