Identity theft is a growing problem. Today, there are many approaches to compromise another
person’s identity: the thief can steal or hack Social Security cards, bank account numbers, credit
cards, and or pins. It is not comforting to know that 650 million Social Security numbers exist,
but we only have 315 million citizens! This number will change over the next two years to protect
50 million Medicare recipients! https://www.youtube.com/watch?v=pCIEHwp2h14
Few people know much about ICDs, DRGs, Procedure Codes and product bar-codes, such as the National
Drug Codes on prescriptions. All are susceptible to fraud. These numbers “tell computers” what to
charge, but keep price information secret, to both you and your providers, aided by HIPPA.) Each
code is used only by who’s paying for the service or products, mostly 3rd parties. Now, nobody
knows the prices of anything. Discounts, off “list prices” based on contracts, “charge backs” and
rebates unknown to patients are silently and secretly produced by computers. However, thieves know
how to use them for fraud.
Last October America switched from ICD-9 codes with 16,000 procedure pricing codes used since 1975
to ICD-10 with 64,000 codes, quadrupling chances of errors. Those who you’re your procedure
determine what’s charged, so keyboard errors can significantly affect bills, up or down.
However, nobody looks for errors. Instead, the errors are seen weeks later after paid by insurers –
except by cash customers. When a procedure code is entered into the computer “the system” applies
whatever discounts, from prices that vary between codes, insurers plans that pay their part and
send remaining amounts for you to pay.
Therefore, there is currently no way for patients to know the original cost or who paid what,
without an itemized bill you must request. Who decides whether your visit or procedure has value?
The difference, while small between codes within a specific procedure type, is not checked by
anyone for errors, while knowing coder input isn’t, always right?
All healthcare products have bar codes, with costs and prices which differ depending on the
insurance plan. All our drugs have U.S. FDA assigned NDC’s, but 90% are not made here and foreign
nation’s specs and numbers are different. Only America uses USP and NF, so why do drugs made in
foreign countries have American NDC’s on them when they’re not made here?
Since 2009 we no longer know what list prices of drugs are, as AMP [average manufacturers price]
replaced AWP [average wholesale price]. Now Americans can only find out “their price” from
insurers. However, those costs differ between plans. Why do some of our politicians want
U.S. Prices to equal Canada’s which are the second highest in the World?
Our identity problems should soon be resolved for there are many ways distinguish one person
from another: computerized fingerprinting, retinal or face scanning, etc.