ASC Coding, Billing & Collections

Rep. Frank Pallone Jr., a Democrat from New Jersey, has announced an inquiry into the high rate of prior authorization denials by Medicaid managed care plans. 

Changes in noncompete agreements, which prohibit physicians from joining a competing practice or setting up their own within a particular distance from their previous practice for a certain period of time, are ramping up in 2023 as states amend their…

Extracapsular cataract removal without endoscopic cyclophotocoagulation is the most common procedure performed at ASCs, according to recent data from Definitive Healthcare. 

As physician and administrative shortages remain high, many health facilities are pivoting to contract labor to bolster their care teams. 

In July, CMS announced its suggested 3.34 percent conversion factor decrease in its proposed Medicare physician fee schedule for 2024. This proposal, coupled with inflation and low reimbursement rates, could put an additional strain on physicians' compensation and healthcare overall.

About 43 percent of physicians receive more claim denials with Medicaid patients than other patients, according to Medscape's 2023 "Doctors Working with Medicaid" report published Aug. 9, which includes survey results from 251 practicing U.S. physicians who currently accept Medicaid…

Here are five physician reimbursement statistics and trends that ASCs should know: 

Cataract removal was the most common ASC procedure by the total number of charges in 2022, according to July 26 data from Definitive Healthcare. 

In 2022, 39 percent of physicians spent one to nine hours on prior authorizations weekly, according to Medical Economics' "94th Physician Report" released Aug. 4.

The administrative costs of healthcare, including prior authorizations, are estimated to make up 20 to 34 percent of healthcare expenditures, according to an Aug. 4 report from the American Enterprise Institute, a public policy think tank.