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How this CEO tackles precertifications
Precertifications are one of many hassles ASCs face when securing reimbursements. -
How to secure reimbursement authorizations, according to one administrator
Handling claims and denials with payers can be an obstacle for ASCs to maximize revenue. -
What reimbursement issues are costing ASCs the most?
From prior authorization to payer consolidation, ASCs have long faced obstacles in securing reimbursements. -
Pain physician, practice in North Carolina to resolve fraud claims for $500K
Kwadwo Gyarteng-Dakwa, MD, and his Greensboro, N.C.-based pain practice agreed to pay half a million dollars to settle allegations he wrongly billed Medicare and Medicaid, according to a May 26 announcement from the U.S. Attorney's Office in the Middle District of North Carolina. -
Florida court orders ASC to show patient billing records
A Florida appeals court ruled May 21 that Orlando-based Sand Lake Surgery Center must produce relevant billing records for the treatment of two personal injury plaintiffs, even though it already sold its stake in the case to a litigation funding company. -
81% of medical groups say prior authorization demands have increased since 2020
Most medical groups have seen an increase in prior authorization requirements since last year, according to polling from the Medical Group Management Association. -
Physician gets 59-year prison sentence for fraud, unnecessary surgeries
A physician in Chesapeake, Va., was sentenced to nearly six decades in prison May 18, according to the U.S. Justice Department. -
Turning over every stone: What to expect from an effective revenue cycle assessment
How well is your ASC’s revenue cycle performing? If you can’t answer this quickly and confidently, you may be overdue for a revenue cycle assessment. -
Texas hospitals to pay $20.9M after alleged kickbacks to physician groups
Three Ascension affiliated hospitals will pay millions for allegedly violating physician self-referral and anti-kickback laws. -
High-deductible plans are changing patient behavior, ASC execs say
Insurers pass risk to patients with high-deductible health plans, and members are becoming savvier about the cost of care as a result. -
Commercial payers: 8 updates for ASC leaders
Cigna's preventive care is back to pre-pandemic levels, and Blue Cross Blue Shield cut a rule that hampered competition. -
How bundled payments are changing the market
The success of bundled payments hinges on a variety of factors — some ASC leaders are wary, while others have found success in value-based payments. -
What ASC execs expect from CMS, commercial payers next
CMS added hundreds of surgeries and procedure codes to the ASC payable list in 2021 and revealed plans to eliminate the inpatient-only list over the next few years. -
Tackling bundled payments: ASC leaders weigh in
More ASCs are considering bundled payments as a part of their strategy. Three ASC leaders spoke with Becker's ASC Review on addressing obstacles with bundled payments. -
4 mistakes to avoid with bundled payments, according to one administrator
Bundled payments are a challenge for some ASCs — oftentimes, these payments mean the ASCs have to coordinate post-operative services and align a plan of care. -
Implant reimbursement vs. ASCs: 5 leaders weigh in
Implant costs are a burden for many ASCs, and many feel ASCs have irreparably shifted the implant industry. -
ASCs and payers: New best friends?
Medicare and commercial insurance companies have developed new policies over the last year that will drive more surgeries to ASCs. But that doesn't mean payers have made things easy for them. -
Implant costs a 'race to the bottom' with ASCs, administrator says
As higher-acuity procedures move to outpatient, ASCs must be sure to consider the cost of implants in commercial payer contracts. -
South Dakota neurosurgeon to pay $4.4M to resolve kickback allegations
A Sioux Falls, S.D.-based neurosurgeon and the two medical device distributorships he owns will pay $4.4 million to resolve False Claims Act violation allegations, the U.S. Justice Department said May 3. -
Ophthalmology clinic to repay CMS $398K after billing errors discovered
A California-based ophthalmology clinic said it plans to refund CMS more than $398,000 after an HHS investigation found inappropriate billing led to overpayment.
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