Sponsored by nimble solutions | Contact us
-
Surgery groups vs. insurers: 4 court battles to know
Four recent lawsuits involving surgical groups and insurance companies: -
ASCs don't want to be out of network in an economic downturn: 3 thoughts from a VP
John Kelly, senior vice president of strategic planning at advertising agency 9Rooftops Health, shared three thoughts on the future of the ASC market: -
Physician practices should avoid these 5 billing mistakes
Seemingly minor billing mistakes can result in major revenue losses for physician practices, according to the Pensacola Voice. -
Total charges in 2019 for the 10 costliest ASC procedures
Some of the most expensive procedures performed in ASCs last year represented over $40 million in total charges, according to Definitive Healthcare. -
Imaging provider sues Cigna for nearly $400K over allegedly improper denials
A new lawsuit accuses Cigna of violating the Coronavirus Aid, Relief and Economic Security Act by improperly denying nearly $400,000 in COVID-19-related claims, according to Law360 and Radiology Business. -
North Carolina ASC reports PPP loan was overstated
An ASC in Wilmington, N.C., reported that the U.S. Small Business Administration overstated how much money it received from the Paycheck Protection Program, according to the StarNews. -
Cigna loses motion to dismiss ASC suit over 'systematic,' 'indiscriminate' claim denials
Cigna's motion to dismiss a lawsuit brought by South Amboy, N.J.-based Metropolitan Surgical Institute was partially denied, according to a document filed July 31 in the New Jersey District Court. -
'We want people to understand why we're upset' — 5 surgery, specialty group leaders on CMS' proposed 2021 fee schedule
CMS released its Medicare Physician Fee Schedule proposed rule for 2021 Aug. 3, which could result in drastic cuts for surgeons across the board. -
What CMS' proposal to eliminate the inpatient only list means for ASCs
There are currently around 1,740 procedures on CMS' inpatient only list, which is reviewed and updated annually. However, CMS proposed eliminating the inpatient only list in 2021 after years of receiving comments advising the agency to allow physicians to decide on the clinical site of service. -
CMS proposes making it easier for some physician-owned hospitals to expand: 4 details
CMS proposed removing some provisions in the expansion exception process for physician-owned hospitals that serve high numbers of Medicaid inpatients in the 2021 Outpatient Prospective Payment System proposed rule. -
11 procedures CMS may add to the ASC payable list in 2021 + a new review process for 2022
CMS proposed adding 11 procedure codes to the ASC payable list, including total hip replacement, according to ASCA. -
CMS could increase ASC reimbursement by 2.6% — 5 insights
CMS released its proposed hospital outpatient payment rule for 2021 that would increase ASC reimbursement rates about 2.6 percent if approved as drafted. -
CMS proposes cutting Medicare payments for some specialty surgeries 6%-9%
CMS released its Medicare Physician Fee Schedule proposed rule for 2021 Aug. 3, which made several drastic cuts to payment rates for both general and specialty surgeons. -
How to Verify Patient Eligibility Under the HRSA Uninsured COVID-19 Program
In early April, the U.S. Department of Health & Human Services (HHS) announced that a portion of the $100 billion CARES Act Provider Relief Fund would be used to reimburse health care providers for COVID-related treatment of uninsured patients. -
Temporary ASC closures wallop workers' comp cases — 3 takeaways
Most workers' compensation surgical cases were postponed as states responded to the COVID-19 pandemic, said Frank Raneri, senior vice president of Paradigm Specialty Networks, in an article on WorkCompWire. -
Employers compare 4 insurance giants on value, payment models & more
UnitedHealthcare has room for improvement when it comes to reducing unnecessary costs and otherwise serving employers that fund health plans, suggested a recent survey of 174 executives. -
11 CPT codes take effect for ASCs
CMS published 11 Current Procedural Terminology Category III codes that took effect July 1 in the ASC payment system. -
Appeals court delivers win for HHS' site-neutral payment policy
The U.S. Court of Appeals ruled July 17 that HHS was within its rights to reduce payments to hospital outpatient departments, reversing a district court's earlier decision. -
Out-of-network billing rates for outpatient, inpatient visits in 6 specialties
Most specialty providers who bill out of network do so less than 10 percent of the time, according to a recent analysis by the Health Care Cost Institute, an independent, nonprofit research institute. -
Patient payments up 1.6% for surgical RCM company: 4 contributing factors
Mnet Health, a company providing revenue cycle management services to the surgical industry, reported a 1.6 percent year-over-year increase in patient payments in June, despite the COVID-19 pandemic.
Page 45 of 93