Cleared to Bill

Stay ahead in a rapidly changing healthcare landscape with insights from leaders in revenue cycle and clinical operations. Our newsletter breaks down emerging RCM trends, proven practice management strategies, and the technologies reshaping how outpatient teams operate, scale, and get paid.

What the $100M Horizon Settlement Reveals About the State of Claims Administration

Horizon Blue Cross Blue Shield of New Jersey agreed to a $100M settlement over alleged failures to follow the state’s “lesser of” payment rule.

ASC Cost Insights 2025: What We Heard in New Jersey

At the NJAASC meeting and ASC conference, leaders stressed that cost drives every decision. Technology adoption depends on clear ROI, M&A activity with hospitals and MSOs is accelerating, and endoscopy centers are shifting from reusables to disposables.

Prior-authorization requirement changes and what this means for procedural and surgical specialties

CMS is expanding prior authorization in 2026, reshaping surgical and procedural care. See how new rules impact ASCs, HOPDs, and practices- and what strategies help avoid denials and protect revenue.

Unpacking Employee Feedback: Strategies to prevent ASC Staff Burnout

Discover the hidden drivers of nurse burnout in ambulatory surgery centers (ASCs)- from overwhelming caseloads and inefficient workflows to poor onboarding and lack of leadership support. Learn strategies ASC leaders can use to reduce burnout, improve staff retention, and strengthen patient care by addressing systemic issues, investing in smarter workflows, and leveraging technology.

Stopping the Revenue Drain: What ASCs Are Saying About Payer DRG Downgrades

Learn why payers downgrade ASC DRG claims and how to fight back. Discover documentation, appeals, and denial management strategies to protect ASC revenue cycles

Handling Medical Billing in ASCs: Outsource or In-House?

Discover why outsourcing medical billing at ASCs may increase denials and delays

Epic’s Move into Ambient Scribes and Implications for Hospital–ASC Joint Ventures

Epic’s reported AI ambient scribe could streamline hospital workflows but limit ASC flexibility in joint ventures, especially for centers running SIS or HST Pathways.

The #1 Missed Opportunity in ASC Operating Room Efficiency

Discover how pre-op workflow gaps reduce ASC OR efficiency, cause costly cancellations, and how surgical centers can solve them to boost throughput.

ExactRx Recognized on the AI Hot 100 List Ahead of NYC Summit

ExactRx has been named to the 2025 AI Hot 100 List and is live at this week’s AI Furnace Summit in NYC.

Beyond the Bill: What Your Margins Are Telling You—and How to Improve Them

Struggling with shrinking margins at your surgery center? Learn how delays, denials, and cancellations erode revenue—and how leading ASCs are boosting ROI with smarter pre-op workflows and OR efficiency.

Beyond the Buzzwords: Why the Smartest Surgical Facilities Are Becoming Early AI Adopters

Surgical centers are overwhelmed with AI buzz, but early adopters are seeing real ROI by piloting tools that automate pre-op workflows, reduce cancellations, and recover lost revenue. Learn how leading facilities are using structured, embedded AI to streamline operations and drive surgical throughput.

Annoucement: Athena Doshi, CEO of ExactRx, Named to Inc.'s 2025 Female Founders 500 List

ExactRx CEO Athena Doshi named to Inc.'s 2025 Female Founders 500. ExactRx is building the infrastructure for AI-native care facilities.

Benefits Shift Alert: Is Your Surgery Center Prepared?

More companies now pay for weight-loss drugs and fertility treatments, changing which surgeries happen at ASCs and making paperwork harder. Surgery centers need better systems to handle the complex insurance rules while keeping their business healthy.

Going Beyond Hospitals: The Rise of Outpatient Surgeries

Ambulatory Surgery Centers now handle 72% of US surgeries, offering cost-effective outpatient care for orthopedic, ophthalmologic, and GI procedures. ASCs provide 45-60% lower costs, 20% shorter wait times, and 92% patient satisfaction. With minimally invasive techniques and streamlined workflows, these 11,521 surgical facilities are projected to grow 25% in four years—reshaping modern surgical practice and value-based care delivery.

Are Consumer Wearables the Future of Surgical Care?

Ōura and Dexcom’s $75M partnership is transforming surgical care with real-time glucose monitoring and wearable health tech. ASCs and surgeons gain data-driven insights for pre-op screening, optimized anesthesia, and faster recovery, reducing complications and readmissions.

Neuralink’s Blindsight Implant: Opening Eyes and Redefining Surgery

With FDA breakthrough status, Neuralink’s Blindsight aims to restore vision and could revolutionize surgery through real-time brain feedback, personalized pain management, and faster recovery.

5 Things to Know About the Anesthesiologist Shortage

The anesthesiologist shortage is causing longer surgery wait times and heavier workloads. Hospitals are turning to solutions like training nurse anesthetists and using telemedicine to ensure patients still receive timely, quality care.