Category: ASC Coding, Billing and Collections

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.

Payers eye ASCs for big growth: 7 notes

The healthcare industry is experiencing monumental changes due to policy shifts and the aftermath of COVID-19. Insurers are taking stock of the situation and see a huge opportunity to direct more care to outpatient settings.

Why an ASC, clinic lost coverage in 2021 

An Illinois clinic lost coverage from Blue Cross and Blue Shield of Illinois and an Idaho ASC lost coverage from CMS in 2021. 

Price transparency and ASCs: 7 insights

Here are seven insights into price transparency and ASCs from the last year:

Will CMS physician pay cuts ever happen?

Potential Medicare pay cuts associated with the 2010 sequestration have loomed large on Capitol Hill for the last decade, but lawmakers continue to kick the can down the road.