{"id":11367,"date":"2020-09-04T20:57:18","date_gmt":"2020-09-05T01:57:18","guid":{"rendered":"https:\/\/www.billingparadise.com\/blog\/?p=11367"},"modified":"2026-03-17T04:44:10","modified_gmt":"2026-03-17T09:44:10","slug":"tennessee-health-approves-provider-overcharges","status":"publish","type":"post","link":"https:\/\/www.billingparadise.com\/blog\/tennessee-health-approves-provider-overcharges\/","title":{"rendered":"Tennessee Health Approves Provider Overcharges"},"content":{"rendered":"

Overcharging is an enormous problem in our health system. According to a study done by <\/span>NerdWallet<\/span><\/a>, more than 90 percent of the hospital bills contain billing errors and the problem is that, most of these errors go unnoticed and they are usually in favour of the hospital.\u00a0<\/span><\/p>\n

The process of reimbursement is complex, but let us focus on the points where the overcharging occurs. A patient visits their doctor, the doctor jotts down all the relevant information – the history, the diagnosis, procedure performed, treatment etc. All of this information is logged into a document called an electronic medical record (EMR), this sheet is then sent to the medical coders, who code everything and fix the prices from the pricing list or the hospital chargemaster. Now, the thing to keep in mind is that in large hospitals and now increasingly smaller hospitals, this is usually done by a third-party vendor, who does not know you nor your physician. All they see are EMRs they assign code and value from the price list. Now the problem occurs, when some medical billing companies charge a percentage of the total amount charged to the patient. So, when they bill more, they make more. This means that the charge becomes more. On the other hand, medical coding is extremely complex. There are three standards ICD (70,000 different codes \u2013 used for diagnostics), CPT (over 10,000 different codes, used for services rendered) , and HCPCS (used for procedures). Now all of this is handled in such a way that speed is prioritized, because as mentioned earlier, when they bill more, they earn more.<\/span><\/p>\n<\/div><\/div>[vc_custom_heading text=”So, now we know that:” font_container=”tag:h2|font_size:20px|text_align:left” google_fonts=”font_family:Roboto%3A100%2C100italic%2C300%2C300italic%2Cregular%2Citalic%2C500%2C500italic%2C700%2C700italic%2C900%2C900italic|font_style:400%20regular%3A400%3Anormal”]