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The No Surprises Act: Preparing Your Practice for the Coming Challenges and Opportunities
The bipartisan No Surprises Act (“the Act”) was enacted on December 27, 2020. The Act provides comprehensive patient protection against surprise medical bills that occur when a patient receives a bill for the difference between an out-of-network provider’s charge and the amount paid by the patient’s insurance company, less patient cost sharing amounts. -
Average ACA marketplace plan deductibles for 38 states
President Joe Biden issued an executive order to reopen the ACA marketplace on Feb. 15 for expanded enrollment during the pandemic to give more Americans access to health insurance. -
Top 5 health insurance plans by membership, market share
The U.S. has more than 900 health insurance companies that provide medical coverage. -
Is the payer outlook bright or dark for ASCs?
While some ASC administrators have seen payers become more accepting of outpatient surgeries and drive cases to the ASC, others report continued challenges in contract negotiations. -
ASCs claims volume dropped 9.8% in 2020: A month-by-month breakdown
ASCs began 2020 tracking ahead of 2019 in terms of overall case volume, based on procedure claims data from Definitive Healthcare. -
National Medical Billing Services gets private equity investment to expand business
St. Louis-based National Medical Billing Services, a revenue cycle management company, received an investment from private equity firm Aquiline Capital Partners. -
Biden exec order reopens ACA insurance marketplaces: What ASCs need to know
President Joe Biden issued an executive order to open a special enrollment period for the health insurance marketplace from Feb. 15 to May 15. -
Urologist's estate pays $1.75M to settle ASC kickback allegations: 4 details
The estate of an urologist agreed to settle allegations he submitted false claims related to lithotripsy procedures, according to the U.S. Attorney's Office for the middle district of Florida. -
Trump pardons New Jersey surgeon who obstructed billing investigation
Prior to leaving office on Jan. 20, former President Donald Trump granted a pardon for a New Jersey surgeon who pleaded guilty to obstructing justice during an investigation of his billing practices, according to a report in the Courier Post. -
New York ASC seeks indefinite status from state health department
Niagara Falls, N.Y.-based Ambulatory Surgery Center of Niagara is seeking permanent certification, Buffalo Business First reported Jan. 18. -
Tennessee county opposes CON-lifting measure
The Williamson County, Tenn., board of commissioners passed a resolution opposing state legislation to revise certificate-of-need laws, the Williamson Herald reported Jan. 11. -
5 ways the stimulus bill changed physician, practice payments
The most recent stimulus bill included multiple changes that will affect physician pay and practices going forward, according to a report in Medscape. -
25 statistics on medical coder salaries
The average salary for medical coding professionals varies by location, practice setting and credential. -
10 changes CMS made in 2021
With the new calendar year, several CMS changes took effect, with more on the way. Here's a roundup of changes CMS made or will make in 2021: -
Medicare pay for arthroscopic surgery down almost 30% since 2000: 4 notes
Medicare reimbursement for orthopedic arthroscopic surgery declined from 2000 to 2019, according to a study published in The Journal of Arthroscopic and Related Surgery. -
Simplify ASC acquires PhyBus Revenue Services
EHR and practice management software company Simplify ASC purchased PhyBus Revenue Services, according to a Jan. 7 news release. -
Cigna, UnitedHealthcare and Centene: 3 payer updates
Health insurers continued to make news as 2020 came to a close and the new year began. -
What Stark law, anti-kickback changes mean for value-based care at ASCs
HHS issued two rules on value-based care arrangements recently that will affect orthopedic surgeons and ASCs. -
Uninsured Americans: 7 things to know
The number of uninsured Americans remains a big challenge for the country and could cause problems for ASCs this year. -
3 Tennessee spine care providers settle improper billing allegations: 5 details
Three Tennessee spine care providers will pay nearly $2 million to resolve improper billing claims for electro-acupuncture.
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