As outpatient procedures grow, ambulatory surgery centers (ASCs) face increasing pressure to maintain operational efficiency, comply with regulations, and deliver high-quality patient care. Amid these challenges, artificial intelligence (AI)-enhanced ASC software is proving to be a powerful solution, streamlining workflows,…
ASC Coding, Billing & Collections
The Wasteful and Inappropriate Service Reduction initiative from CMS is set to take effect Jan. 1, 2026, introducing new prior authorization requirements for select services. Here are seven things to know: 1. The WISeR model will launch as a pilot…
While enrollment in Medicare Advantage has increased over time and allows payers to offer extra benefits to beneficiaries, the program may be contributing to barriers and disruptions to care according to a report released by KFF Oct. 27. The report…
PayrHealth, a payer management firm, and DocSpera, a healthcare technology provider, have formed a strategic partnership to help ASCs comply with new CMS requirements for patient outcomes reporting. Starting in 2027, CMS will require ASCs to collect and submit patient-reported…
ASCs have become increasingly popular and heavily utilized by both patients and healthcare providers for a number of reasons, including their ability to offer the same procedures as HOPDs at a lower cost. Here are 10 numbers demonstrating ASCs cost…
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Commercial insurers paid an average of $1,489 more for common procedures at hospital outpatient departments than at ASCs in 2024, a 78% mark-up, according to a study published in Health Affairs in October. Researchers analyzed negotiated rate data from UnitedHealthcare,…
Here are six major updates from Cigna in the last 30 days: 1. Beginning in January 2026, The Cigna Group and CVS will offer discounted infertility medications through TrumpRx. Cigna’s Evernorth pharmacies — Freedom Fertility and VFP Pharmacy Group —…
The vast majority of U.S. clinicians and office administrators trust artificial intelligence to handle prior authorization, according to a survey conducted by Cohere Health, a healthcare technology company. Among 200 respondents, 99% of clinicians and 96% of administrators expressed confidence…
Massachusetts’ certificate-of-need law is allegedly forcing referrers to recommend patients cross state lines to access affordable radiology services, Radiology Business reported Oct. 13. Amy Boutwell, MD, a private practice internist in Lexington, Mass., told Valley News Oct. 11 that she…
The federal shutdown reached its third week as Democrats and Republicans continued a stalemate over how to fund the government. In an Oct. 10 podcast, Bill Prentice, CEO of the Ambulatory Surgery Center Association, unpacked the impasse and what it…