Hi James,

How are they calculating this?

Medicare is one of our best payers. For Medicare,

99213 we charge $85, they allow $69.31 and pay $55.45.

99214 we charge $120, they allow $102.76 and pay $82.21.

So even if we collect every last dollar of deductable and copay, our collection rate would be 81% on a 213 and 86% on a 214.

Factor in other insurances that pay less, self pays, etc and the percentage drops considerably.

The practices that collect 91-94%- is the denominator what they charge, or what insurance allows?

Thanks. Gene

Gene Nallin MD solo family practice with one PA Cumberland, Md