Category: ASC Coding, Billing and Collections

Optical devicemaker Essilor is paying $16.4 million to settle allegations that it paid kickbacks and violated the False Claims Act, the Justice Department said Aug. 23.

The trend toward value-based care models in recent years has been followed by a push for quality performance metrics.

The Medical Group Management Association recently released its report, “Patient Access and Value-based Outcomes Amid the Great Attrition,” which details the revenue driven from value-based contracts in healthcare by specialty.  

Negotiating contracts with commercial payers is one of the most challenging and fatiguing aspects of an ASC administrator’s role. But there are core strategies administrators should consider when sitting at the table with insurers, including arming one…

Payers UnitedHealth, Anthem and Cigna are some of the largest insurers by membership. 

Healthcare providers have been pushing for prior authorization reform this year, and many states are passing legislation to remove prior authorization requirements. 

CMS’ plan to cut physician pay by 4.42 percent in its Medicare physician fee schedule proposal is leaving many physicians worried about healthcare becoming more impersonal. 

ASCs are looking to value-based care as the industry pivots to support bundled payment models. 

UnitedHealth Group, the nation’s largest operator of Medicare Advantage plans, acquired Texas Medicare insurer KS Plan Administrators, the Star Tribune reported Aug. 16.

A Miami physician has been sentenced to federal prison for committing a $38 million healthcare fraud scheme scheme, the Justice Department reported Aug. 3.