It used to be that when you went to see the doctor you paid your bill directly to the physician. If you were fortunate enough to have insurance, then you sent a copy of the physician’s bill and receipt to the insurance company for reimbursement. Sometime in the late 80s that changed. At some point physicians assumed the overhead of filing insurance claims and took over the responsibility of payroll for employees who used to work for the insurance companies.Now, with every modifier, ICD code match, and E&M code, physicians are spending most of their revenue on billers, coders, and personnel (or services) needed to file insurance claims. How did we ever get hoodwinked into assuming insurance-company overhead just to get paid for the services we provide?However, things are starting to change. Now, with increasing pressures from payers, patients, and government agencies, physicians are beginning to “just say no” to the bureaucracy of filing reimbursement claims.