2020 National Fee Analyzer
Optum360 | 2020 |
National Fee Analyzer provides physician practices with three percentiles of charge data and the average Medicare fee-for-fee schedule development, competitive analysis and contracting purposes. This comprehensive tool can help you estimate competitive fees and reimbursement for all areas of the country. A comprehensive introduction explains issues to be aware of for optimizing revenue when coding, contracting, evaluating and setting fee schedules.
- Charge information by CPT® code. Be prepared when negotiating contracts with insurance companies.
- Includes three percentiles of charge data. Use national 50th, 75th and 90th percentile charge data to discover revenue opportunities by comparing your fees with actual average charge data.
- Data from real-life claims from the FAIR Health database of 1.2 billion charge records. Develop and help maintain competitive fees while having defensible data during contract negotiations.
- Geographic conversion factors. Adjust national averages for specific geographic areas across the country with one resource.
- National Medicare fees and relative values. Stay on top of your fees with national Medicare fee schedule benchmarks.
- Values for the technical and professional components. See calculated percentiles for procedures that have professional (26) and technical (TC) splits.
- Stay up to date on coding and reimbursement issues. Coding and billing tips for both commercial and Medicare claims.
CPT is a registered trademark of the American Medical Association.
Nichole VanHorn, CPC, CCS-P
Ms. VanHorn has more than 15 years of experience in the health care profession. Her areas of expertise include CPT© and ICD-9-CM coding in multiple specialties, auditing, and education. Most recently she served as Clinical Auditor for the Children’s Hospital Physicians at Blank Children’s Hospital, Des Moines, Iowa where she functioned as an auditor for a multi-specialty group. Ms. VanHorn was responsible for the oversight of the physician coding and education section of the Corporate Compliance Program. She has been an active member of her local American Academy of Professional Coders chapter for several years and served as an officer.
Kristin Bentley, CPC
Ms. Bentley has 10 years of experience in the health care profession. She has an extensive background in professional component coding, with expertise in radiation therapy, chemotherapy, radiology, and ambulatory surgery procedure coding. She has conducted chart-to-claim audits and physician education. Ms. Bentley has functioned as a billing specialist and has extensive denial management experience. She is an active member of the American Academy of Professional Coders.