|
|
|
 |
Set Your Fees to Maximize Reimbursement
Just because managed care plans and Medicare pay you a set dollar amount doesn't mean you can discontinue analyzing fees regularly. Just one under-priced fee can cost thousands of dollars each year. Here's what to do to avoid these costly mistakes:
-
Prepare a grid that compares your fees against Medicare and managed care plans. You may be surprised to find that you charge less than plans, and Medicare, in some cases. Our analysis finds that this is very common. Because plan contracts typically state you will be paid "the lesser of your fee or the plan's allowable," you're probably losing money if fees are too low.
-
Use a relative value scale, such as RBRVS, to set fees. Doing so allows you to set fees using a national benchmark, instead of guesswork or hunches.
-
Be realistic. Certainly you want to maximize reimbursement. But setting fees in the stratosphere, just to be sure they are higher than allowables, will inflate the receivables and become problematic for patients who pay out of pocket or out of network. Stick to fees that are relative to market payments.
|
