Category: ASC Coding, Billing and Collections

15% of claims denied regardless of prior authorization: 5 notes

Approximately 15% of all medical claims sent to insurers are denied, including claims that were pre-approved, according to a recent report by healthcare solutions and research company Premier.

Where noncompetes could be banned next

Maine is poised to be the next state to ban noncompete agreements, the National Law Review reported March 25. 

Stark law's unintended consequences

Some of the largest recoveries by the Justice Department in the last year were Stark law violations, and some leaders worry the policy is hurting physicians rather than preventing corruption. 

CMS moves that are hurting, helping physicians 

CMS moves are changing the way physicians practice. Here are four recent moves from CMS that are either helping or hurting physicians:

The latest on prior authorization reform

The push to revamp prior authorization practices has picked up steam recently.

New York City considers own noncompete ban following governor's veto

The New York City Council is considering bills that would ban noncompetes after Gov. Kathy Hochul in December vetoed a bill that would have prohibited them statewide, Newsday reported March 17. 

Washington strengthens noncompete restrictions

A bill amending Washington’s noncompete policy was signed into law by Gov. Jay Inslee on March 13, according to a news release from the Washington Senate Democrats. 

Florida's physician noncompete ban stalls

The Florida Legislature declined to pass two laws banning noncompetes for physicians and doctors of osteopathic medicine, law firm McDermott Will & Emery said in a March 12 blog post. 

The CMS moves helping, hurting ASCs

Here are six CMS moves that are helping and hurting ASCs.

5 ASC procedures seeing a reimbursement decline

Five ASC procedures are projected to experience a decline in reimbursements in 2024, according to a VMG Health report.