Shifting routine outpatient procedures to ASCs can save commercially insured patients $684 on average per procedure, according to a Sept. 8 report from UnitedHealth Group.
ASC Coding, Billing & Collections
Five companies, including three pain management clinics, with the same owner had a second default judgment issued against them for participating in a multimillion dollar billing fraud scheme, the U.S. Justice Department said Sept. 2.
Cigna expanded its Affordable Care Act market reach to three states.
The U.S. Justice Department is suing UPMC, its chair of cardiothoracic surgery and University of Pittsburgh Physicians in a whistleblower suit brought by a former UPMC physician.
Tustin, Calif.-based Orange County Multispecialty Surgery Center is suing Blue Cross and Blue Shield of North Carolina for allegedly paying only a fraction of its patients' bills, the Triangle Business Journal reported Sept. 1.
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ASCs are known as the high quality, low cost setting for surgical care, and CMS has taken notice.
From COVID-19 setbacks to CMS' proposal to cut 258 procedures from the outpatient-approved list, ASC leaders are working through many challenges to secure reimbursements.
The proposed 2022 Hospital Outpatient Prospective Payment System and ASC Payment System, released July 19, outlined nine procedures slated to temporarily remain on CMS' office-based payable list in 2022.
CMS' procedure price look-up tool allows users to compare average pay for procedures in ASCs and hospital outpatient departments.
Steve Eisentrager, president of Ohio Valley Surgical Hospital in Springfield, spoke with Becker's ASC Review on the payer policy trends to which he's paying attention.