Executive SummaryThere is no more controversial issue in the outpatient market today than out-of-network billing. It is important to understand the risks as well as the benefits for your ambulatory ...

Question: I just found out that one of my providers is no longer in network for my Medicare Advantage Plan. What are my options? Answer: There are many important factors to consider when learning to ...

Out-of-network is complex. With the right approach, however, providers can significantly improve reimbursement rates, financial results, and the bottom-line. John F. Bartos, CEO of Collect Rx, ...

Three major medical organizations are urging Anthem to withdraw a policy that would penalize hospitals and outpatient facilities that use out-of-network providers. The American Society of ...

Relying on a 2-stage secret shopper survey, the authors found that inaccuracies in provider directories often persisted for well over 1 year. Objectives: Provider directory inaccuracies have important ...

The dispute between Indianapolis-based Elevance and provider groups centers on the federal No Surprises Act, enacted in 2022, which seeks to protect patients from unexpected, expensive out-of-network ...