ASC Coding, Billing & Collections

Contract negotiations between ASCs and payers are becoming increasingly complex as both sides sharpen their strategies in a tighter reimbursement environment. ASC leaders describe a landscape in which insurers are flexing scale, data analytics and network design to contain costs…

In a recent advisory opinion, the Office of Inspector General ruled a specific urgent care management service organization’s plan to run an affiliated clinical lab would not create prohibited “remuneration” under the federal Anti-Kickback Statute, according to a Feb. 26…

For many ambulatory surgery center leaders, anesthesia has quietly become the fault line where financial and clinical realities intersect. What was once a stable, predictable service line is now one of the most dynamic sources of both risk and opportunity.…

Vice President JD Vance and CMS Administrator Mehmet Oz, MD, announced a series of actions affecting Medicare and Medicaid, including a $259.5 million deferral of federal Medicaid funding in Minnesota and a six-month moratorium on new Medicare enrollment for certain…

Several trends in medical billing have emerged in the wake of the No Surprises Act, which was first implemented in 2022, a recently released report by HHS found.  In its third report on analyzing the impact of the NSA, HHS…

Physician practices say they want clarity in revenue performance, but Encoda’s “The state of financial health” survey, published Feb. 24, suggests most leaders are still operating with limited certainty. Encode surveyed 84 physician practice leaders. primarily from independently or physician-owned…

Michael Taba, MD, of McKinney, Texas, was sentenced to 102 months in prison for his role in a $145 million scheme to defraud the U.S. Department of Labor’s Office of Workers’ Compensation Programs, according to a Feb. 24 news release…

Phoenix-based Southwest Orthopedic and Spine Hospital, doing business as Oasis Hospital, United Surgical Partners International and Dignity Phoenix Surgery Centers, agreed to pay $5.6 million to resolve alleged Stark law violations, according to a Feb. 24 Justice Department news release.…

As insurers struggle to keep pace with rapid advances in biologics, diagnostics and AI-enabled care navigation, more physicians may turn to cash-pay models, according to Joshua Siegel, MD. Dr. Siegel, the director of orthopaedic sports medicine at Exeter, N.H.-based Access…

As ophthalmology practices continue to grow — particularly in high-volume procedures like cataract surgery — administrative workflows are increasingly becoming a constraint on operational scale. Insurance eligibility and benefits verification remains one of the most critical yet labor-intensive revenue cycle…