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This report illustrates the number of ambulatory surgery patients residing in each county by service line and expected source of payment for the 12 month time period January - December of selected year.  Payer groups are defined as follows:

1. Medicare - Title XVIII of Social Security Act
2. Medicaid - Title XIX of Social Security Act
3. Third parties other than the above, such as Indian Health Service, and CHAMPUS.
4. Commercial Insurance -  Any commercial or private insurance company which reimburses the hospital for their charges or some percent of their charges and for which the hospital is not "At Risk" as well as Risk arrangements with third parties, such as health maintenance organizations (HMO), preferred provider organizations (PPO), comprehensive medical plans (CMP), and similar arrangements in which the provider shares risk with the insurer and in which an individual patient-specific payment amount can be identified. Third party risk arrangements may be sponsored by Blue Cross, commercial insurance companies, unions, and others. All patient-specific risk arrangements, regardless of their sponsorship, should be included.
   Except Medicare and Medicaid.
5. Self Pay - Includes services for which a patient has no third party payment arrangement or plans to handle the relations with a third party payer personally and, thereby, is personally liable for the services
   rendered. Also included are patients with no health insurance coverage for any health care service, health insurance that does not cover a particular service rendered or health insurance that does not cover the particular procedure for which the individual sought treatment.
6. Other/Unknown - Includes, unknown and other sources not specified above. NOTE: Workmen’s Compensation to be included in Commercial Insurance.

Ambulatory surgery service lines are assigned by Thomson Reuters.  No direct correlation exists between the inpatient and ambulatory surgery service lines.

Percent of total statewide patients within each service line and payer group is included in this report.

* Source:  The Principles and Practices Board of HFMA