Category: ASC Coding, Billing and Collections

Josh Troast, director of ambulatory surgical services for Muskegon (Mich.) Surgical Associates, joined Becker’s to discuss what ASCs need to thrive in the next five years. 

Health Care Service Corp., a health plan operator for 18 million members across Illinois, Montana, New Mexico, Oklahoma and Texas, is integrating artificial intelligence and augmented intelligence to reform its prior authorization process. 

CMS pitched a 2.8 percent average rate increase for ASCs next year, and many leaders feel the move isn’t enough to offset increasing costs. 

Physician pay is struggling to keep up with inflation, declining reimbursement and Medicare pay cuts.

In the 2024 hospital outpatient prospective payment system, CMS pitched a 2.8 percent average rate increase for ASCs next year.

CMS plans to add only 26 dental surgical codes to the ASC payable list next year, according to the 2024 Hospital Outpatient Prospective Payment System proposal released July 13. 

Here are 16 physician kickback suits Becker’s  has reported on in 2023 that totaled more than $180 million in either restitution or cost of the fraud scheme:

Physicians and patients alike may face challenges due to CMS’ suggested 3.34 percent conversion factor decrease from its proposed Medicare physician fee schedule for 2024.

Two Florida men have pleaded guilty for their roles in a Medicare fraud scheme in which they submitted more than $67 million in false claims for unnecessary genetic testing and durable medical equipment that were procured with kickbacks.

UnitedHealth’s new site-of-service policy is in part driven by the cost savings incurred by ASCs, executives said in a July 14 second-quarter earnings call transcribed by Seeking Alpha.