How Much Did Your Doctor Receive From Medicare?

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From Medicare Part B in 2012


Use the form below to find a doctor or other medical professional among the more than 800,000 health care providers that received payments in 2012 from Medicare Part B, which covers doctor visits, tests and other treatments.

You will need to know the medical providers’ name, specialty and/or zip code.


David MD MBA



Source: The information presented here is from a database released by the Centers for Medicare and Medicaid Services. The database excluded, for privacy reasons, any procedures that a doctor performed on 11 or fewer patients. The total reimbursements for each doctor does not include those procedures either. Results shown above include only the individuals like doctors, nurses or technicians but not organizations like Walgreens. While some providers could have multiple offices, the address shown is the main address indicated in the database. Descriptions of the procedures are from the American Medical Association.



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11 Responses

  1. ARs,

    As health care providers continue to receive greater percentages of practice revenue from third party payers, I think it is prudent for practitioners, both physicians and their financial advisors, to learn how to apply the various Accounts Receivable (ARs) protection strategies.

    A failure to do so is not only putting practice income at risk; a failure to do so will also put lifestyles at risk.

    Leroy Howard MA CMP™ candidate


  2. Even After Doctors Are Sanctioned or Arrested
    [Medicare Keeps Paying]

    A ProPublica analysis of recently released data shows that dozens of physicians who received payments from Medicare in 2012 had been kicked out of Medicaid, charged with fraud, or settled claims of overbilling Medicare itself.



  3. Is your doctor only in it for the money?

    A new report suggests maybe not.




  4. Top Billing: Meet the Docs Who Charge Medicare Top Dollar for Office Visits

    Medicare paid for more than 200 million office visits for established patients in 2012. Overall, health professionals classified only 4 percent as complex enough to command the most expensive rates.

    But 1,800 providers billed at the top level at least 90 percent of the time, a ProPublica analysis found. Experts question whether the charges are legitimate.



  5. Health Insurance Giants to Make Payment Data Accessible to Public

    A new initiative by three of the country’s largest health plans has the potential to transform the accessibility of claims payment data, according to healthcare finance experts. UnitedHealthcare, Aetna, and Humana announced a partnership on Wednesday with the Health Care Cost Institute to create a payment database that will be available to the public for free.

    Experts say cost transparency is being spurred by a number of developments in the healthcare sector. The trend towards high-deductible plans is giving consumers a greater incentive to understand how much healthcare costs and to utilize it more efficiently.

    In addition, the launch of the exchanges under the Patient Protection and Affordable Care Act has brought unprecedented attention to the difficulties faced by individuals in shopping for insurance coverage.

    Source: Paul Demko, Modern Healthcare [5/14/14]


  6. The Side Effects of Releasing Public Health Insurance Data to the Public

    Unintended consequences?



  7. Medicare Overpaid Billions for Office Visits, Evaluations: OIG

    Medicare spent $6.7 billion too much for office visits and other patient evaluations in 2010, according to a new report from the inspector general of the U.S. Department of Health and Human Services. But in its reply to the findings, the Centers for Medicare and Medicaid Services, which runs Medicare, said it doesn’t plan to review the billings of doctors who almost always charge for the most-expensive visits because it isn’t cost-effective for CMS to do so.

    The inspector general’s report estimates that overpayments account for 21 percent of the $32.3 billion spent on evaluation and management (E&M) services in 2010. The E&M category includes office visits, emergency room assessments, and inpatient hospital evaluations. This is the second time that the inspector general has singled out this area for more scrutiny. In 2012, the watchdog said physicians had increasingly billed Medicare for more intense—and more expensive—office visits over time. But that didn’t prove the claims were improper.

    Charles Ornstein, ProPublica via Dr. Joseph Borreggine


  8. Open Payments System Reopens
    [Extends Physician Registration and Review Period]

    CMS announced today that the Open Payments system is once again available for physicians and teaching hospitals to register, review and, as needed, dispute financial payment information received from healthcare manufacturers. The system was taken offline on August 3 to resolve a technical issue. To account for system down time, CMS is extending the time for physicians and teaching hospitals to review their records to September 8, 2014. The public website will be available on September 30, 2014.

    A full investigation into a physician complaint found that manufacturers and group purchasing organizations (GPOs) submitted intermingled data, such as the wrong state license number or national provider identifier (NPI), for physicians with the same last and first names. This erroneously linked physician data in the Open Payments system. CMS has implemented system fixes to resolve the issue, and revalidated all data in the system to verify that the physician identifiers used by the applicable manufacturer or GPO are accurate, and that all payment records are attributed to a single physician. Incorrect payment transactions have been removed from the current review and dispute process, and this data will not be published.

    Source: CMS


  9. Medicare Payments Slated to Decrease by 21% in April

    Under final rules issued by the CMS late Friday, physicians could see all Medicare payments cut by roughly 21% in April if the Medicare sustainable growth rate formula cuts are allowed to take effect. Under the rule, the Medicare sustainable growth rate formula — a payment policy that has forced Congress to repeatedly intercede to avoid major cuts to physician payment—would slash reimbursement to doctors by 21.1% as of April 1.

    The rule also affects reporting of manufacturers’ payments to physicians under the Sunshine Act. Friday’s rule finalized the elimination of the exemption for reporting indirect manufacturers’ payments to physicians for continuing medical education participation.

    According to the CMS, applicable manufacturers and group purchasing organizations now will be required to report compensation provided to physician speakers at continuing education events, unless the payment or other transfer of value is specifically excluded.

    Source: Melanie Evans
    Modern Healthcare [10/31/14]


  10. Medicare Doles Out $45B in Improper Payments

    Any thoughts?

    Ann Miller RN MHA


  11. Medicare



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