The Daily Progress: UVa surgeons detail ‘upcoding’ they say allowed health system to fraudulently bill patients

The surgeons at UVA know the hospital is charging patients too much, as “tremendous pressure” from senior leadership mounts to charge patients more for the treatment they received.

“We have people here who know nothing about billing and coding making very important decisions about billing and coding that shouldn’t be in their hands.”

This practice is called “upcoding”, which is a perfect storm of “a lack of government oversight paired with the subjectivity surrounding billing codes” which easily creates a situation practically “begging for lots of overbilling, upcoding, fraud and lots of wasteful care,” says Michael Cannon of the CATO Institute.

This unethical approach not only burdens patients with excessive medical bills but also raises significant questions about the integrity of the healthcare system, compromising the patient’s financial well-being and trust in the institution.

According to Sage Transparency, UVa is also charging privately-insured patients 207% more than what Medicare pays for care. A former UVa Health surgeon said, “Essentially, individuals no longer mattered, it was really all about either money or reputation.”

It is crucial that hospitals face repercussions for purposely ripping off patients. Hold hospitals accountable and let your legislators know patients deserve better. Better Solutions remains committed to fighting for increased transparency.