by Aimee Wilcox, CPMA, CCS-P, CST, MA, MT, Director of Content
September 9th, 2014
Do you know what the fee schedules are for each of your top insurance companies? Do your providers know how much they are getting paid for the services they provide and manage their practice to maximize reimbursement?
Learn how to maximize reimbursement by knowing, understanding and using insurance fee schedules properly.
Collecting and maintaining insurance fee schedules each year can help your practice in many ways. But, you must obtain the fee schedules first.
- Make a list of your top 10 insurance companies.
- Make a list of the top 50-100 most billed CPT and HCPCS codes you submit to insurance companies and their price.
- For each of the 10 insurances, contact your representative and request the fee schedule for each code on your list. Do not accept their generic top 100 list of codes with prices as it won’t cover the codes your individual practices uses.
- Maintain a spreadsheet by CPT/HCPCS code and columns for each insurance carrier and their allowable fee for each code. Update it annually.
- Find-A-Code can be used to look up the fee schedule for any CPT code billed to Medicare. Look up the individual code and then open fee schedule, (facility or nonfacility) and it will show you the fee.
- Put the fee schedules to use in your practice to help determine deductibles and coinsurances due at the time of service, develop price estimates for patients, and to compare with insurance payments paid to ensure the insurance is paying according to their own fee schedule.