Services ordered during physician visits can account for 60-70 percent of the total healthcare premium dollar, according to an editorial written by Ted Norman, MD, an internist with Big Thompson Medical Group in The Coloradoan.
According to the report, while physician visits only account for 20-30 percent of the total premium dollar, services ordered can influence the total much more. When physicians own a service — by investing in a surgical or imaging center or As a consequence of this high percentage, physicians are in the crosshairs of payment reform.
Rules, regulations and reimbursements are in the process of being tweaked to curtail physician abuse, according to the report. Insurance companies are instituting stricter controls over the procedures that will be covered, and physicians are increasingly using evidence-based guidelines as a tool to minimize unnecessary procedures.
Dr. Norman says some physicians have turned to "concierge" medicine in response to decreasing reimbursement levels. "Some physicians align with healthcare and hospital systems in order to partner with revenue streams directly," he says. "Some physicians are even opting for employment with health insurance companies."
Related Articles on Coding, Billing and Collections:
Administrative Expenses for Medicare Plans Continue to Fluctuate
Report: Less Than 10% of Providers Are Halfway Completed in ICD-10 Transition
CMS Releases Four ICD-10 Implementation Handbooks to Ease Transition
According to the report, while physician visits only account for 20-30 percent of the total premium dollar, services ordered can influence the total much more. When physicians own a service — by investing in a surgical or imaging center or As a consequence of this high percentage, physicians are in the crosshairs of payment reform.
Rules, regulations and reimbursements are in the process of being tweaked to curtail physician abuse, according to the report. Insurance companies are instituting stricter controls over the procedures that will be covered, and physicians are increasingly using evidence-based guidelines as a tool to minimize unnecessary procedures.
Dr. Norman says some physicians have turned to "concierge" medicine in response to decreasing reimbursement levels. "Some physicians align with healthcare and hospital systems in order to partner with revenue streams directly," he says. "Some physicians are even opting for employment with health insurance companies."
Related Articles on Coding, Billing and Collections:
Administrative Expenses for Medicare Plans Continue to Fluctuate
Report: Less Than 10% of Providers Are Halfway Completed in ICD-10 Transition
CMS Releases Four ICD-10 Implementation Handbooks to Ease Transition