Doctors Bills Are Tough – For Doctors

A healthy man gets a pre-employment exam from his doctor. Surprisingly, he doesn’t get the job but the company tells him to call his doctor ASAP. Because two numbers were flipped in a medical billing code, the man had been diagnosed with leprosy. The same error caused the doctor to bill Medicare for 20 cases of leprosy at his office in Canoga Park. That’s one vignette from “Medical Billing Horror Stories,” a book by Sharon Hollander, president of STAT Medical Consulting, a billing service for doctors in Encino. The leprosy case is one of her favorites as it illustrates the theme of the book that medical finances often baffle doctors just as much as their hapless patients. “There are 130,000 regulations about medical billing,” said Hollander, 53, who mostly works with solo practices. “It’s not feasible for one doctor to keep on top of 130,000 rules, and by the time he learns them they’ve changed.” Much of the book explains the complex system of codes, clearinghouses, deductibles and audits that doctors must navigate to get paid. Some of the greatest horrors involve employee theft. One office manager set up a joint checking account with a doctor on the sly, and then siphoned off more than $100,000 from the practice. In another case, the doctor’s wife, who also worked in the office, took all the cash co-pays for herself. National health reform inspired Hollander to write the book, as it has made the system even more confusing. In response to questions from her clients, she assembled a case book of the major problems doctors should prevent. It sells for $15.24 at Barnes & Noble and Amazon.com. “The goal was to share my knowledge in a way that was interesting, and at the end of the day, educate doctors so they will know how to hire a billing service,” she said. – Joel Russell