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Radiation Business Solutions Blog

Response for Radiation Oncologists Regarding the Medicare Physician Payment Information Release

Dan Moore - Thursday, April 10, 2014

As you may know, CMS released Medicare claims data including billed charges and total physician payments to the public on Wednesday. While we can appreciate the need for some transparency in the system, we are concerned that this information can be taken out of context and may lead to some misunderstandings. We offer some of the suggestions that we have provided to our own clients to assist them in responding to questions from patients, referring physicians, and other members of their communities. 

If you haven’t already done so, go out to the CMS website and search for your listing. Review the data posted on the website and compare it to your own records for accuracy. Remember, there is a timing delay between billed charges and collection of payment, so in all likelihood your records will not match the CMS number exactly. In addition, payments that were made under a group provider number will not show in the CMS database under your personal provider numbers, so this may also lead to some discrepancies.

Some talking points that you might want to keep in mind when responding to patients or others:

• “The data is taken out of context. It does not account for the quality of care provided to address individual, specific patient needs. Our practice follows evidence based medicine that is supported by the National Comprehensive Cancer Care Institute (NCCN).”

• “The data does not give any context in terms of the overhead costs associated with our specialty. It costs several millions of dollars to acquire the technology and to build our cancer center, so that we can provide care to our patients.”

• “The ranking data does not account for the differences between each physician’s patient demographics. Every practice has a unique mix of Medicare patients, versus commercial patients, versus self-pay patients.”

• “The data may contain errors. Physicians have not had an opportunity to review the data to make sure that it is accurate."

Finally, this may be a good time to review your media relations policies. Be sure that questions from the press are referred to the appropriate person in your office.

At Radiation Business Solutions, we believe that there is no way to put a price tag on the care and healing that radiation oncologists give to patients and families. Your value is priceless and we are honored to work beside you. If there is anything that RBS can do to help you with this matter, please don’t hesitate to contact us.

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