Category: ASC Coding, Billing and Collections

St. Louis physician accused of fraud 

St. Louis-based physician Sonny Saggar, MD, was arrested on an indictment accusing him of healthcare fraud, the U.S. Justice Department said July 27. 

Physicians are fed up with prior authorization. Here's what they want.

Prior authorization has continued to be a thorn in the sides of physicians nationwide. 

UnitedHealthcare to reduce prior authorization by 20%

On Sept. 1, UnitedHealthcare will begin a two-phased approach to eliminate prior authorization requirements for several procedure codes. 

This trend could reduce the number of ASCs

Anesthesia costs are skyrocketing, and some ASCs are worried about sustainability of these issues if payer reimbursements do not adjust. 

The obstacle stifling ASC growth

Certificate-of-need laws vary by state and consequently can have a huge impact on ASC development in each region.

'Not much squeezing left to be done': Why ASC reimbursements need to increase

Some leaders believe payers will be forced to increase ASC reimbursements as they become more lucrative amid healthcare’s shift to value-based care. 

Value-based care could be ASCs' secret to success 

As a low-cost site of service, ASCs could benefit as value-based care’s influence in healthcare heightens. 

How 4 CMS updates from this month will impact ASCs

July has been a busy month for CMS, from facing Congressional pressure on a prior authorization overhaul to the addition of dental surgical codes in its prospective payment system proposal for 2024. Here is how four changes floated in the last 30 days …

4 major insurers facing lawsuits

Here are four major insurance companies, including UnitedHealthcare and Aetna, facing lawsuits in the last 60 days: 

How do physicians feel about noncompetes? 

Noncompete clauses affect between 37 and 45 percent of physicians, according to a report from the American Medical Association, and often can limit career growth and restrict physicians’ ability to provide care in economically or socially marginalized …