As a means to allow individual consumers to purchase health care coverage and an affordable rate, “ObamaCare” allows for the creation of insurance exchanges. These marketplaces are intended to allow insurances to compete for business by offering competitive rates to individuals. Recently, APS has begun receiving notification of certain PHOs taking advantage of these exchanges, with the result being lower reimbursement. Most notably are contract terms paying 100% of current year (2012) Medicare. APS will keep each client informed to these offers and work tirelessly to negotiate fair reimbursement for clients from commercial payors. If you have questions, please contact your Account Manager.
In working through the wide variety of billing arrangements, APS found payments that we had been missing.