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Showing posts with the label ASC Revenue Cycle

What Is the CY2026 Efficiency Adjustment and How Does It Impact Internal Medicine Billing?

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The CY2026 Efficiency Adjustment is one of the important changes introduced under the 2026 Medicare Physician Fee Schedule. Effective January 1, 2026, CMS finalized a 2.5% reduction to the work RVUs of most non-time-based services . However, the adjustment does not apply broadly to every service billed by an internal medicine practice. Time-based services, including many evaluation and management (E/M) and care management services, are excluded. For internal medicine practices, understanding which services are affected is important because the adjustment can change reimbursement for certain procedures and ancillary services even when claims continue to process normally. For a detailed overview, practices can review What Is the CY2026 Efficiency Adjustment and How Does It Impact Internal Medicine Billing? . What Is the CY2026 Efficiency Adjustment? CMS finalized the efficiency adjustment as part of the CY2026 Physician Fee Schedule. The policy applies a -2.5% adjustment to the work comp...

Where Is Cash Getting Stuck in Your ASC Revenue Cycle?

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Cash gets stuck in the ASC revenue cycle when operational gaps, payer delays, and billing inefficiencies slow the path from procedure to payment. Even high-performing ambulatory surgery centers can experience revenue bottlenecks that quietly drain cash flow and compress margins. Ambulatory Surgery Centers (ASCs) run on tight financial timelines. Case volume may be strong, but if reimbursements lag, working capital suffers. Identifying where cash stalls are the first step toward restoring predictable revenue. The Most Common Cash Flow Bottlenecks in ASCs 1. Front-End Eligibility and Authorization Delays Insurance verification errors and incomplete prior authorizations can halt claims before they even enter the billing pipeline. 2. Coding and Charge Capture Gaps ASC procedures involve complex CPT coding, modifier usage, and implant billing rules. Missed charges or incorrect coding delays clean claim submission. 3. Claim Submission Inefficiencies Late submissions, batching dela...