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Yeah, there's an industry of companies that insert themselves between the medical record and the insurance company to upcode claims and get better payments. This article is about the reverse process, where the insurance company looks at the claims and downcodes them to send worse payments.

IMHO, in office care should be more of a time and materials billing than billing based on procedures done. Of course, then the doctors' billing office would aggressively measure time the doctor spent, and the insurance company would suggest the doctor took too long for whatever.