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Marty Neltner

Articles by Marty Neltner

We work with medical oncologists/hematologists across the country in both the private practice and hospital settings. Based on our experience, I'd like to point out a couple of key flaws in the current Medicare code interpretations.

Physicians regularly miscalculate their non- Medicare fees, which means that revenue is slipping away. Have you reviewed your fee schedules lately to determine if you’re getting proper reimbursement for all your services? Now is a great time to take a look and make appropriate changes for 2009. Here are some steps to determine if private payers are reimbursing you at a fair rate.

Basically, the manufacturer list price for darbepoetin is so high that it is nearly impossible to buy it as a single-source drug. Instead, companies are creatively bundling drugs, putting physicians under contractual obligation to purchase drugs as a package in order to get the best price and get the “rebate.”

I recently attended a healthcare conference titled “Leadership Summit on Evidence-Based Medicine” in Alexandria, Virginia. As you know, private industry, insurance companies, and the government are trying to develop an evidence-based medicine approach to help check the growth of healthcare expenditures.

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