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ASCs can win with this major trend
With the trends in healthcare moving toward value-based care models, ASCs could be in the perfect position for growth. -
3 suits filed against UnitedHealth: What ASCs need to know
Three lawsuits have been filed against healthcare giant UnitedHealth Group and UnitedHealthcare in the last month — including two ASCs filing suits. -
Centene in the headlines: 5 updates in 60 days
Here are five updates from the last 60 day about one the country's largest insurers: -
Medicare payments to hospitals double those to ASCs: 4 study notes
Medicare per-procedure payments to hospital outpatient departments were 2.1 times larger than payments to ASCs, according to new research published by the Rand Corp. -
Physician-owned hospital pays $1.2M to settle billing fraud claims
Oklahoma Heart Hospital South, a physician-owned hospital based in Oklahoma City, paid $1.2 million to settle billing fraud allegations May 16. -
National Medical Billing Services acquires Medi-Corp
National Medical Billing Services acquired anesthesia, ASC and pain management revenue cycle management provider Medi-Corp, according to a May 17 news release shared with Becker's. -
Site-neutral insurer contracts a reality for orthopedic group
Surgery centers have advocated for site-neutral payments with hospital outpatient departments, so the same rates are paid regardless of where the procedure is performed. -
Hospital interests pushing CMS away from ASCs, administrator says
CMS has passed several measures in the last year affecting ASC reimbursements, including removing 255 procedures from the ASC-payable list. For Cathy McCue, MSN, RN, administrator of Uropartners Surgery Center in Des Plaines, Ill., CMS' actions point to a prioritization of hospitals because of a strong hospital lobby. -
Insurers want more surgeries in ASCs
Snagging profitable payer contracts and high reimbursements has historically been an obstacle for ASCs, particularly when competing with hospitals' big pockets. -
Hospitals seek 15% pay bump from insurers — what should ASCs ask for?
Hospitals across the U.S. are seeing labor and supply costs rise with inflation and are clashing with insurers about raising contracted rates, according to The Wall Street Journal. -
Financial opportunities in ASCs and how to capitalize on them — 3 takeaways
Growth opportunities across the ambulatory surgery center (ASC) space continue. -
Maine physician group to cut ties with Anthem over 5 years of flat rates
Portland, Maine.-based independent practice Fore River Urology is cutting its contract with Anthem, Bangor Daily News reported May 3. -
ASC sues UnitedHealthcare for failure to cover surgery
Advanced Surgery Center in Fort Lee, N.J., has filed a lawsuit against UnitedHealthcare for allegedly failing to pay for hernia-related procedures. -
13% of denied prior authorizations met Medicare requirements, HHS says
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 send mixed signals to ASCs, physicians
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 harder to get surgeries approved. -
Physician to pay $4.5M for Medicare fraud at California clinics: 5 details
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. -
4 ASC leaders' thoughts on value-based care
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. -
5 CMS updates
Here are five updates from CMS in the last two weeks: -
50+ stats on ASC operating costs
Here are more than 50 stats about ASC operating expenses from VMG Health's 2022 "Multi-Specialty ASC Benchmarking Study:" -
Surgical Notes adjusting leadership teams after client base tripled in last 12 months
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.