Medical Billing Practices

Setting up a fee schedule for one's Medical practice is a tiring job to begin with. Added to the misery the physician fee schedules changes time to time.

A Health care consultant from Clearwater, Florida says that "Your top priority is to be profitable. If you are not so, you cannot provide quality care." He also added "In Health care, there is no money, there is no business. Eventually, you shut down and the community suffers as a result."

Here are few wise sparks to consider while setting a fee schedule for your practice.

1.Consistency is the key:

Do not allow any inconsistencies in your fee schedule. These inconsistencies when spotted may harm your AR. Instead of changing your fee schedules often, maintain a standard fee schedule such as Medicare Fee Schedule Plus a 10% increase. This can highly reduce the risk of hectic calculations. A consistent fee schedule will throw light on your AR enough to get a clear picture on your collections.

2.Do not lose hard-earned money:

Insurance companies only pay what you ask of them. For example, if CIGMA is liable to pay 120$ for a level 3 office visit but a bill is raised only for 100$. The company will pay you only 100$ (i.e., the amount billed by you). The lack of updates on the fee schedules will cause you to lose your hard-earned money. Another example can be taken into consideration, say the allowable value goes up to 150$ but you bill them for 125$ you will still get only 125$.




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This amount once received cannot be undone; once again you need to restructure your fee schedule. The final verdict is to analyze the AR, Fee schedules and the margin to survive and set a cost, good enough to make you stay afloat in business though caught off-guard in fee-schedule fluctuations.

3.Overcharging repels patients:

Avoid overcharging for your services. Considering the above strategies if you tend to charge 10 times the Medicare allowable, the net result is that you may look scary enough to ward-off patients from your practice. Always understand that the patients have their explanation of benefits that will educate them the payment made by the Insurance to you. In that case, all the extra charges earn you only a bad reputation and loss of visits to your practice.

The above given sparks give you an edge over the constantly changing fee schedules. An idea derived is that once you receive a 100% claim in any of your bills, this is an indication to check your Fees schedule.

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