Patients can receive surprise bills when their care comes from in-network facilities because while an ASC might be in-network, some of its medical staff could be out-of-network, Mnet reports.
Mnet said ASCs should adopt three strategies to prevent surprise bills:
1. Be proactive about making sure most ancillary professionals are in-network. Providers such as anesthesiologists, pathologists and lab professionals might stay out-of-network to receive higher payments than they would if they operated in-network.
2. Clearly communicate to patients. Ensure patients are aware of any services rendered by providers that can’t be brought in-network.
3. Pay attention to surprise billing laws. They can restrict what providers are allowed to charge patients for an out-of-network service and mandate that patients give consent to receiving treatment from an out-of-network provider. Five states, including California, New Jersey and New York, have passed laws intended to protect patients from surprise medical bills. Pennsylvania is preparing to pass similar laws.
More articles on coding, billing and collections:
10 big changes CMS proposes for ASC, outpatient payments
ASC payer landscape: 4 insights from administrators & leaders
Is CMS committed to site-neutral payments? What the proposed 2019 OPPS may indicate for ASCs
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