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Sample relevant radiology savings analysis

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Information about Sample relevant radiology savings analysis
Health & Medicine

Published on March 6, 2014

Author: ScottFuqua

Source: slideshare.net

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PRCDR_ CD 72193 71260 74160 72146 72132 73721 73718 72193 71260 74160 70450 70450 72146 73721 73721 73721 73721 70486 72193 74160 70553 71250 73700 72193 74160 74170 73221 70553 70450 70450 PRCDR_DSCRPTN Computerized Axial Tomography, Pelvis- With Contrast Material(s) Computerized Axial Tomography, Thorax- With Contrast Material(s) Computerized Axial Tomography, Abdomen- With Contrast Material(s) Magnetic Resonance (eg, Proton) Imaging, Spinal Canal And Contents, Thor Computerized Axial Tomography, Lumbar Spine- With Contrast Material Magnetic Resonance (eg, Proton) Imaging, Any Joint Of Lower Extremity-wi Magnetic Resonance (eg, Proton) Imaging, Lower Extremity, Other Than Joi Computerized Axial Tomography, Pelvis- With Contrast Material(s) Computerized Axial Tomography, Thorax- With Contrast Material(s) Computerized Axial Tomography, Abdomen- With Contrast Material(s) Computed Tomography, Head Or Brain- Without Contrast Material Computed Tomography, Head Or Brain- Without Contrast Material Magnetic Resonance (eg, Proton) Imaging, Spinal Canal And Contents, Thor Magnetic Resonance (eg, Proton) Imaging, Any Joint Of Lower Extremity-wi Magnetic Resonance (eg, Proton) Imaging, Any Joint Of Lower Extremity-wi Magnetic Resonance (eg, Proton) Imaging, Any Joint Of Lower Extremity-wi Magnetic Resonance (eg, Proton) Imaging, Any Joint Of Lower Extremity-wi Computed Tomography, Maxillofacial Area- Without Contrast Material Computerized Axial Tomography, Pelvis- With Contrast Material(s) Computerized Axial Tomography, Abdomen- With Contrast Material(s) Magnetic Resonance (eg, Proton) Imaging, Brain (including Brain Stem)- W Computed Tomography, Thorax- Without Contrast Material Computed Tomography, Lower Extremity- Without Contrast Material Computerized Axial Tomography, Pelvis- With Contrast Material(s) Computerized Axial Tomography, Abdomen- With Contrast Material(s) Computerized Axial Tomography, Abdomen- Without Contrast Material, Follo Magnetic Resonance (eg, Proton) Imaging, Any Joint Of Upper Extremity-wi Magnetic Resonance (eg, Proton) Imaging, Brain (including Brain Stem)- W Computed Tomography, Head Or Brain- Without Contrast Material Computed Tomography, Head Or Brain- Without Contrast Material TOTAL_UNI PRCDR_MODIFIER TS _CD 26 26 26 26 26 ALLOWED_AMT 26 RT RT RT 26 26 26 26 LT RT 26 $106.99 $113.81 $116.90 $147.19 $225.58 $1,105.00 $1,097.00 $1,311.18 $1,333.32 $1,393.18 $1,519.98 $1,519.98 $1,934.60 $131.41 $131.41 $1,166.93 $1,197.22 $77.41 $354.25 $391.00 $620.75 $1,618.80 $1,651.10 $1,673.25 $1,673.25 $2,496.60 $2,739.80 $3,819.25 $71.40 $732.16 $1,001,978.45 Employer Group through Aetna Total Paid $1,001,978.45 Total PPO Savings ****Represents page 1 of 29. Total claims reviewed = 1211 $204.00 $218.00 $224.00 $275.00 $484.00 $1,390.00 $1,225.00 $1,599.00 $1,626.00 $1,699.00 $1,617.00 $1,617.00 $2,276.00 $213.10 $213.10 $1,502.53 $2,153.00 $241.00 $354.25 $391.00 $620.75 $1,704.00 $1,738.00 $1,673.25 $1,673.25 $2,628.00 $2,884.00 $3,819.25 $118.00 $832.00 $1,593,407.84 Self Funded Employer Using Aetna 1700 Total Lives on the Plan 1.00 1.00 1.00 1.00 2.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 BILLED_AMT Avg Cost Per CPT $591,429.39 $828.08 Relevant Amount Relevant Savings $50.00 $50.00 $50.00 $60.00 $100.00 $900.00 $900.00 $550.00 $550.00 $550.00 $450.00 $450.00 $900.00 $60.00 $60.00 $700.00 $700.00 $50.00 $50.00 $50.00 $70.00 $715.00 $715.00 $765.00 $765.00 $865.00 $1,000.00 $1,200.00 $50.00 $715.00 $56.99 $63.81 $66.90 $87.19 $125.58 $205.00 $197.00 $761.18 $783.32 $843.18 $1,069.98 $1,069.98 $1,034.60 $71.41 $71.41 $466.93 $497.22 $27.41 $304.25 $341.00 $550.75 $903.80 $936.10 $908.25 $908.25 $1,631.60 $1,739.80 $2,619.25 $21.40 $17.16 $546,465.00 C I T Y _ N SRC_PRVDR_ID M 4049762 4049762 4049762 7994013 7387561 7328055 7328055 6560700 6560700 6560700 6560425 6560435 6560685 7974947 7974947 7723468 6580495 7274613 7781395 7781395 7781395 7924354 4131595 6590365 6590365 9021253 7924354 6590365 7893231 6600315 $449,683.55 Employer Group through Relevant Total Paid $546,465.00 Additional Savings BELOW PPO $449,683.55 44.88% Avg Cost Per CPT Avg Savings Per CPT 45.46% $451.62 $376.46 Newport News Newport News Newport News Norfolk Norfolk Virginia Beach Virginia Beach Virginia Beach Virginia Beach Virginia Beach Norfolk Norfolk Virginia Beach Seattle Seattle Vancouver Seattle Milwaukee Tomah Tomah Tomah La Crosse Tomah La Crosse La Crosse Sparta La Crosse La Crosse Morgantown Morgantown

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