Physicians Practice - January 2008 - (Page 29)

GETTING PAID What you want and why. When you were a kid and you asked mom for something you wanted, which got you more respect: Clearly outlining the beneﬁts and costs of keeping the nifty turtle you just found in the back yard, or sputtering a pouty “’Cause I wanna turtle!”? Likewise for dealing with payers. What goals have you set for the following year? Five years? What will they cost? Why are they worthwhile to pursue? “This will go much farther than, ‘Hey, can you pay me more?’ They’ll say no,” says Breeze. “The next step is ‘Well, here’s why.’ By that you’ve set yourself apart from most other physicians. I’m not going to pretend that every carrier is just going to fall over when you present your numbers. But they’ll take you more seriously.” Know how to walk away. This idea can knot up the most placid physician tummy. “It’s very, very hard to walk away,” says Mertz, especially if it means your waiting room will become 20 percent emptier. But Madden maintains that it could be a step worth taking. “You never lose all of your patients when you drop a plan,” she says. Of course, you want to terminate in the right way. Send a letter to both the insurance company (and the potentially affected patients) that in 12 months you’ll terminate if they won’t raise your rates. Cobuzzi recommends including a sentence like “Your fee schedule is inconsistent with my cost structure.” “If enough physicians start dropping their [contracts] and the panels for these payers get small enough, even if the small doctors drop them — and it may take a year or two or three — the insurance companies will come knocking at the door and say ‘What can we do?’ because they won’t have any physicians to work with,” she says. ALLOWABLES FOR NON-E&M CODES CPT CODE 10021 10022 10040 10060 10120 11000 11100 11101 11200 11300 11301 11305 11400 11401 11730 11750 11900 12001 12032 12051 17000 17003 17004 17100 17110 17250 17311 19103 19120 19125 AVERAGE REIMBURSEMENT $123.50 $134.76 $98.43 $99.05 $115.80 $76.80 $89.15 $37.48 $95.14 $54.90 $99.46 $72.31 $110.42 $128.79 $82.79 $146.08 $37.50 $124.05 $308.38 $199.67 $68.75 $17.58 $204.75 $81.74 $95.22 $61.50 $646.83 $369.80 $506.58 $603.40 $398.68 $2,053.91 $71.58 $82.63 $1,963.37 $1,041.67 $345.17 $600.00 $496.87 $1,734.96 $1,196.67 $1,715.89 $394.63 $843.19 $565.49 $559.15 $809.54 $6,139.30 $684.55 $142.62 $1,117.08 $409.40 $131.91 $2,300.86 $4.63 $6.79 $213.74 $526.48 $348.01 $311.76 $270.57 $306.00 $1,536.19 AVERAGE PERCENTAGE INCREASE IN HEALTH INSURANCE PREMIUMS COMPARED TO INFLATION AND WORKERS’ EARNINGS, 1999 – 2007 16% 14% 12% 19301 19318 20550 20610 22554 23410 25600 25605 26055 27130 27236 27447 28285 29826 29848 29877 29881 30140 30520 31231 31254 31256 31575 33533 36415 36416 I I I Premium Increase Overall Inﬂation Workers’ Earnings 10% 8% 6% 4% 2% 0% 1999 2000 2001 2002 2003 2004 2005 2006 2007 36556 42820 42826 43235 43239 43249 44140 Note: Data on premium increases reﬂects the cost of health insurance premiums for a family of four. The average premium increase is weighted by covered workers. Sources: Kaiser/HRET Survey of Employer-Sponsored Health Beneﬁts, 1999-2007; KPMG Survey of Employer-Sponsored Health Beneﬁts, 1993, 1996; The Health Insurance Association of America (HIAA), 1988, 1989, 1990. Bureau of Labor Statistics, Consumer Price Index, U.S. City Average of Annual Inﬂation, All Urban Consumers (CPI-U) (April to April), 1988-2007; Bureau of Labor Statistics, Seasonally Adjusted Data from the Current Employment Statistics Survey, 1988-2007 (April to April). WWW.PHYSICIANSPRACTICE.COM JANUARY 2008 | PHYSICIANS PRACTICE | 29 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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