How To Increase Reimbursement

As physicians we continually strive to provide the best care for our patients. Unfortunately, there are so many outside factors that effect how we do our jobs – OR schedules, nurses, traffic, insurers etc. By using the GStirrup and converting our exam rooms into surgery suites we can take back control, and get greater reimbursements.

Office vs Hospital/ASC ProceduresMedical Reimbursement

Following, are a few examples of Medicare reimbursement for procedures done in the office versus hospital or ambulatory surgery center. (For Medicare, hospital and ASC reimbursement does not differ.)

52204Cystoscopy with Biopsy
Hospital/ASC
Physician Gain
264Reimbursement Increase
Office

Physicians performing in office procedure utilizing the GStirrup can increase their reimbursement by $264.73 or 172%.

58558Hysteroscopy
Hospital/ASC
Physician Gain
118Reimbursement Increase
Office

Physicians performing in office procedure utilizing the GStirrup can increase their reimbursement by $118.05 or 39%.

Carve Outs For In-office Procedures

Carve outs for in-office procedures can easily be obtained because of the huge cost-savings that insurers experience over hospital fees.  Carve outs are obtained by negotiating the best fee schedule for the particular procedures the physician performs the most. Tubal occlusion (CPT 58565) performed in a surgery center or outpatient hospital settings pays $500 to the surgeon (which includes a pre-operative office visit with all the included explanations of risk, prescription generation, travel to and from the facility, waiting for anesthesia induction, etc.)  At the physician’s office, that same insurer pays approximately $3300 to the surgeon: a 600% revenue increase with less hassles and more control.

Patients also enjoy a cost savings since office procedures are frequently considered office visits. Decreased co-payments and deductible responsibilities make for happier patients. GStirrup can help to make this a reality.

A.D.A. Compliance

The GStirrup helps your practice meet A.D.A. compliance.

“Examinations which require specialized positioning, such as gynecological examinations, must be accessible to a person with a disability. To provide an accessible gynecological exam to women with paralysis or other conditions that make it difficult or impossible for them to move or support their legs, the provider may need an accessible height exam table with adjustable, padded leg supports, instead of typical stirrups.”

Office vs Hospital/ASC ProceduresPrivate Insurer Reimbursement

The following, are a few examples of private insurer reimbursement for procedures done in the office versus hospital or ambulatory surgery center. (For Medicare, hospital and ASC reimbursement does not differ.)

52204Cystoscopy with Biopsy
Hospital/ASC
Physician Gain
378Reimbursement Increase
Office

Physicians performing in office procedure utilizing the GStirrup can increase their reimbursement by $378 or 169%.

58558Hysteroscopy
Hospital/ASC
Physician Gain
370Reimbursement Increase
Office

Physicians performing in office procedure utilizing the GStirrup can increase their reimbursement by $370 or 41%.