New Database to detail out-of-network healthcare costs for consumers

It seems that the effort lead by the New York Attorney General more than a year ago is paying out and there has been some follow up on the issues, we brought this to the attention of the community because it affects all Surgical Assistants specifically.
Here are the links to read more about it. We should see something tangible in about a year.

New York Times (Oct 27, 2009)
Reuters (Oct 27, 2009)
Wall Street Journal (Oct 28, 2009)
Associated Press (Oct 28, 2009)

National Association of Insurance Commissioners 2009 Fall Meeting
Public Hearing

This hearing was a follow up on the New York General Lawsuit that we posted below.

It reports the Usual, Customary and Reasonable practices of major insurance carriers when paying out-of-network claims based on flawed data from Ingenix which by the way was owned by United Healthcare.

We sincerely hope that now this has come to light, these practices come to a halt and Surgical Assistants are reimbursed on a more consistent and fair manner.

Click here to read a transcript of the hearing

THE VIRGINIA BOARD OF HEALTH PROFESSIONS AND THE VIRGINIA DEPT OF HEALTH PROFESSIONS RELEASE A SUMMARY OF STAFF RESEARCH FOR SURGICAL ASSISTANTS AND SURGICAL TECHNOLOGISTS

The report is dated July 23, 2009, however the draft is dated October 2, 2009.

Surgbill, Inc. is mentioned in this research as one of the national private companies seeking reimbursement for Surgical Assistants (Page 39).

It is our opinion that this research is one of the most complete and accurate reports that have been released since the GAO report in 2004.

To read this report click here.

HEALTH CARE REFORM

Regardless of what your opinion is in regards to health reform, please read/watch this interview that aired on PBS on July 10, 2009 with a former Cigna executive.

Click here to watch it.

We are being asked how would health reform affect you as a provider, and the short answer is "We don't know", but as you all have seen, reimbursement is being affected overall negatively.

The insurance industry environment is changing for the worse, especially in the last year, it could due to the economy, with more plans being sold with very high deductibles or co-insurance and it has been affecting us as a billing company and you as a provider not eligible as a provider.

Please educate yourself and get involved, it is our future and yours!

Good news for Illinois Billers (that means Surgbill, Inc.)- the IL Medical Practice Act has been revised and will now permit percentage billing arrangements.

To view the legislation that took effect on August 24, 2009, click here.

Because Surgbill, Inc. does not code claims, we were in compliance with the law before this change. However, what this change does is that we are now allowed to add physicians to our client base and be able to charge a percentage of collected revenue, the same way we have been doing since we started with Non-physician surgical assistants.

In the last 6-8 months we have noticed some Surgical Assistant Billing companies that have initiated business, especially in Texas, and we are extremely honored that they have copied information from our website in some cases an exact obvious "cut and paste", we don't mind being considered the example of what SA billing companies should strive for, but at least spend the time and effort to change their information just enough to not being an obvious copy of ours.

If they don't spend the time to build their informative website, do you think they are going to spend time on researching your claims, appeals, insurance regulations and state legislation?

Another thing to consider is that we are not a SA school or a SA group that does billing "on the side", we are only committed to YOUR account, Surgical Assistant Billing is all we do.

UPDATE ON THE NEW YORK ATTORNEY GENERAL LAWSUIT AGAINST UNITED HEALTHCARE
UnitedHealth Group agrees to a $50 million settlement after investigation
Read the full story here:
Click Here
Story on Jan 13, 2009

The New York Attorney General’s office said that it plans to file a lawsuit against United Healthcare and its subsidiary, Ingenix, and three other subsidiaries. They cite a “scheme by health insures to defraud consumers by manipulating reimbursement rates”.

Read the full story here:
Click Here
Story on Feb 13, 2008

The American College of Surgeons have updated their Surgical Assistant list, the latest update was in 2002, this list can be downloaded from the following link:
Click here

Surgbill, Inc. has added a new exciting feature to the client's area:
Now you can check your claim status on each individual claim with your internet enabled phone.

Empire Blue which is in New York state have determined that RNFAs (AORN) and CSAs (NSAA) will be reimbursed at a rate of approximately 10% of surgeons charges.
Congratulations New York assistants!

We strongly encourage for all non-physician surgical assistants to be active and support legislation in your State for direct reimbursement of your services.
Many States have already done it successfully!

Take part of your State Associations and make a difference in your future!