I'm getting hammered by one of my posts at the notion that a doctor of doctor office would possibly upsell patients for non-covered services. My derm office text me several times a week for me to sign up to deliver covd tests. Easy money.
Here is an example:
Medicare will now pay physician practices and other eligible providers to distribute over-the-counter (OTC) COVID-19 test kits to beneficiaries. Patients with Medicare Part B coverage, including those enrolled in Medicare Advantage plans, can get up to eight tests per calendar month for the duration of the COVID-19 public health emergency.
No new enrollment process is required. Pharmacies and health care providers that currently provide ambulatory care such as vaccines, lab tests or other clinic-type visits to people with Medicare are eligible to participate.
The Centers for Medicare & Medicaid Services (CMS) established an HCPCS Level II code, K1034, to bill for these tests. The code is for a single test and includes all Food and Drug Administration-approved, authorized or cleared COVID-19 tests for which the specimen is self-collected and the test is self-administered. Providers submit claims for the tests to the same Medicare administrative contractor (MAC) to which they submit other Medicare claims. Other payers, including private insurance and Medicaid programs, may also utilize this code.
CMS established a fixed national payment rate of $12 per OTC COVID-19 test. If a participating pharmacy or health care provider usually charges less than $12 per test, then Medicare pays the lower amoun
I am not in any way suggesting that this is a dishonest practice.
Cataract surgery= upsell to premium lenses
Derm= upsell to cosmetic proceedures, sell products
GI= my GI doc recommends and sells her own brand of supplements
PCP= immunizations, requiring virtual visit for RX refills,
ENT= selling hearing aids
FROM AMA site
The new report examines the different methods used to compensate physicians from 2012 to 2018, such as salary, personal productivity, practice financial performance, or bonus unrelated to personal productivity. Physicians in solo practice are excluded from survey questions as their compensation is directly related to practice financial performance, which itself is partly driven by productivity.
Salary was the main method of physician compensation in 2018, with two-thirds of doctors earning a portion of their income from salary and 56.9% earning more than half of their income from this method of payment.
Meanwhile, 54.9% of physicians received compensation based on personal productivity and, for 28.6%, more than half of their income was productivity based.
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