tag:blogger.com,1999:blog-4968787219619380438.post1837915255285846859..comments2023-09-21T04:02:29.457-04:00Comments on Skeptical Scalpel: Lawyer tricks of the trade: Billable hoursSkeptical Scalpelhttp://www.blogger.com/profile/13206922456661320751noreply@blogger.comBlogger12125tag:blogger.com,1999:blog-4968787219619380438.post-42198269778694378042013-11-23T16:09:09.725-05:002013-11-23T16:09:09.725-05:00Patrick, I agree that would be a good way to keep ...Patrick, I agree that would be a good way to keep costs down. Now that there is a glut of lawyers, this might be easier to do.Skeptical Scalpelhttps://www.blogger.com/profile/13206922456661320751noreply@blogger.comtag:blogger.com,1999:blog-4968787219619380438.post-34597695346191376782013-11-23T16:00:21.305-05:002013-11-23T16:00:21.305-05:00I have grown tired of the lack of consistency in r...I have grown tired of the lack of consistency in regards to legal billing. We now only hire legal work on a flat rate. Many other business work in this fashion, why not lawyers? While I get that many types of projects would not allow lawyers to work on a flat rate as their is no way to predict the amount of hours that will be needed. <br />Projects such as contracts, employee agreements, articles of business and such can certainly be charged on a flat rate. Patrick Chavoustiehttp://omnimedicalmarketing.comnoreply@blogger.comtag:blogger.com,1999:blog-4968787219619380438.post-39887624883214619922013-10-25T11:16:27.810-04:002013-10-25T11:16:27.810-04:00Anon, excellent point. I can think of many diagnos...Anon, excellent point. I can think of many diagnoses that no one would want to operate on.Skeptical Scalpelhttps://www.blogger.com/profile/13206922456661320751noreply@blogger.comtag:blogger.com,1999:blog-4968787219619380438.post-56313150645830571622013-10-25T10:31:46.340-04:002013-10-25T10:31:46.340-04:00Of course one side-effect of the "contingency...Of course one side-effect of the "contingency fee" system in lawsuits is that lawyers will only agree to take on a case if it has a very good chance of winning. If physicians did this, who would operate on GBMs?Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-4968787219619380438.post-27416383267987632852013-10-24T16:51:11.806-04:002013-10-24T16:51:11.806-04:00Yes, plaintiff lawyers do. I meant to refer to the...Yes, plaintiff lawyers do. I meant to refer to the legal industry as a whole. artigerhttps://www.blogger.com/profile/13361655152970244221noreply@blogger.comtag:blogger.com,1999:blog-4968787219619380438.post-47843135615904061882013-10-24T16:38:51.840-04:002013-10-24T16:38:51.840-04:00Anon, thanks for commenting. I was with you until ...Anon, thanks for commenting. I was with you until your last sentence. I'm not sure which profession has more greedy people. It would make a good study.<br /><br />Artiger, interestingly, plaintiffs' lawyers do get paid based on results. If they lose a malpractice case, they get nothing. And they have invested their own money and time preparing the case.Skeptical Scalpelhttps://www.blogger.com/profile/13206922456661320751noreply@blogger.comtag:blogger.com,1999:blog-4968787219619380438.post-12584800297756147172013-10-24T10:04:51.840-04:002013-10-24T10:04:51.840-04:00Why can't lawyers' compensation be based o...Why can't lawyers' compensation be based on results? You know, quality measures, value based purchasing, lowering costs, etc?artigerhttps://www.blogger.com/profile/13361655152970244221noreply@blogger.comtag:blogger.com,1999:blog-4968787219619380438.post-2834368541981834582013-10-23T21:48:05.358-04:002013-10-23T21:48:05.358-04:00Yeah, the E&M with electronic systems is a jok...Yeah, the E&M with electronic systems is a joke. I see multi-page pre-op H&P's from primaries now detailing everything from sexual history to neuro exam - for cataract surgery.<br /><br />(Cataract surgery, for those who don't know, are modern medical miracles which take less than 10 minutes surgical time under local anesthesia with minimal sedation if the ophthalmologist is within 20 years from residency. The physiological stress is prob. less than having your teeth cleaned and scraped for an hour by your dental hygienist.)<br /><br />I don't think that doctors are any less greedy than lawyers, except that the latter make much less and have to scramble more.<br />Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-4968787219619380438.post-35393609143927679682013-10-23T10:05:24.872-04:002013-10-23T10:05:24.872-04:00Anon, so true. I have seen the padding of E&M ...Anon, so true. I have seen the padding of E&M codes done by many specialties. It is a joke.Skeptical Scalpelhttps://www.blogger.com/profile/13206922456661320751noreply@blogger.comtag:blogger.com,1999:blog-4968787219619380438.post-37056263966165848542013-10-23T09:18:53.033-04:002013-10-23T09:18:53.033-04:00The thing is we (doctors) don't like the E&...The thing is we (doctors) don't like the E&M system. It was forced on us by medicare. I'm sure I bill medicare much more for E&M codes now than I did 10 years ago for the same office visit because the billing people have told me what to say and document in my H&Ps. Most of it is BS. For example for a healthy hernia patient do I really need to examine for mouth lesions, or take a psych hx, or do a fundoscopic exam?Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-4968787219619380438.post-27452733067756826782013-10-23T07:58:19.863-04:002013-10-23T07:58:19.863-04:00Farrel, excellent point. You may be interested in ...Farrel, excellent point. You may be interested in a post I wrote about upcoding last year--http://skepticalscalpel.blogspot.com/2012/12/electronic-medical-records.htmlSkeptical Scalpelhttps://www.blogger.com/profile/13206922456661320751noreply@blogger.comtag:blogger.com,1999:blog-4968787219619380438.post-91367012140849325182013-10-22T21:20:35.456-04:002013-10-22T21:20:35.456-04:00Billing by the hour means that one can be caught-o...Billing by the hour means that one can be caught-out for billing 26 hours in a day. Is that why doctors generally eschew time-based billing? It is too easy to be caught cheating/lying/fudging. It is much harder to catch someone lying for documenting examination findings they never did (but dictated or checked off) and much harder to catch someone lying for inflating the complexity of the medical decision making. When I first learned how evaluation and management coding was done (by counting bullet points) I was in disbelief. I then learned that it was a "wonderful" system that made it so easy to upcode - if you are so inclined. Then software (electronic medical records) came out that made it oh so tempting. <br /><br />All humans lie. Have your read the "The Honest Truth About Dishonesty" by Dan Ariely.Anonymoushttps://www.blogger.com/profile/14507910657402752532noreply@blogger.com