Usual, Customary, and Reasonable Fees
UCR fees for medical services throughout the U.S.
Healthcare payments have become a complicated undertaking, not just for providers, but for payors as well. Ensuring that the right service is administered at the right cost is a cornerstone of proper healthcare coverage. But with one doctor billing a service at $100, and another doctor right nest door billing the same service at $300, how is a payor or third party administrator to know what's usual, customary, and reasonable?
It's easy: simply consult the Context4 Healthcare Inc. UCR databases. Context's UCR offerings ensure that insurance companies, employer groups, and other healthcare organizations and administrators have direct access to the fee information necessary to operate in today's diverse healthcare environment.
UCR databases currently available
Medical: Developed by a team of fee experts and mathematicians over a period of several years, the Medical UCR database sets new standards for quality while providing a credible, cost-effective alternative to existing payment systems.
Dental: Avoiding overpayment of dental services is a key cost containment component of any employee benefit plan. The Dental UCR database was created to ensure fair and equitable reimbursement for dental services and thereby help users avoid needless overpayments. The data can also be used to assist in the development of premiums through actuarial analysis.
Anesthesia: The Anesthesia UCR database provides users to fees for services personally furnished by anesthesiologists, as well as services provided under the anesthesiologists' medical direction, such as directing concurrent services with a resident or non-physician anesthetist. Fee data for all 50 states and U.S. jurisdictions is included.
HCPCS: Third-party payors are requiring standards against which to measure charges submitted by providers using HCPCS codes, and the HCPCS UCR database can be used to ensure fair and equitable reimbursement for these supplies and materials.
Outpatient facility: The unabated trend toward performing procedures and services in outpatient settings has intensified the need for cost-effective outpatient facility re-pricing data. The Outpatient Facility UCR database meets this increasing demand, allowing fair and equitable re-pricing of facility-based services such as hospital outpatient or ambulatory surgical center services.
Other fee data: Context supplies more than 80 data and fee products, such as schedules for Medicare fees, clinical lab fees, injection fees, DME fees, ASC fees, and much more.
