Beyond managed care and Medicare: Increase reimbursements with a successful OON strategy

The out-of-network payment strategy remains one of the only viable options for ambulatory surgery centers looking to increase reimbursements. While providers and their centers may not have control over their managed care contract rates or Medicare and Medicaid reimbursement rates, they can implement a successful and valuable OON payment strategy.

Additionally, there are a number of reasons ASCs should strongly consider an OON strategy. OON ASCs retain all legal rights under federal and state laws to negotiate reimbursement on behalf of the patient, according to a Becker's ASC Review report.

Also, a truly successful ASC is one with a healthy mix of payer contracts, including both in- and out-of-network options. An Amerinet report notes, "Whatever the ASC chooses, out-of-network billing must be part of an overall business strategy. The right approach to out-of-network billing involves careful analysis of existing contracts and payer mix and a willingness of physicians to drop or decline losing contracts."

Even if with low out-of-network volume, many ASCs are able to increase profitability by as much as 25 percent. To learn more about improving profitability through out-of-network reimbursement as well as strategies to combat insurance companies' attempts to reduce it, tune into a webinar hosted by Becker's ASC Review and CollectRx on May 20 from 1:00 p.m. to 2:00 p.m. CST.

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