UnitedHealth feud could leave more ASC patients with surprise bills: 3 insights

A dispute between UnitedHealth Group and Mednax, a physician staffing firm that provides anesthesiology services at some ASCs, could exacerbate the problem of surprise medical billing, Axios reports.

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What you should know:

1. If the two groups can’t agree on contract terms, Mednax’s anesthesiologists, neonatologists and obstetricians could go out of network for UnitedHealth patients in Arkansas, Georgia, North Carolina and South Carolina at staggered dates as early as March.

2. Alleging that Mednax charges at least 60 percent more than the average in those states, a spokesperson from Minnetonka, Minn.-based UnitedHealth told Axios that the insurer sent Mednax a proposal to reduce rates but never received any counteroffers.

3. In a statement to Axios, Sunrise, Fla.-based Mednax countered that UnitedHealth’s payment terms were presented on a “take-it-or-leave-it basis” and that Mednax’s request for a 60-day extension was rejected.

More articles on coding, billing and collections:
California ASC could drop contract with Anthem over proposed rate decrease: 6 details
North Carolina legislators consider easing certificate-of-need laws for ASCs — 4 insights
Tenet-owned surgical hospital to pay $1.4M to settle False Claims Act allegations 

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.

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Presenters: Joe Ganley, athenahealthJeffrey Flynn, CASC, Gramercy Surgery CenterBryan Tsao, Access Center, Loma Linda University HealthJason Zepeda, Northridge Hospital Medical Center, CommonSpirit HealthGreg DeConciliis, PA-C, CASC, Boston Out­Patient Surgical Suites

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