to have a
21 year old daughter today!
For today's quiz, you need to be old enough to have read classic children's books, and young enough (at heart) to recognize a character:
Posted by Aggravated DocSurg at 9:23 AM
Once upon a time, there was a princess who lived on the hospital surgical ward named Snow White, RN. She was beautiful, cheerful, helpful, efficient, and a damn good nurse. She took great care of her patients, and expected the same level of care from her compatriots. Naturally, that meant that she ran afoul the wicked witch, AKA the Queen Nurse, RN, BSN, PhD, QRS, ABC, etc. Fearing her independence and strengths, the Queen refused to promote Snow White, RN, to management. Every day, she would peer into her Blackberry to ask "
who is the ablest one of all who has filled in the most EBN matrix forms, completed the most forms on the EMR system, answered every question on the staff survey correctly, and doesn't ask "Who is that" on my semi-annual trips to the ward." Never seeing Snow White's name on the Blackberry, she was pleased; she did not need Snow White's heart in a jeweled box, because she was boxed in. (image source)
Posted by Aggravated DocSurg at 10:20 PM
I'm not really sure where it came from. Perhaps it started during medical school, where I funded dates with SWIMBO by typing lecture notes ($30 a pop for the shared lecture note service). Maybe it came later, trying to understand a patient's prior hospitalization reading someone else's notes that were so cryptic Mr. Turing would have had difficulty sorting through them. Regardless, I am sort of compulsive about documentation of my interactions with patients --- histories are always dictated as soon as I see a patient, operative notes are dictated as soon as I have spoken with the patient's family, etc. Even if I check on a (sick) patient half a dozen times during the day, I always leave a brief note in the chart.
Because the Government invests so much trust in physicians on the front end, Congress provided powerful criminal, civil, and administrative enforcement tools for instances when unscrupulous providers abuse that trust. The Government has broad capabilities to audit claims and investigate providers when it has a reason to suspect fraud. Suspicion of fraud and abuse may be raised by irregular billing patterns or reports from others, including your staff, competitors, and patients. When you submit a claim for services performed for a Medicare or Medicaid beneficiary, you are filing a bill with the Federal Government and certifying that you have earned the payment requested and complied with the billing requirements. If you knew or should have known that the submitted claim was false, then the attempt to collect unearned money constitutes a violation. A common type of false claim is “upcoding,” which refers to using billing codes that reflect a more severe illness than actually existed or a more expensive treatment than was provided.
It has created a new interagency task force called HEAT (Health Care Fraud Prevention and Enforcement Action Team) under which health-care officials will collaborate with the FBI to go after Medicare fraud. In addition, it has expanded to several cities the Medicaid Fraud Strike Force that authorizes FBI and Drug Enforcement Agency agents to jointly analyze Medicare claims data in real time to detect and investigate irregularities by area doctors. More chillingly, however, the administration is defining Medicare fraud down to include “unnecessary” and “ineffective” care. And to root this out, it plans to make expanded use of private mercenaries—officially called Recovery Audit Contracts—who will be authorized to go to doctors’ offices and rummage through patients’ records, matching them with billing claims to uncover illicit charges. What’s more, Obamacare increases the fine for billing errors from $11,000 per item to $50,000 without the government even having to prove intent to defraud.
That doesn't give me warm and fuzzies about "single payer" health care delivery in this country.
Posted by Aggravated DocSurg at 11:24 AM