The California Relative Value Studies, an Overview, and the California Physicians Service, the Corporation, and Its Relationship with the California Medical Association: A Study |
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Common terms and phrases
1974 CRVS unit 1974 unit value American Anesthesiologists antitrust arthroplasty assigned Blue Shield Board of Trustees California Medical Association California Relative Value Cardiac Surgery cardiovascular changes charge data coefficient of variation Comparison of 1974 conversion factor cost CPS Medical CRVS Committee CRVS unit values Current Procedural Terminology dialysis Doctor Dollar basis dollar values examination fee schedule fees billed Fees Subsequently Billed Felix Brunner FOLLOW-UP office visit frequently billed procedures higher-cost Home hemodialysis increase listed median charge Medical Policy Committee Medical Society Medicare Medicare Program medicine Nephrology number of procedures Ophthalmology orthopedic Orthopedic Surgeons parent committee patient payment percent physicians Procedure Code procedure numbers Proctology profiles Radiology reasonable recommendations reimbursement Relative Value Studies relativities unit values represent San Francisco specialty specific Subcommittee Chairman subcommittee members Subsequently Billed CPS surgeons Surgery Section Surgery Subcommittee surgical terminology Thoracic Surgery Total number
Popular passages
Page 22 - Civic leagues or organizations not organized for profit but operated exclusively for the promotion of social welfare...
Page 21 - ... which do not contemplate the distribution of gains, profits or dividends to the members...
Page 207 - In determining the reasonable charge for services for purposes of this paragraph, there shall be taken into consideration the customary charges for similar services generally made by the physician or other person furnishing such services, as well as the prevailing charges in the locality for similar services.
Page 25 - Insurance is a contract whereby one undertakes to indemnify another against loss, damage or liability arising from an unknown or contingent event.
Page 22 - Code or of rendering any such services, but it may not engage directly or indirectly in the performance of the corporate purposes or objects unless all of the following requirements are met: (a) At least one-fourth of all licentiates of the particular profession become members.
Page 61 - In holding that certain anticompetitive conduct by lawyers is within the reach of the Sherman Act we intend no diminution of the authority of the State to regulate its professions.
Page 61 - ... they have broad power to establish standards for licensing practitioners and regulating the practice of professions. We also recognize that in some instances the State may decide that 'forms of competition usual in the business world may be demoralizing to the ethical standards of a profession.
Page 21 - Carrying on business at a profit as an incident to the main purposes of the corporation and the distribution of assets to members on dissolution are not forbidden to nonprofit corporations, but no corporation formed or existing under this part shall distribute any gains, profits, or dividends to any of its members as such except upon dissolution or winding up.
Page 207 - Customary is defined as that range of usual fees charged by physicians of similar training and experience for the same service within given specific limited geographic or socio-economic area." "Reasonable is defined as a fee which meets the above two criteria, or, in the opinion of the responsible local medical association's review committee, is justifiable in the special circumstances of the particular case in question.
Page 64 - ... then this second procedure should be given a relative value of two. An RVS is not necessarily a fee schedule, but can be converted to one by using appropriate conversion factors.