Self-Insured Health Plans and Primary Care Physician Practices Find Mutual Advantages of Direct Contracting

A growing number of primary care physicians are negotiating direct working relationships with self-funded employer-sponsored health plans. Direct Contracting is a payment model that shifts risk to a primary care group of physicians to provide a defined set of medical services in exchange for a monthly capitation fee. The model supplants the traditional fee-for-service reimbursement … Continued

Survey Reports Significant Percentage of Ground Ambulatory Service Claims Resulted in “Surprise” Billings, Federal Legislation Continues to Forge New Protections

Prior to the No Surprises Act (NSA), many patients who required air ambulatory transportation received medical bills, much to their surprise, that charged excessive fees for services not covered by their insurance plan. “Surprise” bills can be difficult to dispute, especially charges billed by out-of-network providers such as ambulance services, leaving patients already “financially fragile” further strained … Continued