ASC Coding, Billing & Collections

Submitting a clear and convincing appeal is getting harder for ASCs. Not only do surgery centers have to consider complex contracts with government payers, but also variances within appeal limits, state regulations and, increasingly, employer policies.

Access HealthNet gained three new partners.

CMS released the 2019 final payment rule for hospital outpatient surgery departments and ASCs, including an average rate adjustment on procedures, according to a statement from the Ambulatory Surgery Center Association.

Toledo, Ohio-based ProMedica and Aetna are clashing over contract terms for 2019, 13abc reports.

ChartWise Medical Systems Founder and Chief Innovation Officer Jon Elion, MD, FACC, explained the growing importance of Risk Adjustment Factor scoring in the outpatient space to Becker's ASC Review.

Nashville, Tenn.-based Envision (AmSurg) Healthcare's contract with Minnetonka, Minn.-based UnitedHealthcare expires at the end of the year, and Envision launched a website to clarify where at the companies stand in the negotiation process.

Intervention Insights CEO Clynt Taylor shared with Becker's ASC Review how prior authorization processes affect patients and physician-owned practices.

Intervention Insights CEO Clynt Taylor told Becker's ASC Review how physician-owned practices are increasingly burdened by prior authorization processes.

The growing popularity of high deductible health plans is encouraging more patients to seek care in lower-cost outpatient settings. However, trends in payer consolidation are making it more difficult for ASCs to ensure maximum reimbursement for their work.

Three experts on revenue cycle and operations at ASCs gathered at the Becker's ASC 25th Annual Meeting: The Business and Operations of ASCs conference in Chicago Oct. 19 to discuss how administrators can improve reimbursement per case at their facilities.