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Updateing Charges

  1. #1
    Location
    Dallas/Richardson/Sherman
    Posts
    20
    Smile Updating Charges
    Medical Coding Books
    Who should be the one responsible for creating the appropriate amount for each service fee as well as keeping it correctly updated regulary? I thought that it was up to the physician to let you know what the cost of his services are and if he wants to change them because the fee schedule has changed. If the fee schedule has changed for medicare do we use this as a guideline for all other insurance companies or does each one have its own fee schedule? Thanks!!!! LisaR
    Last edited by code@home; 01-15-2010 at 01:17 PM.

  2. #2
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    Do you have anyone in particular that takes care of your chargemaster? Who creates your CDM? Our billing manager does it here. We are a really small hospital, though, so it may differ in other, larger areas.

  3. #3
    Location
    Dallas/Richardson/Sherman
    Posts
    20
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    It is a small practice and I do billing for him from home (Chiro). I do not charge them alot, because they are such a small practice and not very busy and profitable so I do alot of little extra things for them. However, he is now wanting me to check medicare's fee schedule and compare it to his to make sure he is billing accordingly to their prices. I am just wondering where that usually falls for maintaining a proper fee schedule, the office manager or the billers.

  4. #4
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    My position is a coder/biller for a two physician practice. I review all fee schedules from all major insurance companies. Most are posted on their web pages. I compare the average fee for all and then price a percentage above. I discuss this with the doctor and office manager, and make fee changes based on the current rate.

  5. #5
    Location
    Dallas/Richardson/Sherman
    Posts
    20
    Smile
    Thanks so much that does help me!! I notice that you said that you check each insurance companies web site for their fee schedule. About how often do they update or change their fee schedule? How often would you recommend checking?

  6. #6
    Location
    Charleston, South Carolina
    Posts
    641
    Default
    At most physician practices I have worked, I reviewed our fees, allowables and contracts yearly and made suggestions to the physician(s) who then reviewed them and most of the time approved them (I was biller/coder and billing manager in these positions). Some suggstions were open to discussion and resolved quickly. At a new practice where I was hired as the office manager, the two physicians did not even have fees set up when we opened, I reviewed all contracts and set our fees, with the physicians just giving them a cursory look and approving.

    If you are noticing money left on the table for the physician you are billing for, you may want to ask him if he would like you to review his fees and go from there.
    Machelle Morningstar, CPC, COC, CEMC, COSC
    AHIMA Approved ICD-10-CM/PCS Trainer

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