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The Hidden Perils of Silent PPOs: A Challenge for Healthcare Providers
While PPOs are generally considered beneficial for providers due to the promise of a broader patient base, silent PPOs bring forth an array of hidden pitfalls and challenges they pose for healthcare providers. -
Another health system could go out of network with UnitedHealthcare
Louisville, Ky.-based Baptist Health could be going out of network with UnitedHealthcare for certain Medicare enrollees after its contract with the payer expires on Jan. 1, according to an Oct. 6 report from WDRB. -
University Hospitals launches in-house Medicare Advantage plan
Cleveland, Ohio-based University Hospitals has launched a co-branded Medicare Advantage Plan for individuals in three Ohio counties in partnership with PrimeTime Health Plan. -
UnitedHealthcare in the headlines: 5 notes
UnitedHealthcare is one of the country's largest payers. -
Health system-payer disputes: 3 moves for ASCs to know
ASCs are not the only entities that struggle to strike deals with payers. -
7 Reasons Why Cardiovascular ASCs Should Outsource Their Billing
Cardiology is one of the fastest-growing ambulatory surgery center (ASC) specialties, and we're seeing the development of new cardiovascular ASCs nationally. Fueling the rise of cardiology in the ASC industry is the addition of different types of cardiovascular procedures to the ASC Covered Procedure List (CPL) over the past several years. -
5 notes on noncompetes
Almost 30 million U.S. workers have noncompete provisions in their contract, according to an Oct. 4 report from U.S. News & World Report. -
Maryland tightens noncompete policy
Maryland employers are barred from noncompete provisions for certain employees, according to an Oct. 3 article about state and local employment developments published in JDSupra and written by law firm Faegre Drinker Biddle & Reath. -
Stark law compliance: 5 key notes
Understanding physician arrangements and Stark law is critical to ensure patient care while complying with legal policy, according to an Oct. 4 article published in JDSupra and written by the Health Care Compliance Association. -
The good and bad of CMS moves: 5 leaders' thoughts
Here are five leaders' thoughts on three recent CMS moves shaping the industry: -
The most popular payment models among young physicians
Young physicians are participating in fee-for-service models more than other methods of payment, according to a report published by Medscape. -
Aetna announces largest Medicare offering in its history
CVS Health-owned health insurance provider Aetna has announced its 2024 Medicare products, the largest Medicare offering in its history. -
Prior authorization problems persist for patients, survey shows: 7 things for ASCs to know
Around 6 in 10 adults have experienced problems with their health insurance, according to a Sept. 29 report from KFF, with several problems linked to prior authorization delays and denials from payers. -
'It absolutely causes strife and stress': 3 physicians' thoughts on noncompetes
Here are three physicians' thoughts on noncompetes: -
3 payer moves disrupting the ASC industry
Here are three big payer moves disrupting the ASC industry: -
Noncompetes are going extinct: 5 things to know
The legal landscape is growing increasingly hostile to noncompete agreements, according to a Sept. 27 article in JDSupra by law firm Dorsey & Whitney. -
Three Myths About Out-of-Network Claims
In the intricate web of the modern healthcare industry, the term "out-of-network" has become somewhat synonymous with confusion and uncertainty for both patients and providers. -
CMS forces shaping the ASC industry
The ASC industry is constantly evolving, and one of the major players in its evolution is CMS. -
8 health systems calling it quits with Medicare Advantage: What ASCs should know
This year, eight major U.S. health systems have canceled their Medicare Advantage contracts, often citing low reimbursement rates and prior authorization hassles. -
CMS settles $9.2M in Stark law self disclosures: 3 things to know
CMS settled a record number of 104 Stark law self disclosures in 2022, totaling more than $9.2 million, according to a Sept. 18 JDSupra report from law firm McGuireWoods.
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