Private Payers

The American College of Surgeons (ACS) staff are available to answer questions and assist members who are experiencing issues with private payors (private insurance companies). These issues could include lack of coverage, prior authorization, surprise billing, network adequacy, narrow networks, tiering, or others.

Having problems with private payors? We can help!

Surgeons can contact Lauren Foe, ACS Division of Advocacy and Health Policy, at 202-672-1524 or lfoe@facs.org for assistance.

ACS Advocacy

ACS Letter to CMS Regarding Private Payer Price Transparency

The ACS commented on the Centers for Medicare & Medicaid Services’ (CMS) Transparency in Coverage proposed rule, through which the Agency solicited input on approaches to make health care price information accessible to consumers. In its letter, the College offered guidance to CMS on methods to enhance the usability and accuracy of cost-sharing data presented by private payors to their enrollees.

Read the Transparency in Coverage letter

ACS Letter to Anthem on Erroneous Coverage/Reimbursement Policies

In 2018, the College sent a letter to Anthem leadership expressing concern with several coverage and reimbursement policies that would put patient safety at risk, inappropriately shift costs onto enrollees, delay the provision of necessary care, and unfairly cut physician payment.

• Read ACS letter to Anthem
• ACS Comments on RFI the Future of Program Integrity
  
• ACS February 2018 Letter to Anthem
  
• Transparency in Coverage Comment Letter