'I have zero faith in our payers': Where ASCs are losing money with reimbursements
By Admin | November 20, 2023
ASCs have long faced obstacles to reimbursements, and some leaders are finding increasing obstacles to securing necessary pay for procedures.
Todd Neiss, business manager of Bismarck (N.D.) Surgical Associates, joined Becker's to discuss his organizations' obstacles with payers and claims.
Editor's note: This interview was edited lightly for clarity and length.
Question: Where are ASCs losing money right now?
Todd Neiss: Where ASCs are losing money right now is with payers not processing claims correctly. They deny claims that should be paid or have a third party process claims that don't even follow the payers' policies and guidelines and they deny claims that should be paid. You fight for these claims to get paid, and they require you to appeal and you find out that the appeal is being sent to the same third party processor, and they automatically deny, citing the exact same reason the claim was denied in the first place. They didn't even look at the supporting documents included with the appeal outlining why the claim should be paid. Then finally, you are able to submit a...(More)
For more info please read, 'I have zero faith in our payers': Where ASCs are losing money with reimbursements, by Becker's ASC Review
