A number of third-party insurance contracts are tied to Medicare. In a surgery center where third-party reimbursement is tied to current Medicare reimbursement and the center performs a high volume of orthopedic surgery or general surgery cases, for example, negotiating with third-party payors may not result in a favorable outcome for the surgery center.
Also, if third-party reimbursement is fixed as a percent of the Medicare fee schedule prior to 2008 and the center performs a high volume of gastroenterology or ophthalmology cases, negotiating with third-party payors may not result in a favorable outcome for the surgery center.
Learn more about Sinaiko Healthcare Consulting.
Read more about ASC contract negotiations:
– 10 Points on Using Cost Data for Managed Care Negotiations
– 5 Essential Steps to Turning Around a Struggling ASC
– 10 Statistics Every ASC Should Track
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