Category: ASC Coding, Billing and Collections

2 Texas physicians indicted in $300M kickback scheme

Two Loredo, Texas-based physicians were among 10 indicted in a $300 million healthcare fraud scheme Feb. 10, according to the Justice Department.

6 CMS updates

The No Surprises Act, the federal law requiring ASCs and physician practices to provide cost estimates to self-pay patients, went into effect Jan. 1. 

ASCs must give cost estimates to patients: 7 details

ASCs and physician practices are required to provide cost estimates for expected charges to self-pay patients when scheduling procedures or services as part of the No Surprises Act, which went into effect Jan. 1.

Aetna in the headlines: 5 updates in the last 30 days 

Here are five updates from Aetna, one of the country’s biggest payers, in the last 30 days:

Michigan surgeon pleads guilty to $19.5M billing fraud: 4 details

A Bay City, Mich.-based vascular surgeon pleaded guilty to a multimillion dollar fraud scheme Feb. 8, according to the Justice Department.

ASCA asks members to urge Congress to support ASC reimbursement legislation

The Ambulatory Surgery Center Association is asking members to write to Congress and ask them to support the Outpatient Surgery Quality and Access Act of 2021. 

Commercial payers driving cases to ASCs; orthopedics most primed for growth

A growing number of commercial insurers are revamping policies to push providers and patients out of the hospital and into ASCs, where procedures can be performed at a lower cost.

Woman pleads guilty in $44M scheme to fraudulently bill cosmetic surgeries

A 69-year-old woman pleaded guilty to federal fraud charges after billing cosmetic surgeries at a California surgery center as medically necessary, the Justice Department said Feb. 4.

Ask payers how you can share in the savings, says Surgery Partners exec

Shannon Yarrow, senior vice president of managed care at Brentwood, Tenn.-based Surgery Partners, joined “Becker’s ASC Review Podcast” to talk about reimbursement opportunities for physicians doing outpatient procedures.

Inflation hits ASCs, physicians hard

The cost of essential goods jumped 7 percent last year, outpacing the reimbursement increases to healthcare providers across the board.