ASC Coding, Billing & Collections

Insurers pass risk to patients with high-deductible health plans, and members are becoming savvier about the cost of care as a result.

Cigna's preventive care is back to pre-pandemic levels, and Blue Cross Blue Shield cut a rule that hampered competition.

The success of bundled payments hinges on a variety of factors — some ASC leaders are wary, while others have found success in value-based payments. 

CMS added hundreds of surgeries and procedure codes to the ASC payable list in 2021 and revealed plans to eliminate the inpatient-only list over the next few years.

More ASCs are considering bundled payments as a part of their strategy. Three ASC leaders spoke with Becker's ASC Review on addressing obstacles with bundled payments. 

Bundled payments are a challenge for some ASCs — oftentimes, these payments mean the ASCs have to coordinate post-operative services and align a plan of care. 

Implant costs are a burden for many ASCs, and many feel ASCs have irreparably shifted the implant industry. 

Medicare and commercial insurance companies have developed new policies over the last year that will drive more surgeries to ASCs. But that doesn't mean payers have made things easy for them.

As higher-acuity procedures move to outpatient, ASCs must be sure to consider the cost of implants in commercial payer contracts. 

A Sioux Falls, S.D.-based neurosurgeon and the two medical device distributorships he owns will pay $4.4 million to resolve False Claims Act violation allegations, the U.S. Justice Department said May 3.