Waiting Room: Medicare Appeals Tie Up Hospitals' Millions

by Mark Friedman  on Monday, Jun. 30, 2014 12:00 am  

Peterson said the hospital is thorough before it decides that a patient should be admitted in the first place. Not only is the case looked at by the treating physician and nurses, but a patient’s medical records are also computer analyzed to make sure the patient meets the appropriate criteria.

The hospital also pays $1 million a year to Executive Health Resources of Newtown Square, Pennsylvania, which helps hospitals deal with Medicare and Medicaid compliance, Peterson said.

“So we spend, give or take, $500 per admission just to make sure that we’re trying to comply with the law,” he said.

Peterson finds it frustrating that after the hospital takes all these precautions, an auditor determines that the treated patient didn’t meet admission requirements and holds up the hospital’s money, forcing the hospital to fight to recover the money.

“If you want to talk about wasted dollars in health care, what a way to waste dollars,” Peterson said. “It’s just amazing.”



Please read our comments policy before commenting.