Category: ASC Coding, Billing and Collections

Here are three recent updates on prior authorization for ASC physicians and leaders 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 are facing a trifecta of pay issues — anesthesia stipends, rising expenses and stagnant reimbursements. 

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 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. 

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

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

The future of the Stark law is uncertain following a recent district court decision that a False Claims Act lawsuit against South Charleston, W.Va.-based Thomas Health System could not be resolved without further briefings on the U.S. Supreme Court’s r…

All of healthcare has struggled with declining reimbursements, patient care issues and administrative burdens associated with Medicare Advantage plans. 

Physician frustration is growing as prior authorization and other payer obstacles lead to increased retrospective payment denial.