ASC Coding, Billing & Collections

Thirteen percent of denied prior authorization requests made by Medicare Advantage organizations met Medicare coverage rules, according to a review conducted by the HHS Office of Inspector General released in April. 

Insurers are sending mixed messages to ASCs and independent physicians. On one hand, they want surgery centers and physicians to stay independent to keep costs low; on the other, they are increasing prior authorizations and denial policies that make it…

Donald Woo Lee, MD, was sentenced to 93 months in prison and ordered to pay more than $4.5 million for his role in a Medicare fraud scheme, the U.S. Justice Department said April 28.

Value-based care is gaining traction in the ASC industry as CMS and payers see opportunities in bundled payments over traditional fee-for-service models. 

Here are five updates from CMS in the last two weeks:

Here are more than 50 stats about ASC operating expenses from VMG Health's 2022 "Multi-Specialty ASC Benchmarking Study:"

ASC billing services provider Surgical Notes is promoting several senior managers after the company's client base more than tripled over the last 12 months.

Mnet Health, a revenue cycle management and technology provider, and One Medical Passport, a Mnet company have rebranded as One Mnet Health.

Here are 39 stats about ASC revenue from VMG Health's 2022 "Multi-Specialty ASC Benchmarking Study:"

Anthem has captured the attention of multiple hospitals and health systems across the U.S. as allegations of underpayment and inappropriate denials accumulate.