DecisionHealth, DecisionHealth - 2011 Issue 10 (October)

Benchmark of the Week: Primary care vs. specialists on surgery codes

These charts compare how primary care providers perform against specialists when it comes to denial rates on common surgery services. For each of these codes, primary care is responsible for a significant share of utilization, despite the fact that specialists still bill the majority to Medicare. NOTE: “Primary care” reflects combined data from family practice, general practice, internal medicine, geriatrics and OB/GYN. The “specialists” category represents combined data for more than 20 other specialties, excluding only those with low Medicare utilization (e.g., plastic surgeons). NOTE: The percentages above the bars reflect averagedenial rates.

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