When setting prices for medical services, many providers rely on Medicare data to assess their charges.
However, Veritas Experts follows the American Medical Association’s position that there is no relationship between the Medicare fee schedule and Usual, Customary, and Reasonable Fees (UCR).
Providers must recognize the program only covers a small portion of the population, and its data does not represent all patients.
Second, Medicare reimbursement rates remain flat or have declined over the years while inflation continues to rise. Using Medicare as the chargemaster baseline is not an accurate reflection of market prices.
As a result, providers who use Medicare data to inform their pricing decisions may end up charging too little for their services.
Medical Billing and Benchmarking Databases
To better understand market prices, providers should consult a medical billing professional like those at Veritas Experts.
We excel at sourcing information from benchmarking databases to help healthcare providers set accurate chargemaster rates. By comparing the cost of services in the region, they can better understand what is fair and reasonable for each practice.
More than just the provider’s geographic location, our experts also consider the type of service being provided and the payer mix. In addition, our experts help providers understand how different reimbursement rates from different payers may impact their overall pricing strategy.
By understanding all of these factors, providers can develop a pricing strategy that accurately reflects their services’ true market value, ensuring their practice’s financial health and the best possible care for their patients.
Contact Veritas Experts today to learn more.