Physicians are expected to hear by this summer how their out-of-network pay is affected by the new figures. According to the report, experts are still uncertain whether the database will mean higher rates for physicians who treat patients out-of-network. Determining factors include how many insurers outside New York use the database, how individual polices are structured and how FAIR Health changes the data collection, auditing and calculations compared to its predecessor Ingenix.
Ingenix, owned by UnitedHealth Group, was used for years by large insurers to determine how out-of-network physicians would be paid. After an investigation into Ingenix’ data sources, large New York health insurers agreed to stop using Ingenix data.
FAIR Health was established in Oct. 2009. Data will be released on a staggered schedule, starting with dental and outpatient data.
Read the American Medical News report on FAIR Health.
Read more on out-of-network claims:
–New Jersey Out-of-Network Bill Passes Assembly
–Webinar Discusses Combining In-Network and Out-of-Network Reimbursement
–5 Factors That May Decrease an ASC’s Value
At the Becker’s 32nd Annual Meeting: The Business and Operations of ASCs, taking place October 29-31 in Chicago, ASC leaders, surgeons and healthcare executives will explore strategies to drive growth, enhance operational performance, navigate reimbursement challenges and prepare for the future of ambulatory surgery. Apply for complimentary registration now.