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A Hospital’s ‘E/M Add-On’ Turned Me Into a Radical
The Wall Street Journal ^ | Oct. 21, 2025 4:23 pm ET | Matthew Hennessey

Posted on 10/25/2025 11:44:43 AM PDT by E. Pluribus Unum

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1 posted on 10/25/2025 11:44:43 AM PDT by E. Pluribus Unum
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To: E. Pluribus Unum

Hopefully someone can provide a link to a nonpaywall version of the article. Otherwise, all we know is someone is PO’s after having a doctor’s appt. Dog bites man.


2 posted on 10/25/2025 11:49:40 AM PDT by RedElement
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To: RedElement

I expected to encounter a paywall, but I didn’t.


3 posted on 10/25/2025 11:50:34 AM PDT by Jamestown1630 ("A Republic, if you can keep it.")
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To: E. Pluribus Unum

Hennessey is a wimp for not naming and shaming. Points for calling out BS, but still a failing score for him for failing to do anything constructive.

The WSJ still has some heft. He should have gotten off his butt, scheduled an interview with a senior official with some generic language of his own, and then handed it to the official, reading it aloud while recording, and demanding he explain it in plain English.

And ask the Secretary of Health to comment on it as billing fraud.


4 posted on 10/25/2025 11:55:18 AM PDT by PAR35 (I)
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To: E. Pluribus Unum
Wasy enough to understand. Medicare doesn't want to pay real world cost increases in basic services, so instead they allow new charges to cover overhead, like the E/M charge.

If Medicare paid for restaurant visits, you would soon see additional charges for things like clean silverware or drinking glasses. There would be multisyllabic words in lengthy paragraphs designed to describe and justify the additional fees.

And the fee creators would spread that word that "the bean-counters" are running the place and forcing the additional fees. Can't always blame "Da ......" (select your favorite group to fill in the dots)

5 posted on 10/25/2025 11:55:38 AM PDT by Bernard ("Nothing is as expensive as that which the government provides for free." - Ronald Reagan)
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To: E. Pluribus Unum

I’m not a spring chicken.

When I was young I remember the stink that occasioned when a couple of docs wanted to buy into a radiology practice.

Now the independent doc has almost gone extinct.

And when an HCP works for a health system, you may be the patient, but that HCP doesn’t work for you.

We need to bring back the independent doc.

That would solve a lot of this bravo sierra.


6 posted on 10/25/2025 11:56:41 AM PDT by mewzilla (Swing away, Mr. President, swing away! 🇺🇸 🏴󠁧󠁢󠁥󠁮󠁧󠁿 )
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To: E. Pluribus Unum

Yeah, I might have to respond to that from the hospital with something like:

“Please explain your jargonese in something like straightforward English, with simple declarative sentences. To use the language of the young folks, ELI5, please.”

“Once this has been successfully accomplished, then and only then might I think about paying you for - whatever it is you have up to now failed to explain.”


7 posted on 10/25/2025 11:58:29 AM PDT by FreedomPoster (Islam delenda est)
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To: E. Pluribus Unum

I understand the E/M charge. As someone who lead more than one organization, there are a LOT of overhead expenses not directly related to the medicine, supplies, and doctor’s time. These include support staff, nurses, facility maintenance, equipment, utilities, and insurance just to start. Then there are compliance costs, record keeping, billing, computers, and more.

Never ran a medical facility, but as a businesswoman, I thought of these immediately.

These are not built into the price of services.

My 2 cents.


8 posted on 10/25/2025 11:58:33 AM PDT by TheWriterTX (🇺🇸✝️🙏🇮🇱)
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To: E. Pluribus Unum

Last year, I went to our local ER with extreme ear pain and had earwax flushed out. Simple procedure. This ER was in my insurance “network,” or so it appeared. Weeks later, I got an ER bill from a third party for $1300. Apparently, ER services at our hospital are contracted out to this company, which then negotiates with insurance companies. A year later, my insurance company finally settled with this third party. My copay was $250. What a broken system we have.


9 posted on 10/25/2025 12:00:42 PM PDT by Restless
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To: E. Pluribus Unum

This is bull shit speak for, “she has Alzheimer’s and is difficult so we charge more.” It is indeed, piffle.

I too am easily irritated. If someone says 2+2=5 I can’t just let it pass as not impacting me. Just about everything eventually impacts all of us and if you follow a logical trail it is so. Someone who says 2+2=5 is not just another harmless blithering idiot. In time he will convince some other blithering idiot that this statement is so and thereby spread his stupidity through the masses and on an on the knock-on effects of a wrong go

So, I too have plenty to be irritated about so I try to stay away from people and things that irritate me. Alas, even I irritate me though for lack of exactitude and unsuitable performance..


10 posted on 10/25/2025 12:00:43 PM PDT by Sequoyah101
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To: E. Pluribus Unum

It’s just someone p/o’d at healthcare.

No solution. Leftists don’t solve government problems

“make me grab a pitchfork before too long.”

A pitchfork? Like in a 1930s bring out the burger master

There’s no burger sister

You don’t talk to anyone at Medicare

This guy is talking about how his wife is mad at Medicare. She didn’t do anything about it. Never got her money back

Didn’t switch insurance

It will all be AI within a year. They can charge you whatever they want

Make you take whatever they want you to

Writer says he is now a radical

How? He makes no attempt to explain


11 posted on 10/25/2025 12:02:47 PM PDT by stanne
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To: E. Pluribus Unum; metmom; kiryandil; grey_whiskers; mewzilla

The complexity captured by The Evaluation and Management add-on is....a likely a newly instated charge required due to the level of jabbed patients.

$200/paient/pop goes a long way in dealing with the new health ‘complexities’ they’re having to deal with, of the jabbed.


12 posted on 10/25/2025 12:04:00 PM PDT by Jane Long (Jesus is Lord!)
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To: Jane Long

We can thank GWB for a lot of this.

The EMR regs in his first Porkulus really screwed the independent doc.

Lack of tort reform, ditto.

Etc, etc...

If we want this bleep solved, we need to make it desirable for docs to hang out a shingle again.

Paging RFK, Jr...


13 posted on 10/25/2025 12:07:54 PM PDT by mewzilla (Swing away, Mr. President, swing away! 🇺🇸 🏴󠁧󠁢󠁥󠁮󠁧󠁿 )
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To: mewzilla

In the meantime, thanks to Deep State and Big Med, we now have a de facto NHS.

Gotta admit, that’s one helluva incentive to eat right and exercise.


14 posted on 10/25/2025 12:09:13 PM PDT by mewzilla (Swing away, Mr. President, swing away! 🇺🇸 🏴󠁧󠁢󠁥󠁮󠁧󠁿 )
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To: mewzilla

“ We need to bring back the independent doc.”

Most doctors here wouldn’t know the American economic system from a classic American book. They are not from here


15 posted on 10/25/2025 12:09:55 PM PDT by stanne
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To: TheWriterTX

WHEN I GO TO WALMART OR THE LOCAL RANCH SUPPLY -—I HAVE COSTS ARE DEFINITELY PART OF WHAT I PAY FOR MY PURCHASES-—NEVER AN ADD ON.

HAVE DONE BOOKKEEPING SINCE 1957.

ENGINE BUILDERS (3)

MAYTAG DEALER

ADVERTISING GROUP

CRANK SHAFT GRINDER

HIGH TENSILE NUTS & BOLTS RETAILER

NEVER ANY “ADD ON” LINES ON AN INVOICE


16 posted on 10/25/2025 12:24:47 PM PDT by ridesthemiles (not giving up on TRUMP---EVER)
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To: stanne
I know.

Meanwhile, here's a great idea, and one this geezer would take advantage of in a heartbeat...

To Lower Health Costs, Legalize Catastrophic Health Insurance Plans for All

17 posted on 10/25/2025 12:25:19 PM PDT by mewzilla (Swing away, Mr. President, swing away! 🇺🇸 🏴󠁧󠁢󠁥󠁮󠁧󠁿 )
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To: Restless

I hate how they send me a danged text message to pay a bill instead of sending a hard copy. And it takes weeks/months. 🙄🙁


18 posted on 10/25/2025 12:41:22 PM PDT by RushIsMyTeddyBear
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To: E. Pluribus Unum

I’m surprised they don’t call it a “resort fee” like hotels do or a “shop and materials fee” like mechanics. Those are part of the cost of doing business. Include them in the list price for the service rather than listing one price and then bumping it up with extra fees.


19 posted on 10/25/2025 12:52:38 PM PDT by KarlInOhio (I pray that the sleeping giant has finally awakened and been filled with a terrible resolve.)
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To: PAR35
Because I work with words for a living, I am hard-wired to try to untangle sentences like this. My brain immediately begins breaking down the parts and reassembling them in a way that a person moderately familiar with the English language might find decipherable. I defy you to tell me what this blithering piffle actually means.

You're right... more needs to be done. But at least the guy's making a real effort about being a journalist. There is hope.

20 posted on 10/25/2025 12:54:24 PM PDT by GOPJ (Sicko 'doctors' that sexually mutilate children are worse than Epstein <P><I><B><big><center></B>)
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