Florida Workers’ Comp Revises Wording on Payment to Surgical Centers

The Florida Division of Workers’ Compensation has made a tweak to its proposed reimbursement manual for ambulatory surgical centers.

The change, posted after a Jan. 12 hearing on the issue, would clarify the wording by removing the words “for which there is no dispute as to the medical necessity” in the second sentence of a section of the rule.

The paragraph now reads: “When a carrier denies, disallows, or adjusts payment for ASC charges, in accordance with the time limitation and coding requirements established by statute and by rule, the carrier must remit a minimum partial payment of the ASC’s charges. Minimum partial payment means payment of all non-disputed charges. The payment must accompany the Explanation of Bill Review (EOBR).”

Reimbursement methods to ASCs have been an issue in Florida for the past few years, but in recent months, stakeholders have said that most concerns have been addressed by the division. In November, the DWC posted a change to the minimum payment wording, adding in the language about “for which no dispute as to the medical necessity.” After the hearing last month, that has been revised again.

Questions can be addressed to Mark Harrell, medical health care program analyst, Bureau of Monitoring and Audit, at (850) 413-1726 or Mark.Harrell@MyFloridaCFO.com.

Topics Florida Workers' Compensation