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Usual, Customary and Reasonable Charges for Providers

The white paper surveys which percentile rank different health plans use to determine the UCR charge. The conclusion is the … See more

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URL: https://www.rpcconsulting.com/determining-usual-customary-and-reasonable-charges-an-overview/

AHCA Emergency Department Data

WEBAHCA Hospital Emergency Room Data The Agency for Health Care Administration collects inpatient discharge, outpatient and ambulatory, and emergency room data from acute, …

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Standard Analytical Files

WEBOne of the resulting datasets, the Standard Analytical File, has data organized at the claim level and includes basic information about the beneficiary and services performed for the …

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DETERMINING USUAL, CUSTOMARY, AND REASONABLE …

WEBA threshold percentile determines the maximum reasonable charge for that service in that medical market. Charges less than or equal to the threshold percentile …

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Payment Disputes Economists Billing Disputes

WEBPayment disputes frequently arise between healthcare providers and health insurance plans. Some disputes are covered by contracts between the parties. Others are …

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BAA Best Practices and Templates for HIPAA and TX HB 300

WEBHB 300 and HIPAA differ significantly in their definitions of “covered entities.”. Chapter 181 of the Texas Health and Safety Code defines the term “Covered …

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Texas Hospital Survey

WEBThis survey is a cooperative effort between DSHS, the American Hospital Association and the Texas Hospital Association. The data collected from this questionnaire is released in …

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Certificate of Need

WEBRPC Certificate of Need Consultants. RPC provides Certificate of Need (CON) services to healthcare providers nationally. Our experience spans 30 years and about as many …

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Robin B. Gage, MBA, MHA

WEBRobin Gage, a healthcare consultant with RPC since 2001, has been involved in health care projects in more than 15 states. Experienced in examining development …

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Florida HB 837 Changes to Past and Future Medical Expenses

WEBRonald T. Luke, JD, PhD President. On March 24, 2023, Florida House Bill 837, became law. It has an impact on the valuation and recovery of damages for past …

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THCIC Hospital Outpatient and ASC Data

WEBThe Texas Department of State Health Services collects and releases information on Texas inpatient hospital discharges and outpatient visits on a quarterly basis. There are now …

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Maryland Certificate of Need Research & Planning Consultants

WEBContact RPC Consulting. Should you or your client need an expert team to help you with the. Maryland Certificate of Need Process (CON) please contact Dr. Ron Luke at 512 …

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Research and Planning Consultants, LP

WEB5. There are two methods RPC uses to estimate current prices: (1) calculation of usual, customary and reasonable charges and (2) price surveys by telephone and internet. …

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What Does Texas Law Allow a Plaintiff to Recover for Past Medical

WEBTo recover for past medical expenses in a Texas personal injury case, the plaintiff must prove the past medical expenses were medically necessary due to the …

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