Future financial neonatal shock.
In a changing economic climate, the neonatologist must be aware of all of the forces that can affect the practice of neonatology. In addition to clinical issues, billing and reimbursement must take into account physician work and common procedural terminology (CPT) codes, which accurately describe the medical services and procedures delivered. An understanding of this coding and resource-based work unit system is necessary to prevent financial loss. The influence of managed care, capitation, fixed per-case reimbursement, practice guidelines and care maps have already seriously affected clinical practice patterns. The neonatologist must be proactive in negotiating contracts using historic information and outcome data to define and defend the quality of care provided.
Martin
G I
GI
Neonatal Intensive Care Unit, Citrus Valley Medical Center, West Covina, CA, USA.
Gattshall
K
K
MacPherson
F
F
Tiffany
S
S
D000043:Abstracting and Indexing; D003953:Diagnosis-Related Groups / Q000145:classification* / Q000191:economics; D018588:Fee-for-Service Plans / Q000191:economics; D005251:Fees, Medical; D005544:Forecasting; D006801:Humans; D007357:Insurance, Physician Services / Q000191:economics*; D015931:Intensive Care, Neonatal / Q000145:classification* / Q000191:economics; D008329:Managed Care Programs / Q000191:economics; D016345:Medicare Part B / Q000191:economics; D009359:Neonatology / Q000145:classification / Q000191:economics* / Q000639:trends; D017410:Practice Guidelines as Topic; D012051:Reimbursement Mechanisms / Q000191:economics; D015895:Relative Value Scales; D014481:United States