ASC Coding, Billing & Collections

Ambulatory surgery centers (ASCs) have diverse processes to navigate, from front-end tasks such as collecting demographic information and verifying insurance, to coding and billing compliance in an ever-changing regulatory environment. In the complex world of surgical revenue cycle management (RCM),…

House Republicans have proposed sweeping changes to healthcare policies and other federal programs, marking a significant shift in priorities under President Donald Trump. 

Many ASCs across the U.S. are seeing patient copays increase for outpatient surgery, and collecting upfront from patients is tough. But it's necessary to keep the ASC running smoothly.

On Nov. 1, CMS finalized a 2.83% physician pay cut for its 2025 Medicare hospital outpatient prospective payment system and ASC payment system, marking the fifth consecutive year of cuts to physician reimbursements. 

Here are what three ASC leaders told Becker's they see coming down the pipeline as procedures continue to migrate from the hospital to ASC setting in 2025.

The healthcare industry is entering a transformative era as major legal and regulatory frameworks, including the Stark Law, face significant updates and reinterpretations.

Aetna has filed a lawsuit against Radiology Partners and Mori, Bean and Brooks, RP's Jacksonville, Fla.-based affiliate, alleging a fraud scheme that resulted in overpayments totaling tens of millions of dollars, according to court documents obtained by Becker's. 

In 2024, major developments in insurance and healthcare policies have sparked significant changes affecting ASCs and physicians. 

Here are five numbers for ASC leaders and physicians to know about prior authorization in 2024:

Oroville (Calif.) Hospital agreed to pay $10.25 million to resolve false claims allegations stemming from medically unnecessary inpatient hospital admissions, a kickback and physician self-referral scheme and erroneous diagnosis code use.