For Andrew Lovewell, the success of the ASC industry hinges on presurgery patient optimization and knowing which cases to take on. 

CMS issued the 2022 Physician Fee Schedule proposal July 13, which will lower physician pay next year if it goes into effect without changes.

The healthcare industry is buzzing about a July 6 article in the Wall Street Journal reporting some hospitals charge the highest rates possible for uninsured and cash-pay patients while providing discounts to insurance companies. How do surgery centers structure payments for cash-pay patients?

CMS forged ahead July 1 with a prior authorization requirement for cervical fusion procedures despite protest from several organizations.

The challenge of covering implant costs and keeping up with payer regulations makes maintaining profitability tricky for many independent ASCs.

Aetna began requiring that healthcare providers get preapproval for all cataract surgeries July 1.

CMS is taking on surprise billing with a proposed final rule released July 2.

Chesterfield, Mo.-based National Medical Billing Services, a revenue cycle management company focused on ASCs, opened a new facility in Osage Beach, Mo.

When whistleblowers file lawsuits, they stand to receive a portion of the proceeds from a settlement or financial recovery, which can reach hundreds of thousands of dollars.

Humana named a new CFO, and a Michigan health insurer launched an electronic portal to streamline the preauthorization process. 

The American Hospital Association and other hospitals have spent the last few years disputing the CMS decision to expand its site-neutral pay policy. Now the Supreme Court has weighed in.

CMS' rule to make hospital pricing readily available to patients went into effect Jan. 1, and while many hospitals aren't complying, some expect ASCs to move toward price transparency. 

Blue Cross and Blue Shield of North Carolina wants to make sure independent physician practices survive as the administrative burdens and costs of managing a private practice increase.

For some ASCs, handling revenue cycle functions internally allows staff to ensure and measure appropriate performance. 

ASCs have long faced challenges in collecting reimbursement, making it critical for centers to streamline their revenue cycle management.

Employers are increasingly exploring direct contracting options for orthopedic care, which can provide an additional revenue stream for ASCs as commercial payers continue to reduce reimbursement rates and narrow their networks.

An ENT physician group in Texas accused of an upcoding scheme has paid $750,000 to settle the allegations, the U.S. attorney's office said June 23.

Most physicians spent one to 15 hours each week on prior authorizations in 2020, according to the "92nd Physician Report" from Medical Economics.

CMS added 267 ASC-payable additions in their rules for 2021, and the new CMS administrator was confirmed. 

Managing payer issues from a patient, physician and provider level is key to ensuring reimbursements and high level patient care.