Uh, well, wait a minute. This is something I know about from my work. Medicare rejects tons of claims, but a lot of them are rejected for coding errors. The claims are sent back for correction and resubmission. Sometimes that process goes around and around for months because the provider’s staff can’t figure out what the error was and the Medicare intermediary doesn’t explain it to them. So this makes the numbers look very much worse than they are.
In other words, Medicare isn’t rejecting the claims because they don’t cover a procedure; providers’ staff already know what’s not covered and don’t submit a claim for a noncovered procedure in the first place. The rejection is technical and may well be corrected.
Thanks for that info.
According to your description though, the bureaucracy is paperwork heavy and byzantine to figure out, or else there would not be so many ‘code’ errors.
It would be good to get some true numbers on this though.