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How Billing Turns a Routine Birth Into a High-Cost Emergency
Kaiser Health News Link to more items from this source
Oct. 27, 2021

"[O]ver the past 20 years, hospitals and doctors have learned there's great profit in upcoding visits. After all, the insurer isn't in the exam room to know what transpired. [One] investigation ... found that between 2001 and 2008 the number of Level 4 and 5 visits for patients who were sent home from the ER nearly doubled to almost 50% of visits.... [A Colorado study] looked at emergency visit billing from 2009 to 2016 and found that the percentage of emergency visits coded as Level 5 steadily grew from 23% to 34% for patients with commercial insurance."

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