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Employers compare 4 insurance giants on value, payment models & more
UnitedHealthcare has room for improvement when it comes to reducing unnecessary costs and otherwise serving employers that fund health plans, suggested a recent survey of 174 executives. -
11 CPT codes take effect for ASCs
CMS published 11 Current Procedural Terminology Category III codes that took effect July 1 in the ASC payment system. -
Appeals court delivers win for HHS' site-neutral payment policy
The U.S. Court of Appeals ruled July 17 that HHS was within its rights to reduce payments to hospital outpatient departments, reversing a district court's earlier decision. -
Out-of-network billing rates for outpatient, inpatient visits in 6 specialties
Most specialty providers who bill out of network do so less than 10 percent of the time, according to a recent analysis by the Health Care Cost Institute, an independent, nonprofit research institute. -
Patient payments up 1.6% for surgical RCM company: 4 contributing factors
Mnet Health, a company providing revenue cycle management services to the surgical industry, reported a 1.6 percent year-over-year increase in patient payments in June, despite the COVID-19 pandemic. -
5 statistics on elective surgery delays, losses
Elective surgery delays and the resulting losses for hospitals and surgery centers will drive up costs for employers, payers and patients, ConsumerMedical concluded based on a recent data analysis. -
Michigan ASC hires finance controller as 2nd recent addition
Traverse City, Mich.-based Copper Ridge Surgery Center hired a finance controller, according to the Traverse City Record-Eagle. -
3 ASCs going bankrupt
Three surgery centers that filed for bankruptcy in the past year: -
57 new musculoskeletal codes to take effect in October
The CDC's ICD-10-CM code update for fiscal year 2021 includes 57 new musculoskeletal codes, according to Part B News. -
How interactive analytics improve revenue cycle management: 5 takeaways
As healthcare organizations develop strategies to secure financial well-being during the COVID-19 pandemic, they can glean critical insights from workflow, business intelligence and denial management technologies. -
19 codes used for COVID-19 patients
At the onset of the pandemic, increasing use of three codes — 31500 for emergency intubations, 99291 for intensive care unit treatment and 99233 for complex hospital visits — reflected rising numbers of COVID-19 patients, according to Tony Mira, president and CEO of Anesthesia Business Consultants. -
11 ASCs, specialty groups receiving COVID-19 relief
Ninety-seven percent of U.S. medical practices have taken a financial hit from the COVID-19 pandemic, according to a survey by the Medical Group Management Association. -
Hospitals lose lawsuit against HHS over price disclosure rule
Industry groups representing hospitals and health systems across the nation sued HHS last year, challenging a rule that requires hospitals to disclose the rates they negotiate with insurers beginning in 2021. On June 23, a federal judge granted HHS' motion for summary judgement. -
Chicago allocates $7M in funding to ASC development — 4 details
Chicago-based Sinai Health System received a $7 million grant for its planned ASC in Ogden Commons, an 11-acre mixed-use development in Chicago's North Lawndale neighborhood, the system announced June 18. -
Planned cuts to Medicare payments threaten private practice, surgical groups say
Looming cuts to Medicare reimbursement could be the final straw for private practice surgeons already in financial straits, according to the Surgical Care Coalition, a group of 12 industry organizations opposing the planned cuts. -
6 strategies to re-invent the ASC revenue cycle
Ambulatory surgery centers have long faced challenges in collecting reimbursement, and that became increasingly difficult as patients shouldered more financial responsibility for their care. However, those challenges have intensified during the COVID-19 pandemic and have resulted in an increased need for centers to accelerate revenue collection due to temporary income loss from suspended procedures. -
CMS sets new rules for 5 hospital outpatient services — 5 things to know
New Medicare prior authorization requirements will take effect for certain hospital outpatient department services July 1, according to Bricker & Eckler's Shannon DeBra. -
North Carolina extends CON filing dates, offers guidance on 2021 demand
North Carolina Gov. Roy Cooper extended 2020 deadlines for certificate-of-need applications and released initial projections on healthcare demand in 2021, JD Supra reports. -
CMS approves code for ENT implant in ASCs, hospital outpatient departments — 4 insights
CMS granted Intersect ENT's Sinuva Sinus Implant transitional pass-through payment status for reimbursement under the Hospital Outpatient Prospective Payment System and Ambulatory Surgery Center Payment System. -
'Half the cost, half the risk' at ASCs versus hospitals — Dr. Shakeel Ahmed makes the case for upheaving referral patterns
Costs and infection rates. Those are two healthcare measures made more important than ever by the COVID-19 pandemic — and they're also two areas where ASCs have hospitals beat by a long shot, according to Shakeel Ahmed, MD, CEO of Atlas Surgical Group.
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