Term
| President’s Council of Advisors on Science & Technology (PCAST, 2015) report recommended changes to cut ___ ___ costs, give consumers more ___, & incentivize tech ___ |
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Definition
| hearing aid; choices; innovation |
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Term
| Upshot: Called for improved ___ in fee structures by itemizing prices for services and technology |
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Definition
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Term
| Separate the charges for related products or services |
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Definition
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Term
| What's an example of bundling? |
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Definition
price for fitting appointment, price for hearing aid(s), price for
warranty, price for follow-up appointment(s) |
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Term
| Preferred term for “unbundle” is ___ billing: list the individual units of the parts |
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Definition
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Term
| What are advantages of itemize billing? |
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Definition
| patients understand all parts of the delivery process for hearing aids |
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Term
| Now providers are encouraged to “___” prices |
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Definition
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Term
| cost per hour that must be brought in to cover the fixed costs |
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Definition
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Term
| Once you know the ___ ___ rate, then can make a superbill with CPT codes & Health Care Current Procedure Coding System (HCPCS) codes to determine a fee schedule |
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Definition
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Term
Steps to Determine the Cost of Doing Business:
-Calculate # of annual ___ ___
-Analyze ___ costs
-Determine the ____ hourly rate
-Add in the desired ___ |
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Definition
| contact hours; operating; break-even; profit |
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Term
| How do you determine your annual billable hours? |
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Definition
Figure out:
-patient contact hours per week
-Number of weeks worked per year
-Number of providers
-Then multiple those numbers together |
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Term
| What are the operating costs? |
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Definition
-Salary/benfits
-Clinic expense (rent, utilities, phone, ads)
-Cost of goods (all of the things you by for resale) |
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Term
Hourly Breakeven Rate:
-Subtract the cost of ___ from the total annual ___ expenses
-Divide remaining amount by the annual ___ ___
-Yields: hourly rate needed to ___ |
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Definition
| goods; clinic; contact hours; breakeven |
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Term
| If you want to calculate the hourly breakeven with desired profit then you would do.... |
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Definition
((Annula expenses-cost of goods)+desired profit)/annual contact hours
[image] |
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Term
-Set fees ___
-The most important thing is NOT ___’ prices/fees – it is how much does it cost ___ practice to operate?
-If an in-network provider for insurance that provides hearing aids, then set fees at or above the ___ amount reimbursed by the insurance company |
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Definition
| annually; others; YOUR; maximum |
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Term
Example of In-Network Provider:
-BLANK insurance company covers probe-microphone measures for $80. Then bill ALL patients at least $___(conformity evaluation, V5020)
-Ask for a ___ ___ from all in-network insurance plans to find out the maximum amount an insurance company will pay for procedures
-If you do business with multiple carriers (insurance companies): A pays $65.00, B pays $70, C pays $80. Make sure fee for service is max amount ($___) or more when you bill it to any of the 3 providers (e.g. set ONE price for service) |
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Definition
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Term
Itemizing:
-Puts more value on ___ ___ & less on the hearing aids
-Itemizing helps lower the ___ costs of hearing care
-Only ___ of audiologists surveyed in 2012 understood how to determine an hourly break-even rate & set fees using this information |
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Definition
| audiology skills; upfront; half |
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Term
| What should a purchase agreement include? |
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Definition
-Fees for professional services
-Prices for devices
-Terms of warranty
-Trial period
-Evaluation and adjustment period |
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Term
| What are 2 HCSPCS codes for hearing aid evaluation? |
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Definition
V5011: Fitting/orientation/checking of the HA
V5014: Repair/modification of a HA |
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