As another example, Medicare requires that providers ( doctors.. ) submit claims for payment for medical services using CPT or “Current Procedural Terminology” codes. There are tens of thousands of these codes for every possible procedure that could be performed. Since Medicare is the largest payer, all of the private insurance companies use the same code system. The problem? the codes are “owned” by the AMA (American Medical Association) and anyone that wants to get access to them pays the AMA.
These codes not only inform Medicare and the insurers of the procedure that provider has performed, but is the only real documentation patients see on their bills for services rendered. Regretfully, patients cannot decode the CPT codes without the AMA manuals.
This is just another area where the people’s heroes like Carl would wrestle with the gorilla!