In August, Ontario, Calif.-based Prime Healthcare Services paid $65 million to settle allegations it violated the False Claims Act by admitting patients who only required outpatient care and engaging in upcoding.   By Angie Stewart - 9/11/18

Alpharetta, Ga.-based Surgical Information Systems' Jho Outlaw, senior vice president of revenue cycle services, and Jessica Nelson, director of revenue cycle services shared their insights on the common obstacles that prevent an ASC being paid in a recent webinar. Surgical Information Systems summarized the questions Ms. Nelson and Ms.Outlaw were asked on their blog.  By Rachel Popa - 9/10/18

CMS halted its payments to Oklahoma City-based ESEC Surgery Center Aug. 18, but the center is working diligently to correct two deficiencies, NewsOk reports.  By Eric Oliver - 9/10/18

A New Jersey law designed to shield consumers from surprise medical bills from out-of-network providers went into full effect Aug. 30, with several implications for ASCs, InsideARM reports.  By Angie Stewart - 9/7/18

Managing accounts receivable helps ASC revenue cycle management staff determine where to concentrate collection efforts, according to Outsource Strategies International.  By Angie Stewart - 9/6/18

We've come a long way from the notoriously illegible, handwritten doctor's note. Does it read "sepsis" or "sinus"? The implications of choosing one versus the other are enormous.  By HealthChannels CEO Michael Murphy, MD - 9/6/18

The patient collection process has moved beyond simply collecting patient co-payments and sending billing statements. In today’s healthcare environment, providers and their office staff are faced with the daunting challenge of reframing business practice to help maximize reimbursement from not only health insurers but from patients as well. A TransUnion Healthcare analysis uncovered that patient responsibility or patient out-of-pocket expenses rose on average 11% in 2017; a trend that does not appear to be slowing. With this heightened focus on patient collections, let us explore ways to positively impact the patient experience through the use of new technology, discuss consumer protections and the barriers they add to collections, and review other best practices that will help you maximize your revenue.  By Kylie Kaczor - 9/5/18

The American Medical Association revealed the 2019 Current Procedural Terminology code set, which includes significant changes to CPT codes and descriptors.  By Angie Stewart - 9/5/18

Several obstacles stand in the way of ASCs getting paid, according to Surgical Information Systems Senior Vice President of Revenue Cycle Services Jho Outlaw and Revenue Cycle Services Director Jessica Nelson.  By Angie Stewart - 9/5/18

Bariatric surgeon David Kim, MD, of Colleyville, Texas, pleaded guilty to accepting $4.5 million in kickbacks for referring patients to Dallas-based Forest Park Medical Center, Dallas News reports.  By Eric Oliver - 9/5/18

P.L.2018 c.32 titled: 'Out-Of-Network Consumer Protection, Transparency, Cost Containment & Accountability Act' became effective in New Jersey on August 30.  By Staff - 9/4/18

Bundled payments can help ASCs increase reimbursements while remaining competitive in a value-based environment, according to MNet.  By Angie Stewart - 9/4/18

CMS proposed several updates to ASC payments in the 2019 proposed payment rule, issued July 25. One of the key changes for ASCs would be to broaden the definition of device-intensive procedures, adding around 131 procedures for Medicare beneficiaries in the ASC setting.  By Laura Dyrda - 9/4/18

Orthopedic practices should incorporate telemedicine into physician-controlled bundled payment plans to improve post-acute care, reduce expenses and improve patient outcomes, mHealthIntelligence reports.  By Angie Stewart - 8/31/18

Although surgical bundles have yielded promising results for Medicare, bundling medical conditions hasn't delivered the same success, HealthAffairs reports.  By Angie Stewart - 8/30/18

A $4 million settlement was reached in a Medicare fraud lawsuit under the False Claims Act.  By Rachel Popa - 8/29/18

CMS' proposed 2019 Medicare Physician Fee Schedule would cut reimbursement significantly for specialty physicians' most complex cases, ICD10Monitor reports.  By Angie Stewart - 8/28/18

Houston-based Nobilis Health entered into an in-network contract at Plano (Texas) Surgical Hospital with a large national payer.  By Laura Dyrda - 8/28/18

ASCs must develop new payer strategies to remain competitive, Mnet Health Services CEO David Hamilton wrote in a LinkedIn post.  By Angie Stewart - 8/27/18

It's critical to understand payer policies and regulatory requirements when appealing denials, according to SFM Mutual Insurance Company Bill Review Technical Specialist Michael Strong, CPC.  By Angie Stewart - 8/24/18