Miami County health staff propose updated fee schedule, explain lower "new patient" line

Mackenzie, who presented on behalf of the Miami County Health Department, asked the commissioners to adopt a revised fee schedule and sign a resolution this afternoon to align prices with actual costs and insurance reimbursements. She told commissioners the change would update eight pages of fees and better reflect what the department bills to payers.

Mackenzie said the apparent drop in a single 'new patient' line item — from $120 to about $50 — comes from changing billing practice rather than cutting services. "The new patient fee, the 120, incorporated several services underneath 1 line item," she said. "When you go to bill insurance, they each have, each service that we provide has its own CPT code... So at $1.20, the max payout that we get for that service is around $50 or $45... So we were writing off that difference." She said the department will invoice each procedure separately (labs, medication administration, injections), which reduces write-offs and better matches reimbursements.

Mackenzie also proposed a lab-markup methodology to avoid constant adjustments when Quest or LabCorp change prices: "I'm proposing a, a markup and methodology to that," she said, explaining that the department would round to whole dollars and adjust small changes internally so staff need not return to the commission for minor price shifts. Commissioners placed the item on the afternoon action agenda for formal consideration.