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Ambulatory surgery centers - the financial black hole

Colleague and friend Peter Rousmaniere has an excellent column in the latest Risk and Insurance detailing some of the issues with Ambulatory Surgery Centers. To net it out, while they can get patients in quickly, are usually much nicer (in appearance) than hospitals, and can have equivalent outcomes, they are also wicked expensive (that's my New England accent) , especially in states without an ASC fee schedule.

As a result, payers are increasingly looking to outside expert firms to assist in determining an appropriate reimbursement level. One that is especially adept in this area is Fair Pay Solutions (also an HSA client).

Posted by on April 18, 2006 11:19 AM |

Comments

Joe, I'm in the business of developing and managing surgical centers - Peter Rousmaaniere dose not have it totally right - it is actually much less complicated than his presentation. If it will be helpful to you, I will gladly share my views, point by point with Peter's article.

Posted by: Jeff | April 19, 2006 1:07 PM

Medical Cost Remedy, Inc. is another company the solely performs specialty bill reviews for both in and out-of-network claims. Doesn't take a rocket scientist to understand why specialty bill review firms are gaining in relation to PPO discounts and negotiation firms.

Posted by: Jason McLaren | May 7, 2007 10:52 AM

Good morning Joe - I work with a benefits consulting group that brings payors and bill review companies together. Agreed, my clients often see incredible bills from ASCs. The company you support, Fair Pay Solutions, is no longer an option for one of my clients. Could you please list other options that you may be familiar with. Jason - please provide further info about your firm. Thank you.

Posted by: Ben Chouteau | May 10, 2007 12:37 PM

Ben - thanks for the comment. I responded to you directly via email, and asked Jason to do the same. A direct conversation will ensure confidentiality and speed up communications.
Joe

Posted by: Paduda | May 11, 2007 3:21 PM

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