医疗保险的趋势 提交的费用与眼科服务的允许支付比率
Abdelrahman M Elhusseiny1,2, Muhammad Z Chauhan1, Ahmed B Sallam1,3
1Department of Ophthalmology, Harvey and Bernice Jones Eye Institute, the University of Arkansas for Medical Sciences, Little Rock, AR, USA.
Clinical ophthalmology (Auckland, N.Z.)
|March 25, 2024
概括
眼科服务的医生费用,包括手术和咨询,在2015年至2020年期间相对于医疗保险支付,相对而言稳步增加. 然而,与其他外科专业相比,这些费用支付比率仍然相对较低.
科学领域:
- 眼科医生 眼科 眼科
- 医疗保健经济学 医疗保健经济学
- 医疗账单计费 医疗账单计费
背景情况:
- 医生费用往往超过医疗保险补偿费率.
- 了解眼科的收费与支付比率对于财务分析至关重要.
- 这些比率随着时间的推移的趋势没有得到充分记录.
研究的目的:
- 检查眼科医生收费与支付的比率.
- 分析2015年至2020年程序和商的这些比率的趋势.
主要方法:
- 使用的医疗保险B部分服务费数据 (2015-2020年).
- 分析了眼科医生进行眼科手术和咨询的数据.
- 计算的中位数收费与支付比率 (提交的收费/医疗保险允许的支付).
主要成果:
- 总体中位数费用支付比率从2015年的2.00增加到2020年的2.23 (2.76%的平均年增长).
- 对于眼科手术,该比率从2.79上升到3.03 (2.01%的平均年增长).
- 咨询比率从1.85增加到2.06 (2.71%的平均年增长).
结论:
- 自2015年以来,眼科费用与医疗保险支付比率稳步增加.
- 与其他外科专业相比,眼科的超额费用相对较低.
- 在眼科提供者中,收费与支付比率的变化很小.
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