We are constantly bombarded with stories about how inefficient our US healthcare system is and how much it costs.
From the media reports and articles it is clear that many people outside the healthcare world have no idea how challenging, messy and inconsistent the world of billing within healthcare can be (and often is).
What if Lawyers were paid like Doctors? I decided to do a little tongue in cheek comparison with another profession which probably has the simplest billing methodology, our friends in the legal fraternity.
No offense is meant to my friends in the legal profession by this article and all usual disclaimers are begged for...
(so please don't sue) Let's consider a simple office visit: A new client has a 40 minute appointment to discuss a simple contract dispute with a landlord.
A pretty run of the mill process including a review of the lease agreement and supporting documents.
After 30 minutes of discussion with the client a course of action is agreed to and a legal assistant takes the client into another area to complete a response letter to the landlord.
Now the fun begins...
Based on the complexity of the review (being a simple contract) and the time involved our lawyer friend is going to bill a new client level 3 visit (99203).
So here we go:

• The lawyers front desk staff has already loaded the clients insurance into a billing system and verified the benefits.
  Fortunately this commercial insurance had on line verification so didn't require a 15 minute phone call (with 10 minutes on hold)
• The visit must be clearly documented.
  Not just the letter but the outline of the 30 minute conversation and key elements of the conversation.
  Don't forget to sign and date it.
  
• The letter must be completed then reviewed and signed by the lawyer with a copy going to the client along with accompanying documentation outlining any other steps discussed during the visit.
  
• Once all of this is done an electronic bill must be sent to the insurer through the clearinghouse with all the required electronic codes correctly loaded and names spelled correctly.
  
• All going well the insurer will process the charge and put into their pending payment folder so they can hold the payment for 30 days.
  If anything is missed on the electronic claim our lawyer can expect to receive a vague denial of some kind which will require 15-20 minutes extra work by a special billing team to fix and resubmit (starting the 30 day payment clock again)
• Thirty days later our lawyers receives a payment of $200 for all the work...
  But wait...
  
• Two months later our friend is advised that the patients insurance has been retro termed and the insurance plan takes back its $200.
  
• Now the lawyers special billing staff is involved again and with another 30 minutes of work they discover the patient had switched to Medicaid without telling the front desk so they have to bill them.
  They get to resubmit the bill again to the Medicaid insurer and wait 30 more days.
  
• Woohoo, the payment comes through in a month...
  Our lawyer friend gets to bank the $78.
  61 for all that work.
  How quickly we would have less Lawyers than Doctors...