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Medical invoice format for R&D

hello this is dr eric bricker and thank you for watching a healthcare z today we're going to be discussing relative value units or what are commonly referred to as rvus so most people in employee benefits and even in healthcare have not even heard an rvu before but these are super important and frankly we're going to go down a little bit of a rabbit hole so hold on to your hats so rvus as point number one says here are is actually the way that physician works gets measured in terms of the amount of work like how much work is an office visit that is 15 minutes versus an office visit that is 45 minutes versus an upper endoscopy versus a gallbladder surgery versus an emergency room visit all of these different physician services have to be measured in terms of the amount of work and that is actually done through the system of rvus and the system was actually created back in the early 1990s and it is used by medicare and so almost by default it's then used by commercial insurance plans as well and so it is tied to the cpt code right so i have a previous video where i talk about coding and every single procedure office visit et cetera has a five-digit cpt code and then that five-digit cpt code is then tied to a specific number of rvus so a new patient office visit that is of you know sort of medium or lighter intensity is a 99202 and that has an rvu count of 1.73 rbus okay wonderful now how do we translate that into dollars okay medicare pays about 37 per rvu now medicare is kind of constantly changing or tweaking uh it's reimbursement per rvu so that's approximate okay now commercial insurance plans reimburse higher than medicare for rvus and as you can see here it can range from anywhere from 55 to 70 dollars per rvu and that 70 per rbu tends to be higher on the procedure side and so this is where quote unquote proceduralists whether it be uh surgeons or interventional cardiologists or um gastroenterologists these proceduralists tend to be compensated in general not always in general more per rvu there's somewhat higher compensation for radiologists in their rvus as well but that's a controversial topic we will get into that today okay next up where in the world do these rvus come from well if there is anything like a secret committee or a not so secret secret committee it is ruck which is the relative value scale update committee it is run by the american medical association it has representatives from all the different medical specialties and there's literally a doctor from each of the different specialties and they get around a big table and they take in survey data from ophthalmologists and dermatologists and ear nose and throat doctors to say hey how long does it take you to do xyz procedure and they take that survey data in and then they do a series of votes where they then vote on how many rvus are assigned to the cpt codes the ruck is a private committee uh it is again run by the amer organized by the american medical association it gives recommendations to medicare medicare almost always just takes those recommendations and it's that handoff between ruck and medicare that actually is highly politicized and so different administrations in their relationship with the ama have various degrees of threats positive relationship not so positive relationship with ruck as it relates to how they're going to reimburse medicare based upon those rvus and as goes medicare so does the commercial insurance plus x number of dollars so let me just pause there and close by saying that physicians have their group meetings typically at night where they talk amongst their partners there oftentimes tends to be a lot of like they measure their rvus and like each physician knows how many rvus they have billed for during the previous week month quarter etc and all the physicians will sit we'll talk about how many rvus each one of them is doing and then how much they're getting paid and is that as you can imagine those can be um fairly uh confrontational um high temperature meetings so just know that the rvu is a three-letter acronym that is highly on the mind of physicians and i won't go any further than that today we could literally spend hours and hours on our views but i will pause there and thank you so much for watching a healthcare z