Why Leading ASCs Treat Denial Management as an EBITDA Protection Strategy

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For many Ambulatory Surgery Centers (ASCs), denial management has traditionally been viewed as a back-office billing task. Claims were denied, staff corrected errors, appeals were submitted, and payments were eventually collected. In 2026, however, leading surgery centers are treating denial management very differently. They now view it as a direct EBITDA protection strategy that influences profitability, cash flow, valuation, and long-term growth. This shift is occurring because denial-related revenue loss extends far beyond unpaid claims. Every denied claim creates additional labor expense, delays cash flow, increases accounts receivable (AR), consumes management time, and reduces operating margin. When denial rates rise, EBITDA can decline even if surgical volume remains strong. As reimbursement pressure increases, more ASCs are investing in specialized ASC Billing Services , comprehensive medical billing services , advanced RCM services , and proactive Revenue Integrity programs ...
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Primary Care First (PCF) and Alternative Payment Models

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Primary Care First Model Options is a set of voluntary five-year payment options that reward value and quality by offering an innovative payment structure to support the delivery of advanced primary care. It will help in prioritizing the doctor-patient relationship; enhancing care for patients with complex chronic needs and high needs, seriously ill patients, reducing administrative burden, and focusing financial rewards on improved health outcomes. Primary Care First Model Options will be offered in 26 regions for a 2020 start date.

Background

Primary care is central to a high-functioning healthcare system and thus, there is an urgent need to preserve and strengthen primary care as well as a need for support of serious illness care services for Medicare beneficiaries. PCF will focus on advanced primary care practices ready to assume financial risk in exchange for reduced administrative burdens and performance-based payments. PCF also encourages advanced primary care practices, including providers whose clinicians are enrolled in Medicare who typically provide hospice or palliative care services, to take responsibility for high need, seriously ill beneficiaries who currently lack a primary care practitioner and/or effective care coordination – population groups referred to under the model as the Seriously Ill Population or SIP.

Looking for more information about Primary Care First alternative payment model click here: https://bit.ly/3BBrrrL. also you can get in touch with us at info@medicalbillersandcoders.com or call us at 888-357-3226.

Location: California, USA

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