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Anthem in the headlines: 9 updates from the last 60 days
Anthem is the largest publicly traded Blue Cross Blue Shield affiliate, operating as a Blue Cross or Blue Cross Blue Shield plan in 14 states. -
Prior authorizations and ASCs: 11 insights for 2022
Eighty-one percent of medical groups have seen an increase in prior authorization requirements since 2020, according to a poll conducted by the Medical Group Management Association in May. -
Massachusetts optometrist accused of $35K billing fraud
An optometrist based in Carlisle, Mass., was indicted for billing fraud during the height of the pandemic. -
Florida ASC sues Cigna for $434K spine reimbursement
Melbourne, Fla.-based Surgery Center of Viera filed a lawsuit Jan. 20 in Florida Middle District Court in Orlando against Cigna and Strategic Enterprise Solutions. -
CMS moves boost value-based care in ASCs
Both payers and CMS have noticed opportunities in value-based care to lower costs and strengthen patient care. -
Physician pay cuts and a shrinking ASC-payable list: 12 key reimbursement updates
Here are the major reimbursement updates since July 1: -
9 updates on value-based care & ASCs | 2022
Value-based care and bundled payments have been gaining momentum in the ASC industry as a means to reduce healthcare costs and improve patient care. -
Insurers now required to cover follow-up colonoscopies
Surprise bills for colonoscopies following a stool-based screening test with positive results are now prohibited, according to Health Day. -
Oscar Health introduces tool letting patients compare costs between ASCs, hospitals
New York City-based insurance company Oscar Health introduced a price transparency tool that allows members to compare specific expenses for procedures at ASCs, hospitals and other settings. -
Iowa surgical group pays $612K to resolve fraud allegations: 5 details
Tri-State Specialists in Sioux City, Iowa, will pay hundreds of thousands of dollars to resolve billing fraud allegations. -
Cigna in the headlines: 5 updates in the last 30 days
Cigna is one of the oldest and largest payers in the U.S. with 20.4 million members. -
ASC disputes payer's conclusion that spine cases should have been in the hospital
The Center for Pain Management remains out of network with Blue Cross and Blue Shield of Minnesota after the payer terminated its contract over safety concerns in October. -
National Medical Billing Services buys mdStrategies
ASC revenue cycle management company National Medical Billing Services acquired mdStrategies, a medical coding company focused on ASCs. -
Aetna in the headlines: 7 updates in the last 90 days
Aetna is one of the country's largest health insurers, with 22.1 million members. -
Top-paid balloon sinuplasty physician indicted in fraud scheme: 3 details
Anita Louise Jackson, MD, was indicted Jan. 5 for allegedly spearheading a multimillion-dollar fraud scheme. -
UnitedHealthcare in the headlines: 4 recent stories
UnitedHealthcare is the largest health insurance company by membership with 70 million members. -
New Indiana law aims to reduce surprise billing
An Indiana law going into effect Jan. 1 hopes to reduce surprise billing, WNDU reported Dec. 28. -
California ASC will accept Bitcoin starting in January
Beverly Hills, Calif.-based Center for Advanced Facial Plastic Surgery will accept cryptocurrencies including Bitcoin starting in January, the center said Dec. 20. -
ASC, physician-owned hospital whistleblowers got up to $3M this year: 5 cases
Whistleblowers stand to receive a portion of the proceeds from a settlement or financial recovery, which can be hundreds of thousands or even millions of dollars. -
Ex-physician, ASC company found guilty of $355M fraud scheme
A federal jury on Dec. 16 found a former physician and his company guilty of a scheme to defraud private insurers and the Tricare program by submitting about $355 million in false claims.
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