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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. -
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.
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