Author: Patsy Newitt
Becker’s ASC Review
Anesthesia reimbursement denials are on the upward swing, according to a June 26 blog post from Rita Astani, president of anesthesia for Coronis Health.
Payers seem to be using “computer algorithms or narrowly trained staff to deliberately slow down or sabotage payouts,” according to the post, which cited a KFF report that found that approximately 18 percent of in-network claims are denied on average.
This trend is at odds with provisions in the Affordable Care Act, which prohibits insurance companies from participating in schemes designed to slow payments. Many leaders think the rise in denials is in part due to HHS allowing the rise in denials and turning a “blind eye” to this payer activity, according to Ms. Astani.
This trend means it is “more important than ever for provider groups to partner with revenue cycle experts who have the resources and technical skill to tackle this,” Ms. Astani wrote. Using a revenue cycle expert, providers can better approach the appeals process to secure payments for procedures, she added.