ASC Coding, Billing & Collections

On average, physician specialists bill $3.8 million annually to commercial payers, but some specialties, including orthopedic surgery and urology, bill well over that amount, according to data from AMN Healthcare's 2023 "Review of Physician and Advanced Practitioner Recruiting Incentives" report.

Blue Cross Blue Shield of Michigan has announced a new effort to reduce prior authorization requirements by 20 percent in order to improve healthcare quality and access while reducing administrative tasks. 

From repealing existing prior authorization requirements to adding new ones, here are four states tackling the prior authorization system this year. 

Physicians are facing rising prior authorization requirements and increasing denials, and some leaders say it is taking away their ability to make decisions. 

Three major payers have cut prior authorization requirements in August:

Here are three Stark law updates that may affect ASCs: 

UnitedHealthcare is the largest insurer in the U.S. by market share, according to a July 2023 report from Value Penguin. 

On Sept. 1, UnitedHealthcare will begin its two-phased approach to eliminating prior authorization requirements. 

Cigna, the fourth-largest insurer in the U.S. by membership, has received accolades — and scrutiny — in the last two months. 

The Biden administration has announced the first 10 medications that will be subject to price negotiations with Medicare under the Inflation Reduction Act.