ASC Coding, Billing & Collections

Aetna, a CVS Health company, insurers about 39 million people.  Here are five updates from the company since July 5:

Payers are incentivizing physicians to perform procedures in low-cost settings, which means ASCs are becoming increasingly attractive. At the same time, physicians are balking at some payer moves in the last 30 days.

Payers are incentivizing physicians to perform procedures in low-cost settings, which means ASCs are becoming increasingly attractive, according to ASC leaders. 

Elevance Health, the insurer formerly known as Anthem, is one of the biggest payers by members with 39.9 million members.

Physicians face another year of fee cuts in 2023 as Medicare proposes to reduce the conversion factor by 4.42 percent to $33.08. 

Medicare is recommending removing 10 procedures from the inpatient-only list in 2023, according to its Hospital Outpatient Prospective Payment System and Ambulatory Surgical Center Payment System proposed rule, released July 15.

Four payers have updated their policy for ASC procedures since May 24:

Health insurance company Cigna is delaying the implementation of its modifier 25 policy.

Peninsula Daily News on July 11 released its picks for the top ASC medical billing companies for 2023.

A federal judge rejected the University of Pittsburgh Medical Center's bid to dismiss a whistleblower lawsuit against UPMC, its physicians group and its chair of cardiothoracic surgery, NBC affiliate WPXI reported July 7.