fee schedule

[PMR’s chill]

i'm new to the private world and am setting up my fee schedule with my billing company- they are telling me 300% medicare rate is pretty typical, Is that what most guys/gals out there are doing?

Anyone willing to share a copy of their fee schedule? I'd be very grateful.

Thanks,

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[thecentral09]

I work for a hospital so this doesn’t pertain to me, but that seems absurdly high. I thought good rates were 1.2 or 1.3 times Medicare

 

[bronchospasm]

Used to do 3 x Medicare but patients see these bills are thing we are making millions. Last year I changed it to 1.25 times my commercial payers. The bill now looks a lot more reasonable.

 

[lonelobo]

i'm new to the private world and am setting up my fee schedule with my billing company- they are telling me 300% medicare rate is pretty typical, Is that what most guys/gals out there are doing?

Anyone willing to share a copy of their fee schedule? I'd be very grateful.

Thanks,

3x Medicare is good for a fee schedule

 

[Ferrismonk]

I'm employed, but I think my company does 4x Medicare. That is nowhere near what we collect of course.

 

[jsaul]

I work for a hospital so this doesn’t pertain to me, but that seems absurdly high. I thought good rates were 1.2 or 1.3 times Medicare

you are confusing charges with collections. You are referring to collections. The OP is referring to charges. and yes I charge about 3 times medicare. Of course no one ever gets what we charge.

 

[painfree23]

What’s the point in “charging” x amount if Medicare has fixed payment schedules? Will u get paid more for a lumbar epidural by Medicare if u bill 3x the rate or 1.5x the rate?

 

[unchockey21]

What’s the point in “charging” x amount if Medicare has fixed payment schedules? Will u get paid more for a lumbar epidural by Medicare if u bill 3x the rate or 1.5x the rate?

Not by Medicare. By other payers.

 

[clubdeac]

What’s the point in “charging” x amount if Medicare has fixed payment schedules? Will u get paid more for a lumbar epidural by Medicare if u bill 3x the rate or 1.5x the rate?

The hope is to capture outliers like Ticare, workers comp or even some private insurers. It's a total shell game

 

[promethius]

What’s the point in “charging” x amount if Medicare has fixed payment schedules? Will u get paid more for a lumbar epidural by Medicare if u bill 3x the rate or 1.5x the rate?

I never really understood the reason for "overcharging" until I started my own practice. When you get the contracts from insurance companies to join their networks, they always include a provision in the compensation schedule that says that they will reimburse you the lower of either their fee schedule or what you charge when you submit a claim. To make it simple, physicians just charge a multiple of Medicare rates, so they can capture all of the collections from higher reimbursing insurances, as government insurances such as Medicaid and Medicare typically reimburse lower than private insurances.