Dr. Shawn Birchenough , MD
High MarkupHigher Out-of-Pocket Billing Risk
This practice submits charges that average 5.0 times customary allowable rates. If you have not met your annual health insurance deductible, or if this doctor is out-of-network with your health plan, you may face significant balance billing.
- Confirm network status: Call your insurer to confirm this specific physician and office address are in-network.
- Request in-network labs: Before blood draws or biopsies, ask the nurse to send samples exclusively to an in-network commercial laboratory.
- Ask for a written estimate: Under the No Surprises Act, you are legally entitled to a Good Faith Estimate if you are self-pay or out-of-network.
Balanced Practice
Maintains a steady clinical rhythm balancing focused physical examination with patient discussion.
How is appointment length calculated?
Visit durations reflect official documentation standards for Evaluation and Management (E/M) office billing codes (CPT 99202 through 99215).
Physicians who bill higher-level comprehensive visits (such as 99214 and 99215) consistently spend 30 to 45 minutes reviewing complex records and discussing care plans, whereas routine refill clinics predominantly bill briefer level 2 and 3 codes.
Appointment Length & Visit Style
Clinical appointment coding analysis across standard patient evaluations
Dr. Birchenough maintains a focused, rapid visit cadence suited for straightforward checkups and procedural follow-ups.
Pricing Transparency & Fee Comparison
How this provider bills compared to standard insurance benchmarks
⚠️ Price Outlier Warning: Dr. Birchenough's submitted charges are significantly higher than peer medians (over 5.02x the baseline standard). If you receive treatment out-of-network or without insurance, you could face substantial bills. Confirm in-network participation with your health plan prior to booking.
Verified Clinical Procedures & Surgical Focus
Official annual procedure volumes, customary fee comparisons, and clinical focus areas.
| Clinical Procedure & Code | Annual Services | Doctor Charge | Peer Norm | Standard Baseline | vs. Peer Norm |
|---|---|---|---|---|---|
CPT 99203 | 55 | $303.64 | $234.50 | $106.77 | 1.29x |
CPT 99202 | 34 | $209.06 | $150.00 | $68.78 | 1.39x |
CPT 99212 | 27 | $172.00 | $104.00 | $52.79 | 1.65x |
CPT 14061 | 16 | $4201.00 | $2051.28 | $777.60 | 2.05x |
CPT 14060 | 14 | $3169.57 | $1680.00 | $542.19 | 1.89x |
CPT 14301 | 13 | $4311.54 | $2698.50 | $762.73 | 1.6x |
CPT 15275 | 11 | $543.18 | $330.07 | $61.04 | 1.65x |
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👨⚕️ Physician & Medical Billing Intelligence (Click to view professional coding data)Expand ↓
This section provides clinical practice analytics for healthcare administrators, billing coders, and peer physicians evaluating practice benchmarks:
Estimated appointment time calculation: 24 minutes. Indicates the proportion of high-complexity (99205/99215) vs. moderate-complexity (99204/99214) documentation relative to national specialty peers.
Gross charge multiplier: 5.02x. Useful for fee schedule alignment, out-of-network charge master analysis, and payer contract negotiations.
Patient Guidance: What to Ask Before Your Appointment
- In-Network Confirmation: Confirm directly with your insurance plan that Dr. Birchenough participates in your specific network tier.
- Surgical Facility Fees: If having surgery, verify whether it will be in a hospital or an outpatient surgery center. Facility charges are billed separately from physician fees.
- Written Estimates: If you are paying out of pocket or have a high deductible, request a written good-faith estimate before major treatments.