Physicians Practice - January 2008 - (Page 27)

GETTING PAID AVERAGE REIMBURSEMENT, ALL E&M CODES, 2004 – 2007 I 2004 I 2005 I 2006 I 2007 $120 $100 $80 $60 $40 $20 $0 Middle Atlantic Mountain New England North Central Paciﬁc South Central South East Overall Average more. You have to get a feel for your costs, even if you SWAG it (Scientiﬁc Wild-Ass Guess).” Who your payer reps are. It’s very important to know this, and to foster relationships with them. “The reason for building that rapport is because nine times out of 10, that’s the only person you’ll deal with,” says Jeff Milburn, during his workshop lecture “Managing Your Payer Contracts” at the 2007 Medical Group Management Association conference in October. And remember, justiﬁed or not, these reps take a lot of abuse from providers. “You have to be ﬁrm,” says Millburn. “But being nice doesn’t hurt.” Stay calm, politely state the facts, and let your data speak, rather than emotion. This will go much farther than impassioned pleas based on outrage. Where your contracts are. Administrative turnover can wreak havoc on document organization in a practice. Do you know where your contracts are? They are precious. Store them in one place, and have off-site backups like you would any valuable document. Make sure you have a current contract that is also signed by the payer. How can you dispute the terms if you can’t even prove it’s a ratiﬁed contract? And just as you do (or should do) with your insurance policies, archive the last one to two versions. If the payer ever decides to reevaluate your claims for possible revenue “take-back,” you can point WWW.PHYSICIANSPRACTICE.COM AVERAGE CHARGES (PHYSICIANS’ OWN CHARGE SCHEDULES) 2007 REGION Middle Atlantic Mountain New England North Central Paciﬁc South Central South East Overall Average 99201 $79.05 $67.26 $62.72 $67.29 $91.11 $72.21 $73.06 $73.24 99202 $107.47 $101.18 $88.34 $97.07 $117.49 $103.96 $104.89 $102.92 99203 $148.64 $146.96 $136.87 $136.98 $160.74 $139.94 $143.62 $144.82 99204 $230.15 $207.84 $186.53 $187.54 $210.45 $192.47 $195.61 $201.51 99205 $249.26 $266.17 $232.29 $238.71 $255.42 $251.46 $243.14 $248.06 AVERAGE $162.92 $157.88 $141.35 $145.52 $167.04 $152.01 $152.06 $154.11 REGION Middle Atlantic Mountain New England North Central Paciﬁc South Central South East Overall Average 99211 $52.21 $38.21 $41.31 $40.03 $59.60 $41.20 $43.56 $45.16 99212 $71.14 $62.99 $59.42 $61.88 $81.26 $63.92 $71.19 $67.40 99213 $88.45 $88.57 $84.54 $83.61 $107.54 $85.78 $94.12 $90.37 99214 $124.16 $132.86 $120.16 $123.65 $144.06 $124.07 $131.23 $128.60 99215 $168.20 $187.84 $162.40 $176.52 $190.57 $175.76 $175.89 $176.74 AVERAGE $100.83 $102.09 $93.57 $97.14 $116.61 $98.14 $103.20 $101.65 REGION Middle Atlantic Mountain New England North Central Paciﬁc South Central South East Overall Average 99241 $107.11 $99.62 $95.28 $99.43 $118.36 $104.13 $104.20 $104.02 99242 $205.47 $150.94 $135.89 $144.16 $160.94 $149.59 $138.83 $155.12 99243 $189.04 $197.56 $185.13 $185.98 $198.90 $189.01 $182.93 $189.79 99244 $248.12 $269.77 $245.05 $245.93 $251.85 $253.72 $239.31 $250.53 99245 $303.52 $336.69 $305.94 $304.10 $303.92 $321.81 $299.25 $310.75 AVERAGE $210.65 $210.92 $193.46 $195.92 $206.79 $203.65 $192.91 $202.04 to the clause in your old contracts that limits this activity. The important dates. When are your renewal dates for each of your contracts? What are the requirements for termination? Do you have any evergreen clauses? If so, get those renewal dates in particular into your Outlook calendar or other tickler software, and make sure it conks you in the head in plenty of time to contact the payer to renegotiate. (And make a note to yourself to excise those evergreen clauses for the following year.) JANUARY 2008 | PHYSICIANS PRACTICE | 27 http://WWW.PHYSICIANSPRACTICE.COM

Table of Contents Feed for the Digital Edition of Physicians Practice - January 2008

Physicians Practice - January 2008 Contents The Bigger Picture: Fixing Medicaid Letters Physicians Practice Pearls: You Can Teach an Old Dog New Tricks Noteworthy Cover Story: Fee Schedule Survey: 2007 Results Adding Ancillaries: Bucking the Practice Ask the Experts Idealab: 'How I Got Over My EMR Excuses' Technology: Don't Be Denied The Tech Doctor: Blessing or Curse? The Administrator's Desk: Learning From the Best Coding Career: To Partner, or Not? Management: Controlling Your Inventory Human Resources: How to Fire an Enployee Finance: Beyond Reimbursment - How to Fix Your Mix Classifieds Advertiser Index

Physicians Practice - January 2008

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