Do you leave money on the table in medical cost projections?

Do you leave money on the table when you use medical cost projections (MCP) in negotiations?  You sure do, if  you think that surgeon fees are all that count. This is surprisingly common. Let me give you have a fuller idea of what’s involved in getting a good MCP, so I can help you get the most bang for your buck for your client. Here’s an example. I recently had a potential client ask me for a MCP “for a skin graft,” which he thought might have been for a scarred knee. I told him this would likely take me about 6-7 hours of work, including looking at medical records to see exactly what was being proposed and speaking to the physician. He demurred at this, telling me that he needed to keep costs down. “I’ll just have my client ask the doctor,” he said. Well, because the nurse in me really wanted to help him, I said, “Fine, and let me send you a list of what she should ask the physician when she sees him.” I am sure my not-quite-client was shocked to see this list of likely and possible billable items come across the wire: Preop testing charges– for what tests? General health panel, serum proteins, local area tissue oxygenation (get all CPT codes) Surgeon fees– do they include pre- and post-op office visits, or are those separate? (CPT codes for each) Anesthesia: What anesthesia technique– spinal, regional, general?  Hospital costs and anesthesiologist professional fees (CPT codes for each) CPT codes for all procedures performed as part of this grafting: graft harvesting (allograft, split-thickness, cultured, or other) or other...