ASC Coding, Billing & Collections

WellPoint, which runs Anthem Blue Cross in California, withdrew its request for rate increases in California's individual insurance market after the state's insurance commissioner found flaws with the company's methodology, according to a report in The Wall Street Journal.

Citing the state's "any-willing-provider" law, Georgia's Insurance Commissioner John Oxendine ruled that Blue Cross Blue Shield Healthcare Plan of Georgia must allow Northeast Georgia Cancer Care of Athens into its HMO plan, according to a report in American Medical News.

Excessive administrative complexity related to billing costs physicians practices nearly 12 percent of their net patient revenue, according to a study in Health Affairs.

Here are the 2010 CMS reimbursement rates for five GERD-related upper endoscopy procedures in the ASC setting.

Wellcare Health Plans, a Tampa-Fla.-based company that manages Illinois' largest Medicaid HMO plan, revealed that it had overbilled the state by around $1 million from July 2006-June 2009, according to a report in The Chicago Tribune.

The Centers for Medicare & Medicaid Services has made progress transitioning claims administration to 19 Medicare Administrative Contractors, as set in place by The Medicare Prescription Drug, Improvement, and Modernization Act of 2003; however, the agency encountered some challenges that…

Independent laboratories currently eligible to bill for the technical component of physician pathology services whether patients are inpatient or outpatient are allowed to continue to bill for their services through Dec. 31, 2010, according to the Centers for Medicare and…

Here are the 2010 Medicare reimbursement rates for 11 nerve block procedures performed in the ASC setting.

Several California hospitals will begin using bundled fees, which include both facility and physician fees, when billing for hip and knee replacements, according to a report by the Los Angeles Times.

CMS provides the following list of possible combinations for procedures with more than one surgical modifier (modifiers in parentheses):