In-network ASCs should clearly document and communicate contract terms with payers so both parties understand their obligations to each other, according to Mnet Health Services CEO David Hamilton.
Mr. Hamilton shared the following tip on LinkedIn:
"Important details such as when the billing process should take place, how claims are to be collected and the stipulated time for doing this should be made clear. Also, why claims can be denied and the process of appealing a denial should be stated," Mr. Hamilton said.
"However, it is also important to develop a relationship with the payer's agent to fast track the resolution process of claims denied or underpayment received. This is because insurance companies typically do not relate directly with providers. As such, providers would want to build a cordial partnership between the agents representing payers and their claims management team."