Ambulatory surgery centers (ASCs) in 10 states will soon face new prior-authorization requirements for a handful of procedures, as the Centers for Medicare & Medicaid Services (CMS) expands its oversight efforts into the space. The five-year demonstration, announced earlier this month, is designed to test whether earlier documentation review can reduce improper payments while still protecting beneficiary access, according to CMS. CMS has long turned to prior authorization as a way to … [Read more...]
Denials, Delays and Data: How ASCs Can Survive the Revenue Squeeze
As ambulatory surgery centers (ASCs) enter the second half of 2025, they are dealing with a fast-changing revenue cycle environment. From rising denial rates to tighter payer scrutiny and mounting staffing pressures, the financial terrain has grown increasingly volatile, Patricia Smith, director at Dallas-based revenue cycle management services company SYNERGEN Health, told ASC News. The explosion in denied claims can partly be attributed to the increasing use of artificial intelligence by … [Read more...]