Physician Manipulation of Reimbursement Rules for Patients: Between a Rock and a Hard Place

Article Abstract:

Many doctors lie in order to get insurance companies to pay for certain treatments the doctor believes are necessary. In a survey of 720 doctors, 39% admitted they sometimes exaggerate a patient's symptoms, report symptoms the patient did not have, or change the diagnosis so the patient's insurance company will pay the claim. Many of the doctors who did this had many Medicaid patients or believed this deception was necessary to ensure that patients received the best care possible. Over half of the doctors who deceived insurance companies in this way said they did so more often than they did five years ago.

Statistical Data Included

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Fidelity and Deceit at the Bedside

Article Abstract:

Many doctors are lying to insurance companies. A survey of doctors found that 39% sometimes exaggerated patient's symptoms, made up symptoms that the patient didn't really have, or listed the wrong diagnosis so the insurance company would pay the claim. Doctors have traditionally regulated themselves and many may resent the intrusion of outside authorities. They may feel their loyalty to the patient outweighs the insurance company's desire to cut costs. However, it may be possible to honor the contractual agreement with the insurance company while continuing to provide quality medical care.

Editorial

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Improving relations between attorneys and physicians

Article Abstract:

Several medical liability crises have raised the specter of a profound breach between attorneys and physicians hence emphasizing the importance of considering ways to repair the relationship. Observers note that the 2 professions though the 2 profession have different world views, they share respect for the individual and a commitment to reason, professional judgment, and experience as the basis for decision making.

United States, Legal issues & crime, Legal services, Attorneys, Offices of Lawyers, Management dynamics, Legal/Government Regulation, Offices & clinics of medical doctors, Physicians & Surgeons, Offices of Physicians (except Mental Health Specialists), Management, Company legal issue, Cases, Lawyers, Medical personnel, Company business management, Medical malpractice, Interpersonal relations

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