Archive for July 26th, 2014

Surgery Center Network

Saturday, July 26th, 2014


Put Our Expertise to Work for You – Fee Negotiation Service

Surgery Center NetworkTM has deep, broad and historic relationships with hundreds of outpatient surgery centers across the country. Those relationships are usually with the top executives of the ASC management companies as well as the business office managers and administrators directly at the centers.

These relationships give us unparalleled access to decision-makers who can agree to a significant reduction of an out-of-network claim, more so than the billing and collections staff can usually agree to.

Contact Surgery Center Network with your out-of-network claims and let us negotiate a fair reimbursement for each claim. Surgery Center Network can also fund the payment, if necessary, to help expedite the processing and to maximize the savings.

  • Send Surgery Center Network your important and larger out-of-network claims. Claims should be unpaid, with a majority of the claim’s liability remaining with the plan sponsor.
  • Be sure that you are able to tell Surgery Center Network how quickly you are able to pay the claim once an agreement is reached. The sooner you can pay it, the better the savings can be on the claim.
  • Surgery Center Network needs to know the patient name, date of service, procedures and the appropriate codes, billed charges, plan liability and member liability, facility name and contact information, any payments that may have already been made, and any other relevant information that we might need.
  • Email the information to, and also tell us if the claim is above stop-loss thresholds or not.
  • We can usually have a response and proposal within 24 hours, and then we will secure the signed agreement from the provider.


Cost Plus Health Plans Draw Fire

Saturday, July 26th, 2014


DALLAS — The cost-plus basis under which most public and private health insurance plans are set up is forcing business to discard conventional health insurance plans and adopt self-insured programs at a considerable saving, recent research indicates.

A study by the National Center for Policy Analysis, a privately funded research group in Dallas, concluded: “An insurance system designed to make sure that hospitals cover their costs is inherently adverse to the interests of those who are insured.

See article here –

Editor’s Note: If the  cost plus insurance scheme gains too much market share, will costs go up? Hospitals will have no incentive to reduce costs. The higher their costs the more they make under a Cost Plus Insurance plan. This 1985 article warns readers about the fallacy of cost plus driven pricing that still holds true 29 years later.

Rx Monopoly – $84,000 for 12 Week Treatment Course – $2.3 Billion In Sales In 3 Months

Saturday, July 26th, 2014


Solvadi costs $84,000 for a 12 week treatment course. Sovaldi has prompted fears among insurers and state officials that the breakthrough drug, despite its benefits, could explode their budgets. And that has sparked an urgent and highly sensitive debate in Medicaid offices across the country: How far should society go to make sure the poor get the best available treatments?


Carenet Healthcare Services Adding 200 Jobs In San Antonio

Saturday, July 26th, 2014