ASC Coding, Billing & Collections

Greg DeConciliis, administrator of Boston Out-Patient Surgical Suites and president of the Massachusetts Association of Ambulatory Surgery Centers, told Becker’s that he sees volume growth and operational discipline as the clearest path through today’s cost pressures. “The only solution is…

Next Bio-Research Services, doing business as Next Molecular Analytics, has agreed to pay at least $758,000 to settle allegations it paid illegal kickbacks to physicians and marketers, according to a Dec. 4 Department of Justice news release. What happened?

Greg DeConciliis, administrator of Boston Out-Patient Surgical Suites and president of Massachusetts Association of Ambulatory Surgery Centers, joined Becker’s to discuss his team’s data-first, payer-education approach to rate defense. Editor’s note: This interview was edited  Question: How are you approaching…

Ameet Vohra, MD, owner of Miramar, Fla.-based Vohra Wound Physicians Management, and his companies have agreed to pay $45 million to resolve allegations that they violated the False Claims Act by knowingly submitting claims for medically unnecessary surgical procedures to…

CMS will make significant changes to ASC and outpatient surgery reimbursement next year. In the 2026 Hospital Outpatient Prospective Payment System and Ambulatory Surgical Center Final Rule, published Nov. 21, CMS outlined plans to increase ASC pay and allow for…

A physician in Cordele, Ga., has pleaded guilty to his role in a $24 million scheme to defraud Medicare.  What happened? What comes next?

Here are three recent policy decisions by public and private insurers that are disrupting ASCs and physician practices: 1. Several physician associations are urging Elevance Health to abandon its new policy that penalizes hospitals and contracted facilities for using care…

Peter Bravos, MD, chief medical officer of Sacramento, Calif.-based Sutter Surgery Center Division, joined Becker’s to discuss how integrating ASCs with primary care, post-acute services and surgeon partners is key to success.  Editor’s note: This interview was edited lightly for…

In its finalized 2025 physician fee schedule, CMS included an “efficiency adjustment” of negative 2.5% work relative value units, sparking an outcry among physicians.  Dozens of physician organizations condemned the rule and the reduction, with the American Medical Association arguing…

CMS is advancing a major step toward site-neutral payment reform in its proposed 2026 Hospital Outpatient Prospective Payment System rule, a move that could redefine how hospitals and ASCs collaborate. The proposal, which closed for public comment Sept. 15, aims…