A number of third-party insurance contracts are tied to Medicare. In a surgery center where third-party reimbursement is tied to current Medicare reimbursement and the center performs a high volume of orthopedic surgery or general surgery cases, for example, negotiating with third-party payors may not result in a favorable outcome for the surgery center.
Also, if third-party reimbursement is fixed as a percent of the Medicare fee schedule prior to 2008 and the center performs a high volume of gastroenterology or ophthalmology cases, negotiating with third-party payors may not result in a favorable outcome for the surgery center.
Learn more about Sinaiko Healthcare Consulting.
Read more about ASC contract negotiations:
– 10 Points on Using Cost Data for Managed Care Negotiations
– 5 Essential Steps to Turning Around a Struggling ASC
– 10 Statistics Every ASC Should Track
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.