Ask Caryl: Prompt Payment Legislation

Q: What are insurance prompt payment regulations and how do they affect my ASC’s cash flow?

Caryl Serbin: Many ASCs experience health insurance reimbursement delays, which can adversely affect their revenue stream. Federal and state governing bodies have developed and enacted prompt-payment legislation requiring third-party payers to resolve claims and provide appropriate reimbursement within certain timelines. Your ASC should be fully aware of the prompt-payment laws of your state so you can effectively enforce these requirements. These are available online by searching for prompt payment laws for (your state). We have published a special report on prompt-payment requirements if you are interested in an expanded explanation that outlines your ASC’s rights.

Also be aware that these legislative rights are predicated on receipt of “clean” claims from your ASC. Unsure what that means? Read this clean claims definition.

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