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How are doctors payed? Comprehensive analysis?

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  • How are doctors payed? Comprehensive analysis?

    Anyone have any book/guide/resource recommendations that covers medicare,medicaid,payment schedules,CMS etc and how that ties to different payment models for physicians?

    td;lr: how are we payed really  - resource?

  • #2
    Are you asking about insurance payment or employment models


    • #3
      Both. Insurance payments is a bigger mystery to me.


      • #4
        Instance payments vary quite a bit based on location and whether you are private or part of a health system or can get IPA rates. The latter two being higher rates. Sometimes states try to much around things like MA now trying to penalize docs who use the 25 modifier.


        • #5
          First is to learn coding - I went to many coding seminars my last year of residency and first few years of practice, and still go occasionally. The Medicare rates are public information so you should have no problem getting them - focus on just a few of the codes you use most often and then review IN DETAIL as many EOB's as you can - read the denial codes and footnotes. This way you will learn EXACTLY what the insurance companies actually do (what they're supposed to do may be a different story...). Good luck.