ASC Coding, Billing & Collections

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.

A California-based ophthalmology clinic said it plans to refund CMS more than $398,000 after an HHS investigation found inappropriate billing led to overpayment.

Handling reimbursement issues is critical to ASC success. Here are three ASC leaders on their biggest reimbursement challenges: 

From price transparency requirements to President Joe Biden's CMS nomination, here are six CMS updates for ASC leaders: 

While some ASC administrators have hired extra staff to handle prior authorizations, Andrew Lovewell, administrator at Columbia, Mo.-based Surgical Center at Columbia Orthopaedic Group, has kept those duties in house.

A St. Louis-based pain management physician is suing to keep the federal government from collecting millions in refunds after it allegedly overpaid his practice $14,418.93.

The process of obtaining prior authorization is challenging for some ASC administrators also tasked with other financial duties.

Employers are increasingly interested in direct contracting with surgery centers through regional and national contracts, and ASCs are ready partners as high quality, low cost sites of care.

Navigating reimbursements from CMS and commercial payers is a difficult task for ASCs. Here are six ASC leaders on their biggest problems with payers.