Blue Cross and Blue Shield of North Carolina wants to make sure independent physician practices survive as the administrative burdens and costs of managing a private practice increase.
ASC Coding, Billing & Collections
For some ASCs, handling revenue cycle functions internally allows staff to ensure and measure appropriate performance.
ASCs have long faced challenges in collecting reimbursement, making it critical for centers to streamline their revenue cycle management.
Employers are increasingly exploring direct contracting options for orthopedic care, which can provide an additional revenue stream for ASCs as commercial payers continue to reduce reimbursement rates and narrow their networks.
An ENT physician group in Texas accused of an upcoding scheme has paid $750,000 to settle the allegations, the U.S. attorney's office said June 23.
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Most physicians spent one to 15 hours each week on prior authorizations in 2020, according to the "92nd Physician Report" from Medical Economics.
CMS added 267 ASC-payable additions in their rules for 2021, and the new CMS administrator was confirmed.
Managing payer issues from a patient, physician and provider level is key to ensuring reimbursements and high level patient care.
The federal government was relatively friendly to ASCs during the Trump administration, with CMS paying for more types of surgery in ASCs and HHS loosening regulations on how centers could practice during the pandemic.
Alignment Healthcare is expanding coverage, and Blue Cross and Blue Shield will pay members of its Federal Employee Program to get vaccinated.