Please note the update below!
At the PMI practice management talk last week*, I ran through my usual RVU course which concludes with a walkthrough of the free RVU calculator. It dawned on me that it has a new use in 2013 that I hadn't envisioned when I wrote it.
Calculating what your "Medicaid boost" check is supposed to be.
As many of you know, most states are participating in the ACA-driven program that will subsidize Medicaid, state or private, to pay at Medicare levels for certain procedures. We have many clients who have already received these payments and they are substantial.
The problem is that when a check for $5,000 or $25,000 or even $80,000 (or more!) lands in your lap, you really don't have any idea if the number is right. Sure, it's great to collect that extra money, but what if your $25,000 is supposed to be $30,000? How would you know? When you are on the phone with that frustrating private Medicaid payer, wouldn't it be nice to be able to tell them how much of a check you expect to see before it arrives?
Of course, there are practice management systems that will help you figure this out easily, but for those of you stuck without any RVU functionality, here's what to do:
...and you can see exactly how much you should expect for payment on that code. The formula multiplies your units for each CPT code by the difference between the Medicare fee schedule and what you were paid. Presto!
How hard was that? I have been telling practices that if they get a check for $50,000 and they expect $52,000, it's probably not worth the effort to track the money down. But if you expect $52K and get $40K, that's another story.
* Why are these PMI events not fully packed?! I don't get it. Here's what one attendee had to tell me this week:
"I found the conference fascinating and extremely relevant to running my practice. On Monday, I revised our pricing, spoke to our staff about the 799.xx codes, calculated our Net Collection ratio, instituted the Transitional and Chronic Care Code...and that is only a fraction of my to-do list!
Without hyperbole, I suspect that by 10am Tuesday, I paid for my entry fee and by close of day, paid off my airplane fare and hotel costs. I will be recommending this seminar to anyone who will listen."
How can you beat that?!