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Average ASC revenue per case for each specialty: 2022
Orthopedics tops the pack for ASC revenue per case, according to VMG Health's "Multi-Specialty ASC Benchmarking Study" for 2022. The specialty was only the fourth most-represented among ASC cases, however. -
How CMS is affecting the future of healthcare
From the dismissal of the inpatient-only list to the removal of procedures from the ASC-payable list, CMS plays a massive role in the success of an ASC. -
24% of physicians say prior authorization wait led to hospitalization of patient
Thirty-four percent of physicians reported that delays in processing a prior authorization led to a serious adverse event for a patient in their care, according to a recent survey from the American Medical Association. -
UnitedHealthcare adds prior authorization to physical, occupational therapy in 4 states
UnitedHealthcare now requires members to obtain prior authorization before undergoing physical and occupational therapy at multidisciplinary offices and outpatient hospitals in four states. -
UnitedHealthcare drops patient observation notice requirement
Chicago-based insurance provider UnitedHealthcare has ended its requirement in most plans for providers to submit an observation notification after a patient is discharged home, the company said Feb. 10. -
UnitedHealthcare vs. Cigna vs. Anthem: How the big 3 stack up
Payers UnitedHealthcare, Cigna and Anthem reported the largest year-end revenue in 2021. -
2 Texas physicians indicted in $300M kickback scheme
Two Laredo, Texas-based physicians were among 10 indicted in a $300 million healthcare fraud scheme Feb. 10, according to the Justice Department. -
6 CMS updates
The No Surprises Act, the federal law requiring ASCs and physician practices to provide cost estimates to self-pay patients, went into effect Jan. 1. -
ASCs must give cost estimates to patients: 7 details
ASCs and physician practices are required to provide cost estimates for expected charges to self-pay patients when scheduling procedures or services as part of the No Surprises Act, which went into effect Jan. 1. -
Aetna in the headlines: 5 updates in the last 30 days
Here are five updates from Aetna, one of the country's biggest payers, in the last 30 days: -
Michigan surgeon pleads guilty to $19.5M billing fraud: 4 details
A Bay City, Mich.-based vascular surgeon pleaded guilty to a multimillion dollar fraud scheme Feb. 8, according to the Justice Department. -
ASCA asks members to urge Congress to support ASC reimbursement legislation
The Ambulatory Surgery Center Association is asking members to write to Congress and ask them to support the Outpatient Surgery Quality and Access Act of 2021. -
Commercial payers driving cases to ASCs; orthopedics most primed for growth
A growing number of commercial insurers are revamping policies to push providers and patients out of the hospital and into ASCs, where procedures can be performed at a lower cost. -
Woman pleads guilty in $44M scheme to fraudulently bill cosmetic surgeries
A 69-year-old woman pleaded guilty to federal fraud charges after billing cosmetic surgeries at a California surgery center as medically necessary, the Justice Department said Feb. 4. -
Ask payers how you can share in the savings, says Surgery Partners exec
Shannon Yarrow, senior vice president of managed care at Brentwood, Tenn.-based Surgery Partners, joined "Becker's ASC Review Podcast" to talk about reimbursement opportunities for physicians doing outpatient procedures. -
Inflation hits ASCs, physicians hard
The cost of essential goods jumped 7 percent last year, outpacing the reimbursement increases to healthcare providers across the board. -
Payers eye ASCs for big growth: 7 notes
The healthcare industry is experiencing monumental changes due to policy shifts and the aftermath of COVID-19. Insurers are taking stock of the situation and see a huge opportunity to direct more care to outpatient settings. -
Why an ASC, clinic lost coverage in 2021
An Illinois clinic lost coverage from Blue Cross and Blue Shield of Illinois and an Idaho ASC lost coverage from CMS in 2021. -
Price transparency and ASCs: 7 insights
Here are seven insights into price transparency and ASCs from the last year: -
Will CMS physician pay cuts ever happen?
Potential Medicare pay cuts associated with the 2010 sequestration have loomed large on Capitol Hill for the last decade, but lawmakers continue to kick the can down the road.
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