Alignment Healthcare is expanding coverage, and Blue Cross and Blue Shield will pay members of its Federal Employee Program to get vaccinated.

ASC software company HST Pathways will acquire revenue cycle management solutions company Clariti Health to increase price transparency at ASC practices.

Automation tools have been a key part of boosting collections and managing finances at MidLantic Urology, controller Maryanne Thompson said.

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.

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.

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.

For some time now, humans as a species have been intrigued by the possibility of creating machines that could mimic the human brain.

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.

Three Texas physician practices settled billing fraud allegations related to neurostimulator devices, according to a June 10 Justice Department statement.

Commercial insurers are changing their policies to deny hospitals and ASCs payment for services deemed unnecessary or lacking enough evidence to move forward.

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.

The Orthopaedic Institute, a Gainesville, Fla.-based orthopedic practice, signed a contract for bundled payments with Florida Blue Cross Blue Shield.

Precertifications are one of many hassles ASCs face when securing reimbursements. 

Handling claims and denials with payers can be an obstacle for ASCs to maximize revenue. 

From prior authorization to payer consolidation, ASCs have long faced obstacles in securing reimbursements.

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.

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.

Most medical groups have seen an increase in prior authorization requirements since last year, according to polling from the Medical Group Management Association.

A physician in Chesapeake, Va., was sentenced to nearly six decades in prison May 18, according to the U.S. Justice Department.

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.