Many reimbursement programs contain detailed utilization estimates that help predict how many office visits and procedures the average patient will need in a year. Internists, for example, do not want utilization data that lump all patients over age 65 into one group. Specific utilization data can be invaluable in disputing fees. A growing number of computer programs can help physicians deal with reimbursement issues in managed care. Products range from overall practice management systems that handle all the needs of large groups to smaller, niche systems that carry out more limited functions such as creating fee schedules.
Most products contain relative value units and procedure codes from multiple sources.
The product tracks HMO enrollment, referrals, utilization and payment to physicians and can administer contracts for up to one billion members. ICD-9 and CPT codes electronically. Capitation Calculator allows practices to determine and evaluate capitated contracts. The program allows physicians to choose the procedures they will provide and offers utilization rates and cost data to estimate the cost of taking on a capitated contract. FeeLogic 2.0 helps physicians create, revise and compare fee schedules.