Ambulatory Surgical Center Billing
The Centers for Medicare & Medicaid Services (CMS) defines Ambulatory Surgical Centers (ASCs) as facilities that provide same-day surgical care, including diagnostic and preventive procedures. As outpatient surgery centers. ASCs offer a range of surgical procedures that do not require hospitalization or an overnight stay, such as cataract surgery, colonoscopies, and minor orthopaedic procedures. Although ASC services are getting more popular due to lower cost involved, billing for ASCs are getting more complicated.
For ASC billing, it is important to make sure that the procedure is listed as an approved one and the corresponding CPT code is used. To avoid rejections or denials, it is essential to have proper documentation to support medical necessity and proof of the procedure. Our expert billers and coders have adequate knowledge and expertise to handle the intricacies of ASC billing and provide excellent service to the ASCs improve their revenue cycle and collect appropriate and timely payment.
Unbeatable Service, Quality & Price
ACCURACY
0
%
TURNAROUND TIME
<
0
Hours
COLLECTION
0
%
PRICE
Starting from $
1100
/Month
Challenges
Challenges in Ambulatory Surgical Center Billing
Billing and coding for Ambulatory surgical Centers differs from a standard outpatient medical billing process on several criteria such as medical codes (CPT & ICD-10), billing guidelines, service coverage and documentation requirements and faces unique challenges.
Ambulatory Surgical Centers use a combination of hospital and physician billing which makes their coding and billing process confusing. Most of them are billed using a combination of CPT and HCPCS Level II codes, while some insurers insist on using ICD-10 Codes. Also, there are certain other guidelines by Medicare such as filing claims through CMS 1500 and using modifiers to differentiate ASCs that makes the billing process more cumbersome. With only a few approved procedures in the facility, an ASC billing process involves many restrictions and guidelines.
The billers also need to be aware of coverages that is allowed for ASCs to avoid claim rejections. Use of specific diagnosis codes, modifiers, proper documentation that supports codes will ensure a better outcome for ASC billing.
OUR PROCESS
Our Ambulatory Surgical Center Billing Process
Our team of coding and billing experts follows latest guidelines to perform end-to-end ASC billing activities and ensures proper documentation to support codes used in claims. They also methodically make sure that the procedure is covered under approved list. Rigorous review and audit activities at every stage of revenue cycle ensure accuracy and compliance of our billing process. Our billing experts work diligently and follows industry standard best practices for revenue cycle management to minimize errors and reduce claim rejection rates, resulting in better turnaround time and higher revenues for your practice.
Our ASC billing team is well versed in coding applicable for ambulatory surgical services and latest billing guidelines to ensure your practice receives accurate reimbursement for services rendered. Our efficient process for denial management and AR follow-up ensures timely payment and eliminates payment delay. Our pre-service billing workflow ensures clean claim submission and reduces denials significantly. Our metrics driven reporting tool captures and reports every aspect of process performance – productivity, quality and $ collections in a transparent way and gives you full control over your billing process.
Scheduling & Registration
Well coordinated appointment Scheduling, update insurance details and handle inbound outbound calls from/to patients.
Eligibility & Benefits Verification
Confirm patient primary and secondary insurance and benefits coverage and verify the patients’ coverage, co-pays, co-insurance and deductibles
Prior Authorization
Initiate request for prior authorization with the payer, follow-up to check Auth status till closure and finally update the system with Auth approval reference number.
Medical Coding
Check accuracy of codes and modifier according to specialty and assign corresponding and appropriate charges to the codes.
Charge Posting
Audit the claims thoroughly to check for accuracy and edit if necessary and submit claims – both EDI and paper format.
Claims Edit & Submission
Audit the claims thoroughly to check for accuracy and edit if necessary and submit claims – both EDI and paper format.
Payment Posting
Carry out both auto as well as manual posting for payments received and conduct reconciliation against claims.
Denial Management
Analyse and categorize denial claims according to denial codes, $ amount and payers, and resubmit claims after correction.
AR Management
Follow-up with payers to gather status for unpaid claims, and their resolution.
Patient Collection
Sending patient statements and follow-up with patients for final and outstanding payment.
Tailored to your specific needs, you have the flexibility to entrust us with either your entire billing requirements or select any combination of our Urgent Care billing services. Our seamless integration ensures smooth operations without causing any disruption to your billing operations.
BENEFITS
Outcomes Guaranteed
Our methodical approach to manage ASC billing presents unparalleled advantages for your business and elevates your ROI. We provide regular reports in a transparent way and we assure you a much-improved financial outcome – maximized revenue, and reduced operational cost while complying with HIPAA regulations.
WHY US?
Why partner with us
Our ambulatory surgical center billing service encompasses all facets of your billing needs, seamlessly integrating into your existing billing infrastructure. By following industry standard best practices and procedure for quality control and compliance, our dedicated team provides a superior and improved billing service. We provide regular updates on process performance and quality metrics to our valued partners, so that you have a complete view and full control of your billing process. Partner with us today to transform your billing process and safeguard financial health of your practice.