Category: ASC Coding, Billing and Collections

An Alexandria, La.-based physician has been charged for his role in a $32.7 million Medicare fraud scheme involving medically unnecessary definitive urine drug testing services. 

Beginning Jan. 1, Duluth, Minn.-based Essentia Health will no longer be in-network with UnitedHealthcare and Humana Medicare Advantage plans.

A district court dismissed an oncology trade association’s challenge to Stark law guidance prohibiting physicians from dispensing drugs in locations outside of their office on Aug. 30.

Here are five updates on Anthem Blue Cross Blue Shield companies, which are owned by Elevance Health, one of the largest payers in the U.S., as reported by Becker’s since May 21:

ASC software solutions provider HST Pathways has partnered with revenue cycle management services company Synergen Health. 

CMS’ Medicare Merit-based Incentive Payment system has new reporting options to fulfill traditional MIPS requirements.

MedHQ, a provider of advisory and administrative services for ASCs in the U.S., has acquired Trajectory Revenue Cycle Services. 

As some areas see an uptick in post-procedure claim denials from payers, ASCs may be at a loss on how to salvage payments.

From an ousted CEO to shifting financial expectations, CVS Health-backed insurer Aetna has seen an eventful August. 

Around 36% of physicians earned income from an employment source outside of their practice in 2023, the highest number in five years, according to Medical Economics’ 2024 Physician Report published Aug. 14.