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Why one CEO handles revenue cycle internally
For some ASCs, handling revenue cycle functions internally allows staff to ensure and measure appropriate performance. -
How 3 ASCs manage their revenue cycle
ASCs have long faced challenges in collecting reimbursement, making it critical for centers to streamline their revenue cycle management. -
How ASCs should think about direct-to-employer contracting: 4 experts weigh in
Employers are increasingly exploring direct contracting options for orthopedic care, which can provide an additional revenue stream for ASCs as commercial payers continue to reduce reimbursement rates and narrow their networks. -
Texas ENT group pays $750K to settle 'upcoding' allegations
An ENT physician group in Texas accused of an upcoding scheme has paid $750,000 to settle the allegations, the U.S. attorney's office said June 23. -
How long do physicians spend on prior authorizations each week?
Most physicians spent one to 15 hours each week on prior authorizations in 2020, according to the "92nd Physician Report" from Medical Economics. -
CMS changes in 2021 ASC leaders need to know
CMS added 267 ASC-payable additions in their rules for 2021, and the new CMS administrator was confirmed. -
3 key priorities for an ASC payer strategist
Managing payer issues from a patient, physician and provider level is key to ensuring reimbursements and high level patient care. -
What ASCs can expect from CMS in the next year
The federal government was relatively friendly to ASCs during the Trump administration, with CMS paying for more types of surgery in ASCs and HHS loosening regulations on how centers could practice during the pandemic. -
8 payer updates
Alignment Healthcare is expanding coverage, and Blue Cross and Blue Shield will pay members of its Federal Employee Program to get vaccinated. -
HST Pathways to acquire Clariti Health to expand ASC revenue cycle offerings
ASC software company HST Pathways will acquire revenue cycle management solutions company Clariti Health to increase price transparency at ASC practices. -
How automation helps MidLantic Urology manage revenue cycles, prior authorizations
Automation tools have been a key part of boosting collections and managing finances at MidLantic Urology, controller Maryanne Thompson said. -
Feds crack down on pain procedure billing fraud
Multiple physicians and chiropractors have agreed to pay the federal government millions of dollars over the past six months to resolve fraudulent billing allegations related to pain management procedures. -
Former hospital pharmacist, whistleblower alleges he was fired for pointing out fraudulent ASC billing
David Schwartz, former pharmacy director of a Dallas hospital, alleges that he was fired for airing concerns that an affiliated surgery center was fraudulently overbilling state and federal payers, according to Bloomberg Law. -
How a surgical technology solution can improve physicians' notes, workflow and billing — 3 takeaways
The complexity of medical coding makes accurate and streamlined surgical documentation critical; if the notes lack necessary detail, the billing and reimbursements may be wrong, ultimately costing the provider money. -
Artificial Intelligence, Big Data, and the Potential Revenue Cycle Win for Ambulatory Surgery Centers
For some time now, humans as a species have been intrigued by the possibility of creating machines that could mimic the human brain. -
Illinois ASC, clinic says BCBSIL terminated contract without warning
Springfield (Ill.) Clinic accused Blue Cross Blue Shield of Illinois of terminating its in-network provider agreement without warning, according to an ABC affiliate News Channel 20. -
3 orthopedic, pain groups resolve neurostimulator billing fraud allegations for $1M
Three Texas physician practices settled billing fraud allegations related to neurostimulator devices, according to a June 10 Justice Department statement. -
New reasons insurers are denying payment
Commercial insurers are changing their policies to deny hospitals and ASCs payment for services deemed unnecessary or lacking enough evidence to move forward. -
Practice penalized after YouTube-trained nurses performed neurostimulator procedures
A Houston-based chiropractor and her practice are paying $2.6 million and foregoing participation in federal healthcare programs for a decade to resolve billing fraud allegations, according to a June 8 Justice Department statement. -
2-ASC orthopedic group inks bundled payment contract with Florida Blue
The Orthopaedic Institute, a Gainesville, Fla.-based orthopedic practice, signed a contract for bundled payments with Florida Blue Cross Blue Shield.
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