Category: ASC Coding, Billing and Collections

5 numbers on prior authorization in 2024

Here are five numbers for ASC leaders and physicians to know about prior authorization in 2024:

California hospital to pay $10.25M for false claims, physician self-referral scheme

Oroville (Calif.) Hospital agreed to pay $10.25 million to resolve false claims allegations stemming from medically unnecessary inpatient hospital admissions, a kickback and physician self-referral scheme and erroneous diagnosis code use.

26 payer moves impacting ASCs in 2024

Here are 26 moves by payers for ASC leaders and physicians to know in 2024:

What's going on with prior authorization?

Here are three recent updates on prior authorization for ASC physicians and leaders to know:

CMS' proposed changes to Medicare Advantage: 10 things to know

On Nov. 26, CMS proposed reforms to the Medicare Advantage and Part D programs for contract year 2026, including changes to prior authorization and GLP-1 coverage. 

ASCs' pay problems intensify

ASCs are facing a trifecta of pay issues — anesthesia stipends, rising expenses and stagnant reimbursements. 

What's going on with site neutrality?

Many ASCs have voiced support for site neutrality, which would create parity between ASC and hospital reimbursements, yet has been met with pushback from hospitals. 

The administrative burdens holding back ASC growth

The ASC market will likely see significant growth into the next several years, but many ASC leaders and physicians continue to feel tied down by arduous administrative burdens. 

SIS acquires Surgical Notes

ASC software leader Surgical Information Systems has acquired ASC-focused, revenue cycle management, transcription and coding services provider Surgical Notes. 

Why physicians are not feeling pay increases

While many physician specialties have seen salary increases in recent years, those increases are being felt less by physicians.