Question

Some physician practices will bill at rates from 100% of medicare to 500% of medicare. which one do you think is correct and why? discuss what are you going to look for and why?

Answer 1

From the perspective of the patient, clearly we would like to be billed at the lower rate of 100%. However, the physician most likely wants the maximum revenue so he would like the 500% rate. Somewhere in between should be acceptable. If a physician is only charging the 100% rate, as a patient, that may make me think that he is charging a reduced rate, possibly because he is not that good of a physician and needs more patients. I think a rate of 200-250% would be a good indicator that the physician is good and fair. He is not overcharging, but he is also not charging to little, which would be a red flag.