Practice Management
Q: What is case-rate reimbursement, and how does it work in the urgent care sector? A: Case rate, sometimes called flat rate, describes a reimbursement structure in which providers receive a flat reimbursement rate for every patient visit, no matter what service they provide. Case-rate reimbursement means that the urgent care is contracted with the payor to receive the same reimbursement regardless of the acuity of care, whether it’s the treatment of a hangnail or …
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UnitedHealthcare Commercial in New Jersey and UnitedHealthcare Oxford of New Jersey will stop reimbursement of HCPC code S9083 as of January 1, 2018, according to a letter sent to providers. Instead, the plans are advising providers to “only report the evaluation and management and/or procedure code(s) that specifically describe the service(s) performed.” S9083, they say, is “informational” and relates to a type of reimbursement rather than a specific service. Charges billed for S9083 will be …
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