Acknowledging the adage that “if it isn’t documented, it didn’t happen,” the Centers for Medicare and Medicaid Services (CMS) have announced a new policy that they assert will clarify reimbursement disagreements between medical practitioners and reimbursement organizations. Starting next month, all advanced practitioners of medicine who wish to receive compensation for their services must now explicitly document a phrase in their note requesting to be paid or they will no longer be eligible for any financial remuneration whatsoever. Decisions by CMS govern all compensation decisions by Medicare and Medicaid and are frequently adopted by most insurance companies as well, so it will only be a matter of time before this concept becomes standard in the marketplace.
“We realized that medical practitioners frequently see patients that either don’t pay or have no intention to pay for their services,” commented CMS director, Mr. Mortimer Burns, MBA, “Thus, it can be hard to tell if a physician really wants to be paid or if they are doing their work out of the kindness of their heart. We have taken that thought to the next level. If a medical practitioner doesn’t document that he/she wants to be paid, then we will henceforth assume that he/she wishes to do the work for free.”
To ease the transition, CMS has released with some suggested phrasings to satisfy this new reimbursement requirement. Some examples are as follows:
“I, Dr. Smith, hereby request to be compensated for my work. Please. Pretty please.”
“I, Dr. Smith, would appreciate the opportunity to be provided compensation for my effort. Seriously, I have $200,000 in student loans, multiple child care expenses, and I’ve only eaten Ramen noodles for the past week. Please pay me.”
“I, Dr. Smith, performed the evaluation documented in my note to the best of my ability. I really, really, really want to be paid for what I did. It would mean so much to me.”
“I, Dr. Smith, will bow to the will of my CMS overlords whom I respect so much. Please allow me to be paid a pittance for my services so that I may put food on the table for my family. Seriously, at least 10% of what my services are worth would be swell”!
“I am Dr. Smith and I GOTS to get paid, yo'”!
Some physicians have come out against this policy calling it demeaning, unfair, and just plain mean. They assert that they have no control over the patients that come and see them and, in the case of the ED physician, are legally obligated to see all patients that come in, regardless of ability to pay. The prevailing thought among the medical community is that this policy is a continuation of a long standing trend of the government nickel and diming medical practitioners in order to balance the general budget without having to raise taxes, Medicare premiums, or copays.
For those detractors, Mr. Burns had the following response: “There are so many other industries that provide a service and don’t get paid for it. Freelance journalists, clergy, some civil servants in third world countries….Frankly, why should doctors be any different”? For doctors that are unhappy with their compensation, Mr. Burns has suggested they start following NASCAR’s lead and consider selling advertising on their lab coats or stethoscopes.