The pricing of recommended medical and surgical procedures to be included within the life care plan can be difficult at times. One may be asked for the medical codes associated with the procedure or, worst-case scenario, be informed that the provider, whether it be the hospital, physician, etc., will not give you the information requested.
When researching the life care plan pricing for procedures/hospitalizations, I continued to run into walls, including requests for medical/surgical codes. Because of this, I decided it would be a wise move to learn more about the medical coding field. It did not take long to realize there was a lot more to this field and its importance in appropriately pricing medical/surgical procedures and/or hospitalizations. Because of this, I became a Certified Medical Coder (CMC) so that I could better perform the task at hand.
When performing research for the pricing for a medical/surgical procedure, I utilize medical/surgical codes with reputable databases of healthcare pricing associated with the codes/procedures.
When requested to price a specific procedure, I will provide one with the codes, code descriptions, and pricing in the geographical area requested for the facility, physician, assistant, or co-surgeon, if appropriate, and anesthesia. This information will be in a Microsoft Word document, including a table(s) with the pricing and codes.
It is difficult to explain all that is included within the process of the pricing for the procedures. Each procedure is unique and may have different requirements than another. The pricing included is not reimbursement costs but usual and customary charges.
I charge $75 per hour with a one-hour minimum for procedure pricing and research. Please feel free to contact me for more information.