Looking for some opionion as to how to arrive at your practice's fees. We are reviewing all of our charges and feel that we need to make some adjustment's to our current fees. We have been looking at charging 125% of the higher reimbursements, but we are not sure if that is the best way.
I am not asking for your fees - just a good solid way to decide what the fees should be
Thanks in advance for your information
Erica Thorne, CPC
AFD
Erica,
I do all of mine by hand!!! yippppie

(I hate it

) but let me tell you what I do.
I get a list of all of the contracts that my practice participates with.
Next I pull the allowables for every CPT the practice does for every insurance.
I put all of these in a spread sheet and use Excel to tell me what percentage each insurance pays of the current Medicare fee schedule. (This will help you in the long run - I always always get phone calls, how much does this insurance pay for this, or what percentage does so and so pay for this ... it's such a pain, but I always resort back to the spread sheet)
I determine who is the highest payer. My highest payer pays roughly 150% of the Medicare fee schedule - so I know that all of my fees must be higher than 150%.
Then I will make columns for say 160%, 170%, 180%, 200% - I will recommend what I think is appropriate (keeping in mind speciality, write offs, self pay, and occassional off the wall insurances who pay exactly what you charge) and I will let the physician/practice decide. Normally they always go with what I say. (Unless it's a hospital practice, that has to go through regulatory...)
I always use a % of Medicare to give me my final fee (Most payers always default to a % of Medicare)
Then as a procedure pops up that they have never done before, just pull up the Medicare allowable and times it out by your final percentage.
Hope this helps
