Major Payor Threatens to Withdraw Coverage for Two Las Vegas ASCs

Durango Outpatient and Parkway surgery centers in Las Vegas may lose coverage from the Health Services Coalition, a group of 24 self-funded insurance plans, if the payor organization cannot resolve its dispute with St. Rose Dominican Hospitals over reimbursement rates, according to a Las Vegas Sun report.

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St. Rose Dominican Hospitals operates three hospitals — Rose de Lima, Siena and San Martin hospitals — in addition to the two surgery centers. If Health Services Coalition ends its relationship with the health system, patients would have to find different organizations for care or pay out-of-pocket for healthcare.

The dispute stems from a disagreement over reimbursement rates. Health Services Coalition says St. Rose facilities charge too much for treatment and cannot afford to pay the rates. The system argues that HSC’s rates fall below the cost of providing care.

Read the Las Vegas Sun report on the reimbursement rate dispute.

Read more on payor-ASC relationships:

5 Steps to Maximize Payment on Every Surgery Center Case

13 Benchmarking Statistics on Medicare as Percentage of ASC Payor Mix

4 Key Steps to Improve ASC Billing and Increase Collections

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