Category: ASC Coding, Billing and Collections

UnitedHealth Group has decided to stop mailing prior authorization and clinical decisions to providers on paper.

Health insurers have made several moves to grow their networks, become more efficient and institute new policies over the last few weeks, and one major company was hit with a lawsuit by the Justice Department.

UnitedHealth Group, parent company of ASC management company United Surgical Partners International, reported sizable year-over-year growth in 2021. 

Brockton Urology Clinic in Boston will pay thousands of dollars to settle allegations it accepted kickbacks from a hospital for services never provided, according to the Justice Department.

National Medical Billing Services, a healthcare revenue cycle management company focused on ASCs, closed its second transaction of the year.

Gastroenterology claims the highest case mix, on average, among the nation’s 6,028 ASCs, according to VMG Health’s “Multi-Specialty ASC Benchmarking Study” for 2022.

Orthopedics tops the pack for ASC revenue per case, according to VMG Health’s “Multi-Specialty ASC Benchmarking Study” for 2022. The specialty was only the fourth most-represented among ASC cases, however.

From the dismissal of the inpatient-only list to the removal of procedures from the ASC-payable list, CMS plays a massive role in the success of an ASC.  

Thirty-four percent of physicians reported that delays in processing a prior authorization led to a serious adverse event for a patient in their care, according to a recent survey from the American Medical Association. 

UnitedHealthcare now requires members to obtain prior authorization before undergoing physical and occupational therapy at multidisciplinary offices and outpatient hospitals in four states.