ASC Coding, Billing & Collections

Brockton Urology Clinic in Boston will pay thousands of dollars to settle allegations it accepted kickbacks from a hospital for services never provided, according to the Justice Department.

National Medical Billing Services, a healthcare revenue cycle management company focused on ASCs, closed its second transaction of the year.

Gastroenterology claims the highest case mix, on average, among the nation's 6,028 ASCs, according to VMG Health's "Multi-Specialty ASC Benchmarking Study" for 2022.

Orthopedics tops the pack for ASC revenue per case, according to VMG Health's "Multi-Specialty ASC Benchmarking Study" for 2022. The specialty was only the fourth most-represented among ASC cases, however.

From the dismissal of the inpatient-only list to the removal of procedures from the ASC-payable list, CMS plays a massive role in the success of an ASC.  

Thirty-four percent of physicians reported that delays in processing a prior authorization led to a serious adverse event for a patient in their care, according to a recent survey from the American Medical Association. 

UnitedHealthcare now requires members to obtain prior authorization before undergoing physical and occupational therapy at multidisciplinary offices and outpatient hospitals in four states.

Chicago-based insurance provider UnitedHealthcare has ended its requirement in most plans for providers to submit an observation notification after a patient is discharged home, the company said Feb. 10.

Payers UnitedHealthcare, Cigna and Anthem reported the largest year-end revenue in 2021. 

Two Laredo, Texas-based physicians were among 10 indicted in a $300 million healthcare fraud scheme Feb. 10, according to the Justice Department.