Each Preventative Service performed through Ceriom is billable directly to Medicare or private insurers. Although numbers vary between practices, an average office can expect reimbursement for each visit of $120-$350. This is in addition to revenue from your normal office visit for the patient.
Each Insurance Type treats Preventative Services differently:
Medicare actively promotes and publishes its support for Preventative Services, including all of those offered by Ceriom. The majority of Preventative Services are deductible and co-pay waived under Medicare.
You can view the payment amounts for all Medicare services directly in the Medicare Provider Payment Schedule. An excerpt of which is below.
Most State Medicaid programs cover the majority of Ceriom preventative services.
For the 33 states that expanded Medicaid under the Affordable Care act, they are required to have coverage for most Prevounce offered services.
The other 18 states that did not expand their Medicaid programs generally still have coverage for preventative services, but which they will pay for varies from state to state.
PPOs and EPOs
PPO insurances have been increasingly covering preventative services over the last five years. Part of this is due to the Affordable Care Act, which mandated coverage for many of the services in Ceriom with fully waived co-pays.
PPOs do not directly publish a fee schedule, but you can expect PPOs to pay around 1x to 2.5x Medicare depending on your location and if you have any contracts with the specific PPO.
HMOs and ACOs
We are always looking for new HMO partners to make use of our innovative and intuitive software!
If you are an HMO or other managed care organization, Ceriom can increase your quality of care, reduce your preventative medical costs and save you time. Enterprise level Ceriom installations also offer direct integration into your EMR and software billing solution.