Originally posted by gini
You are just itching to stir up some trouble aren't you Richard?
I already got Sara to agree with me....I feel troublesome today!



There is a billing method called DRGs (diagnosis related groups) each illness group (for example, all gall bladder operations are lumped together) has a code and a costing total associated with it.

A hospital bills with the DRG code and the insurance or government will pay the rate stated in that table, not one cent more....


I am not sure of the nuts and bolts of the system....it had just started when I left that department.....but that's the gist of it....

that's how hospitals make/lose money....I am sure there is a coder out there that can exploain it better.