Tenpas Andrew, Dietrich Eric
Texas A&M Irma Lerma Rangel College of Pharmacy, 1010 W. Avenue B, Kingsville, TX 78363, United States of America.
University of Florida College of Pharmacy, 1225 Center Drive, Gainesville, FL 32610, United States of America.
Explor Res Clin Soc Pharm. 2023 Mar 6;9:100238. doi: 10.1016/j.rcsop.2023.100238. eCollection 2023 Mar.
Billing issues are more commonplace than most healthcare professionals, including pharmacists, even realize. Undercoding-or billing outpatient visits for a lower level of service than may be justified-leads to decreased reimbursement, but almost no data captures what is being sacrificed, especially at the state level. Using publicly available data from the National Ambulatory Medical Care Survey and Centers for Medicare and Medicaid Services, we attempt to approximate just how much Medicare reimbursement is lost annually to undercoding in Florida. We also discuss the hidden dangers of undercoding, including how it could hinder the ability of clinical pharmacists to build sustainable clinical services and contribute to the broader healthcare team.
计费问题比包括药剂师在内的大多数医疗保健专业人员所意识到的更为常见。编码不足——即对门诊就诊的计费服务水平低于合理水平——会导致报销减少，但几乎没有数据能反映出所牺牲的内容，尤其是在州一级。利用来自国家门诊医疗护理调查和医疗保险与医疗补助服务中心的公开数据，我们试图估算佛罗里达州每年因编码不足而损失的医疗保险报销金额。我们还讨论了编码不足的潜在危害，包括它如何可能阻碍临床药剂师建立可持续临床服务的能力以及对更广泛的医疗团队的贡献。
