Wiki Setting practice fee schedule

[Lori22]

I work for an orthopedic surgeon who recently left a large group setting to start his solo practice. The consultant who set up our system set our fees at 3 times the Medicare allowable, but our doctor feels this is too low.We see a large amount of Workers compensation & private injury patients as well as Medicare and private insureds. Any advice on how to come up with a fee schedule that won't leave money on the table, but also won't inflate our AR?

 

[dclark7]

When I worked in an Ortho practice we set our fee schedule by taking our highest dollar amount payer and going slightly over their fee schedule (I don't remember the percentage). That way we were getting paid close to our charges for the higher paying insurers.

 

[mdoyle53]

I set fees 10% above the highest paying payor. That way there is no money left on the table and revenue is optimized

 

[orthobiller2000]

We are Ortho too and set our fees 20% above the highest payor.