ASC Coding, Billing & Collections

The No Surprises Act, the federal law requiring ASCs and physician practices to provide cost estimates to self-pay patients, went into effect Jan. 1. 

ASCs and physician practices are required to provide cost estimates for expected charges to self-pay patients when scheduling procedures or services as part of the No Surprises Act, which went into effect Jan. 1.

Here are five updates from Aetna, one of the country's biggest payers, in the last 30 days:

A Bay City, Mich.-based vascular surgeon pleaded guilty to a multimillion dollar fraud scheme Feb. 8, according to the Justice Department.

The Ambulatory Surgery Center Association is asking members to write to Congress and ask them to support the Outpatient Surgery Quality and Access Act of 2021. 

A growing number of commercial insurers are revamping policies to push providers and patients out of the hospital and into ASCs, where procedures can be performed at a lower cost.

A 69-year-old woman pleaded guilty to federal fraud charges after billing cosmetic surgeries at a California surgery center as medically necessary, the Justice Department said Feb. 4.

Shannon Yarrow, senior vice president of managed care at Brentwood, Tenn.-based Surgery Partners, joined "Becker's ASC Review Podcast" to talk about reimbursement opportunities for physicians doing outpatient procedures.

The cost of essential goods jumped 7 percent last year, outpacing the reimbursement increases to healthcare providers across the board.

The healthcare industry is experiencing monumental changes due to policy shifts and the aftermath of COVID-19. Insurers are taking stock of the situation and see a huge opportunity to direct more care to outpatient settings.