Can physicians charge whatever they want to Insurance Payers?

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CodeCast | Medical Billing and Coding Insights

Terry Fletcher

49 episodes

5 days ago

National Speaker and Healthcare Consultant, Auditor and Educator, Terry Fletcher CPC, CCC, CEMC, CCS, CCS-P, CMC, CMSCS, CMCS, ACS-CA, SCP-CA, knows from over 25 years medical reimbursement industry experience that Coding, Billing and Compliance for physician practices and hospitals can be tough to navigate. Her CodeCast Podcast series will share insights to current rules and regulations the Medicare payer requires, along with Commercial insurance plans' rules and reimbursement challenges. Discover revenue opportunities to maximize reimbursement in your medical practice, focusing on different medical specialties and platforms each episode.

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Health & Fitness

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National Speaker and Healthcare Consultant, Auditor and Educator, Terry Fletcher CPC, CCC, CEMC, CCS, CCS-P, CMC, CMSCS, CMCS, ACS-CA, SCP-CA, knows from over 25 years medical reimbursement industry experience that Coding, Billing and Compliance for physician practices and hospitals can be tough to navigate. Her CodeCast Podcast series will share insights to current rules and regulations the Medicare payer requires, along with Commercial insurance plans' rules and reimbursement challenges. Discover revenue opportunities to maximize reimbursement in your medical practice, focusing on different medical specialties and platforms each episode.

Show more...

Health & Fitness

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Can physicians charge whatever they want to Insurance Payers?

CodeCast | Medical Billing and Coding Insights

14 minutes 22 seconds

4 months ago

Can physicians charge whatever they want to Insurance Payers?

A question I’m often asked is, “Why do physicians charge so much?” There’s no easy answer, as there isn’t a fixed price list for medical services. Due to the healthcare system’s complexity and the absence of set prices, providers are largely free to charge what the market will bear.
However, can there be consequences for over-pricing or egregiously overcharging payers? Yes. It’s crucial to pay close attention to this issue, as it could lead to trouble not only legally but also in terms of regulatory compliance.
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