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Surprise billing proposal wins support of physician groups — but leaders want 'inadequate' networks addressed
A new bill that would establish an arbitration process to settle disputes over "surprise" medical bills has garnered support from the American Association of Orthopaedic Surgeons, the American Medical Association and the Physicians Advocacy Institute, among other industry groups. -
Feds get involved with Nashville ophthalmology group false billing case
The federal government is involved with a case against Nashville, Tenn.-based SouthEast Eye Specialists, which is accused of defrauding Medicare of "tens of millions of dollars," The Nashville Post reports. -
ASC revenue cycle insights from 3 experts
Here are three revenue cycle insights for ASCs to know: -
Protecting hospitals or stifling competition? Key thoughts on the legal battle around Iowa's CON law
The U.S. Court of Appeals for the 8th Circuit is in the middle of deciding a case from two physicians arguing the state's certificate-of-need laws are unconstitutional and protect existing outpatient surgical facilities while stymying potential competitors. -
'A socialist takeover' — Everything President Trump said about healthcare in the State of the Union
President Donald Trump delivered his State of the Union address Feb 4., criticizing proposals for a single-payer system while highlighting his efforts around price transparency and pharmaceutical pricing, Politico reports. -
3 things ASCs can do now to jumpstart revenue in 2020
Denied claims present a significant challenge for healthcare providers. Appealing denials costs healthcare organizations an estimated $8.6 billion annually, according to a 2017 analysis. Due to the high cost and administrative burden associated with appealing denied claims, many providers forgo the process for claims that could be successfully reworked, leaving potential reimbursement on the table. -
5 ways ASCs can manage orthopedic costs
Blue Cross Blue Shield received about $25 billion in medical claims for adult beneficiaries undergoing elective orthopedic procedures in 2017, according to a 2019 review cited by Tara Vail, chief operating officer at ASC software company HST Pathways. -
US inching closer to financial crisis, CBO estimates say
The Congressional Budget Office released 10-year estimates showing the national deficit will hit $1 trillion in 2020, and while the figure alone is alarming, it's not the most concerning aspect of the report. Analysts believe the amount of federal debt held by the public will rise from 81 percent in 2020 to 98 percent in 2030, which could lead to a financial crisis. -
Anthem concentrating on risk-based arrangements, appropriate care settings in 2020
Anthem is focusing on bundled payment initiatives and incentives for delivering care in the appropriate setting, according to a fourth-quarter 2019 earnings call transcribed by The Motley Fool. -
Improve your ASC's cash flow in 2020 — 5 tips
ASCs can improve their cash flow by regularly evaluating aspects of the revenue cycle process, according to Serbin Medical Billing. -
Surgeon lets patients pay medical bills by volunteering — 5 insights
Demetrio Aguila, MD, has a novel solution to healthcare affordability: allowing patients to pay for surgical procedures through volunteer work. -
3 ASC payment trends
ASC software developer Surgical Information Systems outlined key surgery center payments trends. -
Medicare's bundled payments overcompensate for post-surgical care, analysis says
Medicare might be overpaying surgeons because of built-in reimbursements for postoperative care, according to an analysis by RAND Corp., a nonprofit research organization. -
DOJ collected $3B+ from healthcare fraud cases in 2019 — 5 cases involving ASCs
The Department of Justice collected over $3 billion from civil cases involving alleged False Claims Act violations in 2019, according to a Jan. 9 announcement. -
Outpatient coding worsened in 2019, inaccuracies uncovered in contest — 5 insights
An annual coding contest revealed that the accuracy of outpatient coding worsened in 2019, ICD-10 Monitor reports. -
Crozer-Keystone, Cigna partner — 3 insights
Springfield, Pa.-based Crozer-Keystone Health System reached an agreement to join Cigna's network, providing Cigna Medicare Advantage customers access to all Crozer-Keystone facilities. -
Washington hospital eyes more outpatient surgeries to balance budget
WhidbeyHealth in Coupeville, Wash. is recruiting surgeons to increase its volume of outpatient surgeries as it attempts to cut losses and increase revenue, according to local newspaper the South Whidbey Record. -
Texas' new surprise billing legislation — 4 insights for ASCs
Texas recently passed legislation that generally prohibits the practice of balance billing in cases where patients can't choose their medical provider, according to law firm Gray Reed. -
7 critical steps for financial success in your ASC
New and interesting and complex procedures such as cardiology, orthopedic and spine are being performed in ambulatory surgery centers (ASCs) which makes this a particularly interesting time for the space. -
Insurers, hospitals clash over service shift to ASCs
A new policy that steers patients getting colonoscopies away from hospital outpatient departments and into ASCs is stirring up controversy in Minnesota, according to the Minneapolis Star-Tribune.
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