A petabyte of health insurance prices per month

Post by tanseydavid » Tue, Jul 11, 2023, 7:52 PM UTC

bradgessler wrote: post #20

thomascgalvin wrote: post #15

There are separate charge codes for everything , and all of those codes need to be reflected in the pricing data. There's a price to slap on a bandaid. There's a price to give someone a Tylenol. Hell, W61.61XA is the medical code for "Bitten by duck, initial encounter." Presumably, this means there's also a code for "Bitten by duck, again." Medical billing is broken , and it's no surprise that the amount of data is o…

Here's the full list of codes for "Bitten by ____, _____ encounter" https://www.icd10data.com/ICD10CM/Codes/V00-Y99/W50-W64/W61- The hierarchy looks like this: W61.6 Contact with duck = W61.61 Bitten by duck == W61.61XA …… initial encounter == W61.61XD …… subsequent encounter == W61.61XS …… sequela = W61.62 Struck by duck == W61.62XA …… initial encounter == W61.62XD …… subsequent encounter == W61.62XS …… sequela = W6…

Post by NoMoreNicksLeft » Tue, Jul 11, 2023, 7:53 PM UTC

Reptur wrote: post #24

They're using information overload tactic. This approach leverages a psychological principle that suggests when people are given too many choices or too much information, they can become overwhelmed and struggle to make decisions. The point is to overwhelm, the consumer, the people trying to fix this system etc.

Post by tristor » Tue, Jul 11, 2023, 7:54 PM UTC

natosaichek wrote: post #61

valleyer wrote: post #52

Earlier quoted context omitted.

Because, like it or not, a doctor's discretion can sometimes be self-serving. The more treatments a doctor gives, the more they get paid, and there is an enormous information imbalance between doctor and patient. (As in, they went to medical school, and you didn't.) Unfortunately, some doctors are willing to take advantage of this.

It's kinda ridiculous that because it costs x billion in doctors overcharging, we'll spend 100x on administration to control costs. Cutting off one's nose to spite one's face and all that.

Post by webstrand » Tue, Jul 11, 2023, 7:55 PM UTC

cool_dude85 wrote: post #59

pc86 wrote: post #28

Earlier quoted context omitted.

That's exactly what it is, because as another comment pointed out the legislation currently doesn't allow them to just publish a [human,machine]-readable rules engine for calculating price, so they must publish this asinine amount of data every month in perpetuity until someone who's taken a math class in the last 70 years ends up in Congress.

This does seem to be machine readable, but inefficient. Given the fight the insurers have put up about publishing this, I would expect any allowance of "rules engine" to allow them not to publish anything, or to just play the same game again. For instance, my "rules engine" is to look up the price contained in my db table (proprietary, of course) and multiply by another record in a different table. Or if a court forc…

Post by chimeracoder » Tue, Jul 11, 2023, 7:57 PM UTC

valleyer wrote: post #52

maweaver wrote: post #39

Earlier quoted context omitted.

But why? I could understand from a treatment perspective the type of animal mattering (but even then initial vs subsequent encounters?). From a billing perspective, wouldn't it make sense to have animal bite exam fee, with possible additional charges for bandaging, stitches, rabies shot, etc based on doctor's discretion?

Because, like it or not, a doctor's discretion can sometimes be self-serving. The more treatments a doctor gives, the more they get paid, and there is an enormous information imbalance between doctor and patient. (As in, they went to medical school, and you didn't.) Unfortunately, some doctors are willing to take advantage of this.