Ken Bulow is COO of GENASCIS.
Q: How do ambulatory surgery centers come up with usual and customary fees to bill insurance companies for out-of-network procedures?
Ken Bulow: We typically use one of the following methods:
- Medicare times X percent where X can be 10-15 times Medicare.
- Some percentage of the Ingenix rate for that area.
- We will also use our proprietary MEDIBIS database to determine current prevailing market rates in the area.
Learn more about GENASCIS.
Read more from GENASCIS:
- 4 Best Practices to Control Labor and Supplies for Surgery Center Cases
- 4 Steps to Improve Collections Through Contractual Write-Offs
- 6 Steps to Improve Collection of Time of Service Patient Co-Pays