Jeffrey Rihn, CFO of the Surgery Center at Cranberry in Cranberry Township, Pa., wants to change in-network provider requirements by requiring insurers to recognize any provider who meets basic accreditation requirements, according to a Pittsburgh Business Times report.
Like many other independent ASCs in the region, the Surgery Center at Cranberry does not contract with UPMC Health Plan, making it an out-of-network provider for more than 1.5 million people covered by the insurer.
ASCs are increasingly moving away from out-of-network strategies, as insurers try to force patients to seek providers in-network and surgery center buyers value out-of-network surgery centers at much lower multiples than in-network facilities. Under the new legislation, all surgery centers who meet accreditation requirements would automatically go "in-network," potentially opening up a previously inaccessible pool of patients and increasing ASC value for future sale.
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Like many other independent ASCs in the region, the Surgery Center at Cranberry does not contract with UPMC Health Plan, making it an out-of-network provider for more than 1.5 million people covered by the insurer.
ASCs are increasingly moving away from out-of-network strategies, as insurers try to force patients to seek providers in-network and surgery center buyers value out-of-network surgery centers at much lower multiples than in-network facilities. Under the new legislation, all surgery centers who meet accreditation requirements would automatically go "in-network," potentially opening up a previously inaccessible pool of patients and increasing ASC value for future sale.
Related Articles on Coding, Billing and Collections:
AHIMA Disappointed With AMA's Opposition to ICD-10-CM Implementation
Missouri Likely to Pass on Implementing Health Insurance Exchange
Employer Health Insurance Premiums Increased 50% From 2003-2010