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Month: November 2019

Don’t Look Now, But . . .Surprise Medical Bills Update

Don’t Look Now, But . . .Surprise Medical Bills Update

November 27, 2019 Some months ago, the healthcare industry was abuzz with whispers and rumors of a major move on the part of the federal government to intercede in the surprise medical bill debate.  For years, patients have bemoaned the injustice of receiving an exorbitant bill for services they had assumed were performed by a participating provider only to learn later that the clinician was not in-network with the patient’s insurance.  The cacophony of complaints became so pronounced that legislators…

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On Shifting Ground: Site of Service Policy Hits Hospitals

On Shifting Ground: Site of Service Policy Hits Hospitals

November 20, 2019 A major health plan is implementing a new policy that essentially requires large numbers of procedure types to be performed in settings other than the hospital.  On November 1, 2019, UnitedHealthcare (UHC)—the nation’s largest health insurer—implemented a pre-authorization process for hundreds of medical procedures that will involve screening for “site of service” necessity.  If one of these procedures is scheduled to be performed in the inpatient or outpatient hospital, rather than in an ambulatory surgery center (ASC)…

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