If you think doctors are the only ones with creative billing fees, ProPublica has a story that exposes the shady nature of the healthcare billing industry. It turns out that most doctors have to pay a fee in order to get paid. Nowadays, insurers send payment electronically instead of issuing a check. However, these insurers charge a fee of up to 5% for this convenience, which can add up to significant costs. Larger medical practices may pay around $1 million a year, while smaller practices may pay $100,000. This means that instead of using that money to improve patient care, practices have to allocate it towards processing fees.
Karen Jackson, a retired senior official at the Centers for Medicare & Medicaid Services, finds this situation ridiculous. The CMS actually eliminated these fees in 2017, but the decision was quickly reversed. The story delves into how this reversal occurred, with a focus on lobbyist Matthew Albright, who used to work for the CMS and now represents the very industry he once regulated. It suggests that Albright still wields significant influence within the federal agency. The problem doesn’t just lie with insurers; there is also a new industry of payment processors seeking their share of the money. Read the full story to learn more.
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