The Joke's On Us (healthcare finance)

From a fellow family physician, more reasons to avoid expanding centralized, government insurance:

The Joke's On Us as ALWAYS!
Remember that 4.4% Fee Schedule Reduction we had to start the year from Medicare?
Remember we were given that back through all the efforts of the AMA and AAFP?
Forget about the fact that the fee reductions are going to come over the next few years - from anywhere from 12% to 27%.

Here's the bigger farce:

Many of the insurance companies that were secondary carriers for Medicare, still have not resumed the correct schedule, so your 4.4% reduction sticks and the $$ you were supposed to get back from the beginning of the year you are still not getting back.

But here is the real JOKE.
Having seen what my billing has to accomplish in terms of extra time, extra effort and the complexity of the accounting I was dumbfounded!
First we were getting dribs and drabs of $2+/- checks.
Now we have received this past week (and we expect many more to come) 4-5 checks from Medicare varying in size from $250 - $500 (rounding off). HOWEVER, these checks are hundreds and hundreds of individual accounts on patients we were paid the Medicare Fee Schedule less 4.4% .... each of these individual patient account items varies between $ 0.94 (that's right NINETY FOUR CENTS) and $ 9.02 with an average about $2-$3.
Can you imagine being a Billing person who has to post all these and the hourly costs and wages that goes into posting checks with so numerous payments of such small amounts!
Absolutely hysterical!
Sure you can create ONE big dump and cash the checks, but that will make the accounting of individual patient accounts incorrect and will make continued monitoring of reimbursements a near impossibility. So each little $ 0.94 and $2.70 and $3.30 needs to be adjusted out of each account and then reapplied to correct the account and account for these checks coming in.

I once received a $0.02 check from Medicare.

The doc figures that one of the larger checks will cost 10 hours of a biller's salary --- he will lose $40 in the book-keeping mix up on one $500 check, on top of the money he lost waiting for months to get paid for the work he did in giving medical treatment to a couple of hundred patients. He already had to pay his employees, rent, suppliers, etc.

This was in the midst of a conversation about the costs of billing patients. The consensus is that it costs about $5 to $6 to send a bill, so many do not bill for smaller amounts. Instead, we try to collect from the patient at the next appointment, in order to avoid "fraudandabuse".