Category: ASC Coding, Billing and Collections

The Medicare Payment Advisory Commission proposed aligning Medicare pay rates for ASCs, hospital outpatient departments and physician offices during policy meetings April 7 and 8.

Gastroenterology comprises 41 percent of cases for ASCs in the Atlantic, the highest of any region, while orthopedics represents 20 percent of cases for surgery centers in the Mountain area, according to VMG Health’s “Multi-Specialty ASC Benchmarking S…

ASCs in the South receive the highest percentage of their collections from commercial payers, followed by surgery centers in the Midwest, according to VMG Health’s “Multi-Specialty ASC Benchmarking Study” for 2022.

Insurers and health systems across the U.S. have been at odds during the most recent cycle of contract negotiations, and terminated contracts are affecting thousands of patients.

Aetna, a CVS Health company, insurers about 39 million people. 

Kaiser Permanente Health Plans was the largest payer by total incurred claims in 2020, according to data firm Definitive Healthcare. 

College Park, Md.-based internal medicine physician Anuja Kurichh, MD, has agreed to pay more than $500,000 to resolve billing fraud allegations, according to the U.S. Justice Department.

Centene is one of the nation’s largest health insurers by membership. 

Despite an increased demand for patient care in 2021, national health spending growth has slowed to 4.6 percent compared to 9.7 percent in 2020, according to a CMS news release shared with Becker’s.

Miami physician Mark Zager, MD, was sentenced to two years in prison for healthcare and wire fraud, the Justice Department said March 24.