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Medical record errors raise insurance costs

MedSave Admin | April 14, 2009

Errors in personal medical records often cause people to be excluded from the lowest priced health insurance plans. While we approach this issue from a consumer's perspective, this interesting article at e-patient.net explains the issues from an IT perspective. The article reaches the same conclusion as MedSave.com has long preached, saying "the time has come for patients to take responsibility for their personal medical data".

The underlying cause of medical record errors is different in this article than what we observe in our work. E-patient.net blames the limitations of medical vocabulary, data codes and clerical error. The article says "billing codes are often misapplied by "coders" (clerks), to feed something into a claims payment system that it'll accept. So the "information" placed into the system might not be something the doctor would ever have said in the first place". MedSave.com takes a more cynical view, presuming that medical diagnostic codes are embellished to ensure and enhance provider payments from insurance companies. Regardless of the underlying cause, these errors hurt patients financially and restrict access to the most affordable health insurance plans.

Preferred risk health insurance companies like Celtic Insurance and UnitedHealthOne offer significantly lower rates to those with unhindered medical records. The preferred risk rates are typically discounted by 15% below standard rate. Rates for individuals with medical diagnosis in their medical records can typically be more than 40% than standard rates. The primary basis for rating decisions is the medical diagnostic codes listed in the applicant's personal medical records.

We recommend that everyone should obtain a copy of their own medical records from their own physician(s) or medical providers and review the medical diagnostic codes for accuracy. We estimate that about 1 in 5 people would find diagnostic codes for medical conditions they were unaware of based on discussions with the physician.

Tags : medical record

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