The deeper you dig into health care data, the more interesting the stuff you learn. For years, insurers and health plans have been analyzing patient, physician, procedure, and facility data in an effort to learn more about the inter-relationships of costs, outcomes, demographics, and scores of other factors. A lot of this is arcane, a good bit useful, and some downright intriguing.
Into the latter category comes a study that shows surgeons performing the same procedures at the same hospital on similar patients with similar outcomes can incur very different costs.
The study, authored by Washington University in St Louis, indicates that costs can vary by as much as 45%.
What does this mean for you?
When assessing provider performance, you have to consider all aspects, including the total costs for their patients, and not just the physician components,
May
17
This is really interesting! Do you think the different rates might have something to do with different types of insurances, payers or the uninsured? Thanks for sharing….
Kathlene
It has to do with the billing practices of the offices. When authjorizing the procedure it is best to request billing costs with the ICD code and CPT code. Once this information is available to the UR office it can be transmitted to the BR company.