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I'd be grateful if anyone could tell me what they charge for patients seen via insurance payment?

Especially for:

Routine treatments
Laser
Nail Surgery
Musculoskeletal Podiatry: New Patient assessment
Video Gait Analysis and casting
Review and fitting
Orthoses (if they're covered)
Does anyone know of any national guidance with respect to what we should be charging the insurance companies for these treatments?

I will contact the Society this week as I'm sure they've got something!

Thanks a million!

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nicpod1

Would it not be fraudulent to charge those who are insured more? Is that not ripping off the insurance company? Its different if the insurance company dictates the fees and you charge the un-insured more. Surely the fees should be the same.

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Craig Payne
Department of Podiatry
La Trobe University
Melbourne, Australia
http://www.latrobe.edu.au/podiatry
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God put me on this earth to accomplish a certain number of things - right now I am so far behind, I will never die.
The views expressed above are those of the author and not that of La Trobe University
This is where I am, where are you?

Craig,

I totally agree!

However, what if everyone else is charging something else (higher or lower) and I trump up with significantly different prices? Would this not raise some eyebrows?

At present, I charge the same, but I think I'm under-charging within musculoskeletal Podiatry for reviews etc anyway!

Also, yes, some of the companies do set rates, but not many.

As you probably realise aswell, for self-paying patients, your rates are not always what you would want them to be anyway, as, in some areas, people just wouldn't pay them. This also, obviously, depends on what stage of business growth you're at. The more successful you are, the closer your fees would be to what really should be being paid.

At present, my self-paying fees are significantly below those of the Physios in the practice, mainly because of perception of the profession and because I'm still building my reputation, but I don't think that this should be the case should it?

Also, as most of the insurance companies do not cover orthoses, would it not be possible to help your patients by spreading some of the cost of the orthoses onto your appointment fees and just charging cost price for the Orthoses themselves?

I'm a long way from thinking about fraud, but there are several economical issues, which mean that I'm not actually charging what I should to self-payers and this could be rectified with the insurance companies?

Thanks for your concern!

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nicpod1

Hi.
Another aspect of Med Ins work is that often the patient, having already paid out their insurance premiums, is unwilling to pay for their treatment up-front.
This means the Pod has to bill the Ins Company and wait anything up to three months for payment.
Meanwhile cash which should be in the Practice Account is still in an Ins Company Account earning them interest.
Cheers,
davidh

David,

Yep!

The situation with a lot of my patients is that they are referred by people who are seeing them on their insurance and they expect that to continue!

In an ideal world, I wouldn't see any insurance patients at all! Would be more simple!

Thanks!

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nicpod1