ASC Coding, Billing & Collections

As healthcare continues its shift toward outpatient care and value-based models, orthopedic surgeons are finding themselves at the intersection of payer dynamics and clinical innovation. Brett Shore, MD, president and CEO of Shore Orthopedics and an orthopedic surgeon with DISC…

Site neutral payments for hospitals and surgery centers are on the horizon, but they may not have the positive impact ASC owners hoped for. Hospital outpatient departments are paid significantly more than surgery centers for the same services, and lawmakers…

CMS is adding prior authorization requirements for certain fee-for-service procedures under traditional Medicare as part of its new Wasteful and Inappropriate Service Reduction model. A total of 17 procedures, identified by CMS as especially vulnerable to fraud, waste or overuse,…

Healthcare consulting group Sg2, a Vizient company, released its “2025 Impact of Change Forecast” on June 23, laying out several growth trends that will impact ASCs over the next 10 years.  Here are 10 takeaways from the report: 1. The…

Physician pay jumped 4.9% in the last year, according to AMGA’s 2025 Medical Group Compensation and Productivity Survey. The organization gathered data from more than 184,000 providers in 500 medical groups. Here are five notes to know: 1. Medical specialists…

In what the federal government called the “largest Justice Department healthcare fraud takedown in history,” 324 individuals — including 96 medical providers — have been arrested in connection with schemes that amount to $14.6 billion in fraud, according to a…

Across the healthcare landscape, prior authorization is undergoing significant changes aimed at reducing administrative burden and expediting care delivery.  Here are three major updates to know: 1. Nearly 50 health insurers, representing commercial, Medicare Advantage and managed Medicaid plans covering…

A Washington, D.C., physician has been sentenced to 18 years in prison for illegally prescribing narcotics in exchange for cash, the Justice Department said in a June 26 news release.  What happened? 

A Bloomfield, Mich.-based physician was sentenced to four years in prison in a $6.3 million Medicare fraud scheme involving medically unnecessary orthotic braces, the Justice Department said in a June 26 news release.  What happened?

Here are five physician fraud cases Becker’s has reported on since June 17: 1. Columbus, Ohio-based Robert Florea, MD, was sentenced to 24 months in prison for a $1.5 million Medicaid fraud scheme. Dr. Florea fraudulently billed the Ohio Department…