Category: ASC Coding, Billing and Collections

AHA weighs in on CMS' proposed ASC payment system

The American Hospital Association, which represents 5,000 member hospitals, health systems and other healthcare organizations, has submitted a letter to CMS commenting on its proposed hospital outpatient prospective payment system and ambulatory surgic…

Here's what 10 physician specialties bill to commercial payers every year

On average, physician specialists bill $3.8 million annually to commercial payers, but some specialties, including orthopedic surgery and urology, bill well over that amount, according to data from AMN Healthcare’s 2023 “Review of Physician and Advance…

Blue Cross Blue Shield of Michigan to reduce prior authorizations by 20%

Blue Cross Blue Shield of Michigan has announced a new effort to reduce prior authorization requirements by 20 percent in order to improve healthcare quality and access while reducing administrative tasks. 

4 states tackling prior authorization

From repealing existing prior authorization requirements to adding new ones, here are four states tackling the prior authorization system this year. 

Is payer behavior taking away autonomy? This physician says yes

Physicians are facing rising prior authorization requirements and increasing denials, and some leaders say it is taking away their ability to make decisions. 

Payers cutting prior authorizations: 3 major moves to know

Three major payers have cut prior authorization requirements in August:

3 Stark law updates affecting ASCs

Here are three Stark law updates that may affect ASCs: 

5 largest payers by market share

UnitedHealthcare is the largest insurer in the U.S. by market share, according to a July 2023 report from Value Penguin. 

The new prior authorization rules going into effect Sept. 1

On Sept. 1, UnitedHealthcare will begin its two-phased approach to eliminating prior authorization requirements. 

Cigna in the headlines: 9 updates in 60 days

Cigna, the fourth-largest insurer in the U.S. by membership, has received accolades — and scrutiny — in the last two months.