Editorial (pdf file) from the Journal of American Physicians and Surgeons discusses two GAO reports from 2002 and 2004 that found that 96% of simple Medicare billing questions posed to Medicare customer service reps (CSRs) were answered incorrectly.

The author, a Dr. Huntoon, decided to pose several "yes/no" Medicare questions to a local toad (the hopping kind). The toad jumped right to indicate "yes" or left to indicate "no." Evidently the toad answered the questions "correctly" 50% of the time.

If Dr. Huntoon's interpretation of the GAO report is correct (I haven't been able to track it down yet), then 96% of Medicare claims that were completed with the help of Medicare CSRs were incorrect. The lesson seems to be that doctors should bill Medicare in a random fashion as the odds that a claim will be repaid seem a bit higher. On the other hand, the 4% of claims correctly filled out with the help of CSRs might have been big ticket items, thereby making the expected value of the CSR-assisted claim higher than the toad-assisted claim.

Nevertheless, I would trust the toad.

One great paragraph from the editorial:

Consider what would happen if your local fast-food restaurant got the orders wrong 96 percent of the time. The customer oriented free market would never tolerate such poor performance. The anti-free-market Medicare bureaucracy, however, is neither accountable to its "beneficiary/ customers," nor to its slave "providers." Thus, the Medicare bureaucracy not only tolerates poor performance, but judging from the way it monitors performance, it considers accuracy and competence irrelevant.

Amen, brother.