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Applied Economics, 2004 has published the research
paper “An analysis of the variation in billing charges of medical
providers: causes and implications” by Dr. Michael
A. Spinelli, and Dr. George C. Canavos of
the Management Department, VCU School of Business and Dr. Douglas
M. Brown, Department of Economics, Georgetown University.
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The purpose of this paper is to review the billing methodology
of physicians that participate in fee-for-service plans, and, using
a data set of billing charges, determine the significance of the
variation in fees by providers of certain kind of procedures. Providers
use cost-plus pricing and take into account the medical aspects
of the services and market forces. Using the current Procedural
Terminologies (CPT) established by the American Medical Association,
the providers define the medical services by the six digit CPT
code, and bill accordingly. The statistical evidence shows that
there is some evidence that fees of providers who bill under the ‘medicine’ codes
tend to exhibit more variation in charges than other procedures.
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