Medical Billing Forum
Billing => Billing => : vchere6535 June 03, 2010, 06:06:02 PM
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When a docotor starts their own medical practice, how do they know how much to bill? I can't picture a doctor calling other practices to find where they fit in with the fee schedule? And for Insurance Cos., etc - are the fee schedules publicly available?
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There is a calculation method they use.
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Medicare fee schedules are posted on the carriers web site. Many providers use the Medicare allowed amount and multiply by 130 - 150% and then round it. For example, if Medicare allows $99.05 for a 99214 then the provider may want to allow between $130-$150.
Michele
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I can't tell you how gratefull i am for this info. But I DON'T want to tell you how long I've tried to research this info. Thanks so much!!
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Our electronic billing system came with the Medicare Fee Schedule already built in. Then we did like the above poster said & multiplied it by 150% for other payers. Good luck!