Three Ways to Achieve Four Important Fee Schedule Traits

By paying careful attention to your practice fee schedule, you’ll not only ensure you are getting paid insurers’ allowable charges but you also may help make sure health plans pay you on time.

That’s because your practice could be subject to arguments by insurers if you don’t maintain a sound practice fee schedule, says Bill Reynolds in TMA’s on-demand webinar Prompt Pay and the Revenue Cycle.

Your fee schedule, he says, should be:

  • Reasonable,
  • Defensible,
  • Consistent, and
  • Transparent.

You can realize these four criteria with these three tactics:

1. Establish a methodology for setting your fee schedule. For example one that is:

  • A percentile of national averages;
  • Cost-based using total work value units (RVUs) or standard costs; or
  • Time-based, using work RVUs or activity-based costs.

2. Benchmark your fee schedule against other fee schedules.
3. Review your fee schedule annually to stay competitive.

See How to Set a Standard Fee Schedule for Your Practice, for resources you use both to set and to benchmark fees. Others are:

Prompt Pay and the Revenue Cycle is Part 1 of a two-part series available in the TMA Education Center.

Published July 11, 2017

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Last Updated On

July 12, 2017

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