Skagway clinic finance committee weighs switching fees to RBRVUs; staff to return with comparisons

At a finance committee meeting of the Skagway Municipality Del Memorial Clinic, members reviewed a proposal to change how the clinic sets fees and charges, discussing a shift to a resource‑based relative value unit (RBRVU) model tied to Medicare rates and asking staff to prepare a side‑by‑side comparison of current fees versus proposed rates for the board.

The change matters because committee members said it could raise the clinic’s billed fees to better match commercial payers while also requiring a 30‑day public notice before any adopted increases; committee members and staff emphasized concerns about protecting uninsured patients and clarifying how non‑Medicare items such as dental services and certain pharmacy charges would be handled.

Committee discussion and next steps

Melanie Patton, the clinic’s billing and coding manager, told the committee that the clinic’s current policy is already “based off resource based relative value units,” and that Medicare’s fee schedule is the common national reference. Patton said the clinic has been setting its codes at “300% of Medicare’s fee schedule” for codes not covered by a previous fee analysis, and that commercial payers are increasingly basing reimbursements on RBRVUs. "It's a lot easier to defend these charges if we have to appeal things with…