Sample relevant radiology savings analysis

•

1 like•414 views

Scott Fuqua

Health & Medicine

PRCDR_
CD

72193
71260
74160
72146
72132
73721
73718
72193
71260
74160
70450
70450
72146
73721
73721
73721
73721
70486
72193
74160
70553
71250
73700
72193
74160
74170
73221
70553
70450
70450

PRCDR_DSCRPTN

Computerized Axial Tomography, Pelvis- With Contrast Material(s)
Computerized Axial Tomography, Thorax- With Contrast Material(s)
Computerized Axial Tomography, Abdomen- With Contrast Material(s)
Magnetic Resonance (eg, Proton) Imaging, Spinal Canal And Contents, Thor
Computerized Axial Tomography, Lumbar Spine- With Contrast Material
Magnetic Resonance (eg, Proton) Imaging, Any Joint Of Lower Extremity-wi
Magnetic Resonance (eg, Proton) Imaging, Lower Extremity, Other Than Joi
Computerized Axial Tomography, Pelvis- With Contrast Material(s)
Computerized Axial Tomography, Thorax- With Contrast Material(s)
Computerized Axial Tomography, Abdomen- With Contrast Material(s)
Computed Tomography, Head Or Brain- Without Contrast Material
Computed Tomography, Head Or Brain- Without Contrast Material
Magnetic Resonance (eg, Proton) Imaging, Spinal Canal And Contents, Thor
Magnetic Resonance (eg, Proton) Imaging, Any Joint Of Lower Extremity-wi
Magnetic Resonance (eg, Proton) Imaging, Any Joint Of Lower Extremity-wi
Magnetic Resonance (eg, Proton) Imaging, Any Joint Of Lower Extremity-wi
Magnetic Resonance (eg, Proton) Imaging, Any Joint Of Lower Extremity-wi
Computed Tomography, Maxillofacial Area- Without Contrast Material
Computerized Axial Tomography, Pelvis- With Contrast Material(s)
Computerized Axial Tomography, Abdomen- With Contrast Material(s)
Magnetic Resonance (eg, Proton) Imaging, Brain (including Brain Stem)- W
Computed Tomography, Thorax- Without Contrast Material
Computed Tomography, Lower Extremity- Without Contrast Material
Computerized Axial Tomography, Pelvis- With Contrast Material(s)
Computerized Axial Tomography, Abdomen- With Contrast Material(s)
Computerized Axial Tomography, Abdomen- Without Contrast Material, Follo
Magnetic Resonance (eg, Proton) Imaging, Any Joint Of Upper Extremity-wi
Magnetic Resonance (eg, Proton) Imaging, Brain (including Brain Stem)- W
Computed Tomography, Head Or Brain- Without Contrast Material
Computed Tomography, Head Or Brain- Without Contrast Material

TOTAL_UNI PRCDR_MODIFIER
TS
_CD

26
26
26
26
26

ALLOWED_AMT

26
RT
RT
RT
26
26
26
26
LT

RT
26

$106.99
$113.81
$116.90
$147.19
$225.58
$1,105.00
$1,097.00
$1,311.18
$1,333.32
$1,393.18
$1,519.98
$1,519.98
$1,934.60
$131.41
$131.41
$1,166.93
$1,197.22
$77.41
$354.25
$391.00
$620.75
$1,618.80
$1,651.10
$1,673.25
$1,673.25
$2,496.60
$2,739.80
$3,819.25
$71.40
$732.16
$1,001,978.45

Employer Group through Aetna
Total Paid
$1,001,978.45
Total PPO
Savings

****Represents page 1 of 29. Total claims reviewed = 1211

$204.00
$218.00
$224.00
$275.00
$484.00
$1,390.00
$1,225.00
$1,599.00
$1,626.00
$1,699.00
$1,617.00
$1,617.00
$2,276.00
$213.10
$213.10
$1,502.53
$2,153.00
$241.00
$354.25
$391.00
$620.75
$1,704.00
$1,738.00
$1,673.25
$1,673.25
$2,628.00
$2,884.00
$3,819.25
$118.00
$832.00
$1,593,407.84

Self Funded Employer Using Aetna
1700 Total Lives on the Plan

1.00
1.00
1.00
1.00
2.00
1.00
1.00
1.00
1.00
1.00
1.00
1.00
1.00
1.00
1.00
1.00
1.00
1.00
1.00
1.00
1.00
1.00
1.00
1.00
1.00
1.00
1.00
1.00
1.00
1.00

BILLED_AMT

Avg Cost Per
CPT

$591,429.39

$828.08

Relevant Amount

Relevant Savings

$50.00
$50.00
$50.00
$60.00
$100.00
$900.00
$900.00
$550.00
$550.00
$550.00
$450.00
$450.00
$900.00
$60.00
$60.00
$700.00
$700.00
$50.00
$50.00
$50.00
$70.00
$715.00
$715.00
$765.00
$765.00
$865.00
$1,000.00
$1,200.00
$50.00
$715.00

$56.99
$63.81
$66.90
$87.19
$125.58
$205.00
$197.00
$761.18
$783.32
$843.18
$1,069.98
$1,069.98
$1,034.60
$71.41
$71.41
$466.93
$497.22
$27.41
$304.25
$341.00
$550.75
$903.80
$936.10
$908.25
$908.25
$1,631.60
$1,739.80
$2,619.25
$21.40
$17.16

$546,465.00

C
I
T
Y
_
N
SRC_PRVDR_ID M

4049762
4049762
4049762
7994013
7387561
7328055
7328055
6560700
6560700
6560700
6560425
6560435
6560685
7974947
7974947
7723468
6580495
7274613
7781395
7781395
7781395
7924354
4131595
6590365
6590365
9021253
7924354
6590365
7893231
6600315

$449,683.55

Employer Group through Relevant
Total Paid
$546,465.00
Additional
Savings BELOW
PPO
$449,683.55

44.88%

Avg Cost Per
CPT
Avg Savings Per
CPT

45.46%

$451.62
$376.46

Newport News
Newport News
Newport News
Norfolk
Norfolk
Virginia Beach
Virginia Beach
Virginia Beach
Virginia Beach
Virginia Beach
Norfolk
Norfolk
Virginia Beach
Seattle
Seattle
Vancouver
Seattle
Milwaukee
Tomah
Tomah
Tomah
La Crosse
Tomah
La Crosse
La Crosse
Sparta
La Crosse
La Crosse
Morgantown
Morgantown

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Sample relevant radiology savings analysis

1. PRCDR_ CD 72193 71260 74160 72146 72132 73721 73718 72193 71260 74160 70450 70450 72146 73721 73721 73721 73721 70486 72193 74160 70553 71250 73700 72193 74160 74170 73221 70553 70450 70450 PRCDR_DSCRPTN Computerized Axial Tomography, Pelvis- With Contrast Material(s) Computerized Axial Tomography, Thorax- With Contrast Material(s) Computerized Axial Tomography, Abdomen- With Contrast Material(s) Magnetic Resonance (eg, Proton) Imaging, Spinal Canal And Contents, Thor Computerized Axial Tomography, Lumbar Spine- With Contrast Material Magnetic Resonance (eg, Proton) Imaging, Any Joint Of Lower Extremity-wi Magnetic Resonance (eg, Proton) Imaging, Lower Extremity, Other Than Joi Computerized Axial Tomography, Pelvis- With Contrast Material(s) Computerized Axial Tomography, Thorax- With Contrast Material(s) Computerized Axial Tomography, Abdomen- With Contrast Material(s) Computed Tomography, Head Or Brain- Without Contrast Material Computed Tomography, Head Or Brain- Without Contrast Material Magnetic Resonance (eg, Proton) Imaging, Spinal Canal And Contents, Thor Magnetic Resonance (eg, Proton) Imaging, Any Joint Of Lower Extremity-wi Magnetic Resonance (eg, Proton) Imaging, Any Joint Of Lower Extremity-wi Magnetic Resonance (eg, Proton) Imaging, Any Joint Of Lower Extremity-wi Magnetic Resonance (eg, Proton) Imaging, Any Joint Of Lower Extremity-wi Computed Tomography, Maxillofacial Area- Without Contrast Material Computerized Axial Tomography, Pelvis- With Contrast Material(s) Computerized Axial Tomography, Abdomen- With Contrast Material(s) Magnetic Resonance (eg, Proton) Imaging, Brain (including Brain Stem)- W Computed Tomography, Thorax- Without Contrast Material Computed Tomography, Lower Extremity- Without Contrast Material Computerized Axial Tomography, Pelvis- With Contrast Material(s) Computerized Axial Tomography, Abdomen- With Contrast Material(s) Computerized Axial Tomography, Abdomen- Without Contrast Material, Follo Magnetic Resonance (eg, Proton) Imaging, Any Joint Of Upper Extremity-wi Magnetic Resonance (eg, Proton) Imaging, Brain (including Brain Stem)- W Computed Tomography, Head Or Brain- Without Contrast Material Computed Tomography, Head Or Brain- Without Contrast Material TOTAL_UNI PRCDR_MODIFIER TS _CD 26 26 26 26 26 ALLOWED_AMT 26 RT RT RT 26 26 26 26 LT RT 26 $106.99 $113.81 $116.90 $147.19 $225.58 $1,105.00 $1,097.00 $1,311.18 $1,333.32 $1,393.18 $1,519.98 $1,519.98 $1,934.60 $131.41 $131.41 $1,166.93 $1,197.22 $77.41 $354.25 $391.00 $620.75 $1,618.80 $1,651.10 $1,673.25 $1,673.25 $2,496.60 $2,739.80 $3,819.25 $71.40 $732.16 $1,001,978.45 Employer Group through Aetna Total Paid $1,001,978.45 Total PPO Savings ****Represents page 1 of 29. Total claims reviewed = 1211 $204.00 $218.00 $224.00 $275.00 $484.00 $1,390.00 $1,225.00 $1,599.00 $1,626.00 $1,699.00 $1,617.00 $1,617.00 $2,276.00 $213.10 $213.10 $1,502.53 $2,153.00 $241.00 $354.25 $391.00 $620.75 $1,704.00 $1,738.00 $1,673.25 $1,673.25 $2,628.00 $2,884.00 $3,819.25 $118.00 $832.00 $1,593,407.84 Self Funded Employer Using Aetna 1700 Total Lives on the Plan 1.00 1.00 1.00 1.00 2.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 BILLED_AMT Avg Cost Per CPT $591,429.39 $828.08 Relevant Amount Relevant Savings $50.00 $50.00 $50.00 $60.00 $100.00 $900.00 $900.00 $550.00 $550.00 $550.00 $450.00 $450.00 $900.00 $60.00 $60.00 $700.00 $700.00 $50.00 $50.00 $50.00 $70.00 $715.00 $715.00 $765.00 $765.00 $865.00 $1,000.00 $1,200.00 $50.00 $715.00 $56.99 $63.81 $66.90 $87.19 $125.58 $205.00 $197.00 $761.18 $783.32 $843.18 $1,069.98 $1,069.98 $1,034.60 $71.41 $71.41 $466.93 $497.22 $27.41 $304.25 $341.00 $550.75 $903.80 $936.10 $908.25 $908.25 $1,631.60 $1,739.80 $2,619.25 $21.40 $17.16 $546,465.00 C I T Y _ N SRC_PRVDR_ID M 4049762 4049762 4049762 7994013 7387561 7328055 7328055 6560700 6560700 6560700 6560425 6560435 6560685 7974947 7974947 7723468 6580495 7274613 7781395 7781395 7781395 7924354 4131595 6590365 6590365 9021253 7924354 6590365 7893231 6600315 $449,683.55 Employer Group through Relevant Total Paid $546,465.00 Additional Savings BELOW PPO $449,683.55 44.88% Avg Cost Per CPT Avg Savings Per CPT 45.46% $451.62 $376.46 Newport News Newport News Newport News Norfolk Norfolk Virginia Beach Virginia Beach Virginia Beach Virginia Beach Virginia Beach Norfolk Norfolk Virginia Beach Seattle Seattle Vancouver Seattle Milwaukee Tomah Tomah Tomah La Crosse Tomah La Crosse La Crosse Sparta La Crosse La Crosse Morgantown Morgantown

Sample relevant radiology savings analysis

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Sample relevant radiology savings analysis