Payer reimbursement has become an increasingly complex issue for healthcare providers. Unfortunately, many spine and pain management ASCs may be letting significant revenue from insurers slip through the cracks.
ASC Coding, Billing & Collections
Many U.S. antitrust regulators are concerned Anthem's $48 billion acquisition of Cigna will fail to maintain competition in the insurance industry, according to Wall Street Journal.
The White House is providing states $22 million to enhance their state-level "rate reviews" to fight health insurance companies on premium increases, according to The Hill.
The American Medical Association is changing the Quadruple Aim to include a fourth measure that accounts for physician work-life balance, according to Medscape.
Andy Slavitt, acting administrator of CMS, attended the American Medical Association 2016 Annual Meeting in Chicago to discuss goals to help improve the quality payment program, according to The CMS Blog.
Advertisement
Negotiating with payers is a daunting task, especially for independent physicians. Tonyi Long, client development representative at Plano, Texas-based Medical Practice Solutions, noted key reasons payers deny claims, including incorrect coding.
Connecticut Gov. Dannel Malloy 'quietly signed legislation,' giving state legislators the ability to conceal documents about payers from the public, according to International Business Times.
Evergreen Health Cooperative, a Maryland co-op, filed a lawsuit against the federal government to avoid more than $22 million in fees, according to The Hill.
CMS will give $32 million to help 27 states enhance enrollment of children for the Children's Health Insurance Program and Medicaid, according to HealthPayer Intelligence.
Bundled payments still possess a veil of mystery — the term means a variety of things to different people.