We all know that Physician Compliance Union (PhyCU) Reimbursement Scores are critical to maintain. But do you know how they are determined and what can cause your score to decline?
Senators William Kornbot (D-Nebraska) and Lee-Ann Inbitwyin (R-Maine) are spearheading a bipartisan effort to limit physician payments to those physicians with a PhyCU Score of over 700.
“Our bill would authorize the Center for Medicare and Medicaid Services to monitor and regulate every physician’s Reimbursement procedures,” claims Senator Inbitwyin.
Libertarian Ron Paul, a physician himself, was overheard saying, “No.”
But the bipartisan trend in Washington is clear. Both major parties are cooperating to ensure physician compliance with unilateral reimbursement mandates. So you better repair your PhyCU Reimbursement Score today!
Reimbursement Scores range from a low of 400 to a high of 870. Above 800 is excellent. 700 to 800 is considered good. 600 to 700 is fair. If you are below 600, then very few respectable third-party payers will grant you payment. Indeed if you receive any payments at all, those payments will be substantially reduced compared to the substantially-reduced payments received by your colleagues with higher PhyCU Reimbursement Scores.
So, what most damages your PhyCU Reimbursement Score? First, removing yourself from old third-party payment contracts is the worst thing you can do. Refusing unilaterally-dictated contract terms these days is just plain foolish. Too short a duration of your contract history will assure you a lower PhyCU Reimbursement Score. So make sure to renew all your old dysfunctional contracts, no matter what terms they insist upon.
Having too few contracts with different third-party payers is an insurmountable sin. You need to have no less than 40 contracts with different third-party payers. The more conflicting their rules, the higher your score.
Make sure to sign all your contracts right away. Even a single late signature is sufficient to lower your PhyCU score by 30 or more points.
Of course we all know that the biggest insult to your PhyCU score is arguing a claim. Don’t do that. Ever.
Your PhyCU Reimbursement Score can be checked in the form of a “Hard” or “Soft” inquiry. Whereas Soft inquiries are harmless, Hard inquiries can cause substantial injury that may not heal for two years or more. Hard inquiries might be inflicted on you if you buy a book that teaches you how to manipulate CPT codes to augment your reimbursements. No one really understands Hard inquiries, or how they lower your score. But they do.
You can check your full PhyCU Reimbursement Report for free one time every year by contacting each of the major PhyCU agencies. New services offer you the ability to track your TriBureau score all year for free (see FreePhyCUReport.com, Crazy_hose.com, Bendover.com, or PhyCUHard.com).
Once you have checked your score, improving it is simpler than you would think. The best way to rapidly increase your PhyCU score is to fail to seek reimbursement on 50% or more of your eligible claims. Also, when you seek reimbursement, have your coders choose your codes in reverse order to minimize your reimbursement. The best coders will maximize your minimization of reimbursements.
It’s really just like your optimizing your credit score: have lots of available credit, but don’t use it. Have lots of contracts with third-party payers, but never ask them to pay you anything. That’s the trick to PhyCU!
Next year, the Physician Compliance Union Reimbursement Score is expected to be substantially expanded by Executive Order to include full surveillance of all physician-patient-payer communications.
Certainly if Senators Kornbot and Inbitwyin succeed in their bipartisan efforts, PhyCU will be on everyone’s lips.
John Hunt, MD is a pediatric pulmonologist, allergist, and immunologist, and author of a satirical medical novel, “Assume the Physician” that must be read by every person on the planet. Today preferably. Profits from sales of the book support his non-profit Trusted Angels Foundation, which supports orphanages, schools and entrepreneurs in Liberia, West Africa.
