MedReview Meets New York Presbyterian
June 1, 2011
By Bendix Anderson
To stop the relentless swelling of health care costs, doctors and medical review organizations should engage in a healthy conversation. That’s why NYCHSRO/MedReview, Inc., one of the leading medical claims auditing firms in the country, invited the head of one of the best hospitals in the country to lunch April 29.
“We should understand each other,” said Dr. Hebert Pardes, president and CEO of New York Presbyterian Hospital of Columbia and Cornell and New York Presbyterian Health Care Systems. New York Presbyterian is the top-rated hospital in New York City and one of a few institutions on the “Best Hospitals Honor Roll” kept by U.S. News and World Report.
Up till now, the primary communication between MedReview and New York Presbyterian has taken place when MedReview contests medical bills sent out by the hospital on behalf of its clients, which include several union health care plans.
Dr. Pardes shared stories from his life and his decades of experience in health care including several memories on the kind of medical success that a teaching hospital like New York Presbyterian can provide. That’s because of what Dr. Pardes called the “concentrated aggregate of specialized expertise” of its doctors. When his own son needed a liver transplant, it was a teaching hospital that was best able to treat him. “The day after you find that you have a complicated illness, a teaching hospital becomes the most important thing in your life.”
However, bringing all this expertise together is necessarily costly. “We have to get the budget under control, but not at the expense of busting what is one of the strongest fields in which America prevails.”
In turn officers from Medreview gave a brief description of how the review company audits medical claims. “There is mutual respect we understand the plights of the hospitals and their need to be compensated in a timely and appropriate manner,” said Joseph Stamm, president and CEO of MedReview. “If we are going to curtail payment, there must be a sound reason as to why.”
The conversation eventually turned to places in which auditors and hospitals could potentially agree to streamline the system such as some types of regulation. “Everyday we are being inspected by someone,” Dr. Pardes said.
After the luncheon, Pardes returned the favor, inviting officers of MedReview to come to New York Presbyterian. “I am thrilled,” said Stamm. He hopes meeting like these can be the start of a productive dialogue.