Sponsored by nimble solutions | Contact us
-
What ASCs can expect from CMS in the next year
The federal government was relatively friendly to ASCs during the Trump administration, with CMS paying for more types of surgery in ASCs and HHS loosening regulations on how centers could practice during the pandemic. -
8 payer updates
Alignment Healthcare is expanding coverage, and Blue Cross and Blue Shield will pay members of its Federal Employee Program to get vaccinated. -
HST Pathways to acquire Clariti Health to expand ASC revenue cycle offerings
ASC software company HST Pathways will acquire revenue cycle management solutions company Clariti Health to increase price transparency at ASC practices. -
How automation helps MidLantic Urology manage revenue cycles, prior authorizations
Automation tools have been a key part of boosting collections and managing finances at MidLantic Urology, controller Maryanne Thompson said. -
Feds crack down on pain procedure billing fraud
Multiple physicians and chiropractors have agreed to pay the federal government millions of dollars over the past six months to resolve fraudulent billing allegations related to pain management procedures. -
Former hospital pharmacist, whistleblower alleges he was fired for pointing out fraudulent ASC billing
David Schwartz, former pharmacy director of a Dallas hospital, alleges that he was fired for airing concerns that an affiliated surgery center was fraudulently overbilling state and federal payers, according to Bloomberg Law. -
How a surgical technology solution can improve physicians' notes, workflow and billing — 3 takeaways
The complexity of medical coding makes accurate and streamlined surgical documentation critical; if the notes lack necessary detail, the billing and reimbursements may be wrong, ultimately costing the provider money. -
Artificial Intelligence, Big Data, and the Potential Revenue Cycle Win for Ambulatory Surgery Centers
For some time now, humans as a species have been intrigued by the possibility of creating machines that could mimic the human brain. -
Illinois ASC, clinic says BCBSIL terminated contract without warning
Springfield (Ill.) Clinic accused Blue Cross Blue Shield of Illinois of terminating its in-network provider agreement without warning, according to an ABC affiliate News Channel 20. -
3 orthopedic, pain groups resolve neurostimulator billing fraud allegations for $1M
Three Texas physician practices settled billing fraud allegations related to neurostimulator devices, according to a June 10 Justice Department statement. -
New reasons insurers are denying payment
Commercial insurers are changing their policies to deny hospitals and ASCs payment for services deemed unnecessary or lacking enough evidence to move forward. -
Practice penalized after YouTube-trained nurses performed neurostimulator procedures
A Houston-based chiropractor and her practice are paying $2.6 million and foregoing participation in federal healthcare programs for a decade to resolve billing fraud allegations, according to a June 8 Justice Department statement. -
2-ASC orthopedic group inks bundled payment contract with Florida Blue
The Orthopaedic Institute, a Gainesville, Fla.-based orthopedic practice, signed a contract for bundled payments with Florida Blue Cross Blue Shield. -
How this CEO tackles precertifications
Precertifications are one of many hassles ASCs face when securing reimbursements. -
How to secure reimbursement authorizations, according to one administrator
Handling claims and denials with payers can be an obstacle for ASCs to maximize revenue. -
What reimbursement issues are costing ASCs the most?
From prior authorization to payer consolidation, ASCs have long faced obstacles in securing reimbursements. -
Pain physician, practice in North Carolina to resolve fraud claims for $500K
Kwadwo Gyarteng-Dakwa, MD, and his Greensboro, N.C.-based pain practice agreed to pay half a million dollars to settle allegations he wrongly billed Medicare and Medicaid, according to a May 26 announcement from the U.S. Attorney's Office in the Middle District of North Carolina. -
Florida court orders ASC to show patient billing records
A Florida appeals court ruled May 21 that Orlando-based Sand Lake Surgery Center must produce relevant billing records for the treatment of two personal injury plaintiffs, even though it already sold its stake in the case to a litigation funding company. -
81% of medical groups say prior authorization demands have increased since 2020
Most medical groups have seen an increase in prior authorization requirements since last year, according to polling from the Medical Group Management Association. -
Physician gets 59-year prison sentence for fraud, unnecessary surgeries
A physician in Chesapeake, Va., was sentenced to nearly six decades in prison May 18, according to the U.S. Justice Department.
Page 43 of 99