Thread by @KBFischer

Ah... @UHC is escalating their questionable legal documentation arms race! Brief thread on what this will actually mean in practice...
racmonitor.com/automated-down…

@UHC First:
Let's not pretend that it's anything other than a quick attempt at a cash grab.

Also, they'll probably make some extra money doing it, so congrats on building towards a future reddit late stage capitalism thread.

They'll also get sued, but I'm sure they've done the math

@UHC The stated policy is this:
"UHC announcement notes that the Optum Evaluation and Management Professional (E&M Pro) tool will determine the “correct” code-based solely on the patient’s age and the diagnoses submitted on the claim"

OK, fine.

@UHC What happens next is predictable:
Doctor: You won't reimburse appropriately without the "appropriate diagnoses submitted?" (NOTE: That's diagnoses plural). I can handle that.

Every submitted claim: Diagnoses: Chest pain, coronary artery disease, elevated troponin, CHF

@UHC Random chest pain diagnosis in the era of the HEART score:
Chest pain, hypertension, obesity, nicotine dependence (Gotta document those risk factors!)

Predictable patient response: "I already knew about my blood pressure, weight and smoking. Why is that my diagnosis?"

@UHC How about a pulmonary embolism?
Now the diagnoses need to be:
Pulmonary embolism, tachycardia, hypoxia, dyspnea

@UHC These nonsense insurance company games are ridiculous and probably illegal. @UHC is effectively creating a documentation arms race that may temporarily boost their bottom line, annoy doctors, and probably will be used to stick their patients with bills for going to the ER
/fin/