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26 CODING & BILLING 16 ASCs embracing price transparency By Angie Stewart B oulder (Colo.) Surgery Center. Boul- der Surgery Center provides estimates for the 25 most commonly performed procedures on its website. e prices don't apply to patients covered by health insur- ance. Healthcare providers are required by Colorado's Transparency in Healthcare Pric- ing Act of 2017 to provide this information. North Texas Team Care Surgery Center (Mes- quite). is four-OR facility offers flat-rate pric- ing for most surgeries, which is required to be paid in full prior to surgery. e cost includes surgeon's fees, facility fees and fees related to nursing, anesthesiology and routine preopera- tive lab work. Patients can find prices for an extensive list of surgical procedures through a drop-down menu on its website. Seaside Surgery Center (Naples, Fla.). Seaside Surgery Center posted all-inclusive orthopedic surgery pricing on its website in December 2017. e ASC was designed and built exclu- sively for same-day joint replacements. Ocean Surgery Center (Torrance, Calif.). A multispecialty facility operating under the direction of Sherif Khattab, MD, Ocean Sur- gery Center provides detailed online pricing for general surgery, gynecology, urology, orthopedics, podiatry and other procedures. It offers a printable version of cost estimates. Surgery Center of Oklahoma (Oklahoma City). Surgery Center of Oklahoma is a mem- ber of the Free Market Medical Association. Its website features a comprehensive list of proce- dure costs, including 14 prices for arthroscopic procedures. A link to a form for requesting a specialist is listed next to each item. Medarva Stony Point Surgery Center (Richmond, Va.). Medarva Stony Point Surgery Center displays online price esti- mates for ENT, eye, face, gastroenterology, orthopedic and pediatric procedures, along with others. Before accessing the out-of- pocket costs webpage, patients must check a box stating they have read and understood a pricing disclaimer. Preston Surgery Center (Frisco, Texas). In January, Preston Surgery Center announced it posted transparent cash pricing on its website for self-pay patients and self-funded employ- ers. Physicians at the facility specialize in pain management, spine surgery, orthopedics, cardiology, hand surgery, podiatry and GI. Avalon Surgery Center (Glendale, Ca- lif.). Avalon Surgery Center's website dis- plays pricing for more than 100 procedures. e costs include fees for the facility, surgeon and anesthesiologist, as well as the initial con- sultation and uncomplicated follow-up care. North Hills Surgery Center (Fayetteville, Ark.). North Hills Surgery Center allows pa- tients to view online pricing for ophthal- mology, endoscopy, shoulder, ENT and other services, and to request a specialist. Costs listed don't include diagnostic studies, implants or hardware or expenses resulting from postoperative complications. St. George (Utah) Surgical Center. e physician-owned St. George Surgical Cen- ter offers online procedure pricing for more than two dozen services. e prices include facility fees, surgeon's fees, anesthesia fees, stan- dard implants and hardware and up to 23-hour overnight/extended stay for certain procedures. Cedar Orthopaedic Surgery Center (Ce- dar City, Utah). e single-specialty Cedar Orthopaedic Surgery Centerprovides price quotes through a "transparent pricing engine" on its website. e prices include the surgeon's fee, surgery center facility fee, total joint im- plants, anesthesia fee and physical therapy fee. Foothills Surgery Center (Boulder, Colo.). Foothills Surgery Center's web- site lists price estimates for ophthalmology, general surgery, orthopedic, ENT, pain management, urology and neurology ser- vices. e pricing tool is intended to provide information on the average price patients pay at the ASC. Orthopaedic and Spine Center of Southern Colorado (Colorado Springs). Opened in 2014, the Orthopaedic and Spine Center of Southern Colorado allows patients to down- load expense estimates for neurology, pain management and orthopedic procedures. Skyline Endoscopy Center (Loveland, Colo.). e 8,936-square foot Skyline Endos- copy Center provides price estimates for its 25 most commonly performed procedures. Services include colonoscopy, sigmoidos- copy, upper gastrointestinal endoscopy and InterStim procedures. Peak One Surgery Center (Frisco, Colo.). Gastroenterology and orthopedics are among the services with cost esti- mates listed on Peak One Surgery Center's website. e ASC encourages patients to contact the business office for information about rates not shown online. e Surgery Center at Lutheran (Wheat Ridge, Colo.). More than 43 surgeons practice at e Surgery Center at Lutheran, which offers procedure pricing for six service areas. Patients can view service descriptions and costs, and find surgeons within that specialty. n 3 ASCs, Cigna settle alleged ERISA violation suit By Laura Dyrda Cigna settled a lawsuit accusing three centers of violating the Employee Retirement Income Security Act, according to Law 360. Connecticut General Life Insurance as well as Cigna Health and Life Insurance filed the suit against three surgery centers, alleging Cigna overpaid the ASCs around $8 million. The ASCs allegedly waived patient payments for out-of- network bills but continued to bill the insurance company. In April, the Texas-based ASCs filed a motion for the partial summary judg- ment, alleging no support for Cigna's claims after more than a year. The motion stated: "Cigna's plan interpretation is legally incorrect and cannot be enforced under ERISA 502(a)(3)," according to an SE Texas Record report. The motion also argued Cigna's overpayment provision has "inscrutable language" and highlighted different court opinions on whether overpayment prevision "facially creates an equitable lien by argument." The parties agreed to settle the case. n TO REGISTER: CALL 800 417 2035 • FAX 866 678 5755 • REGISTRATION@BECKERSHEALTHCARE.COM OR VISIT www.beckersasc.com/TBD