ASC Medical Billing Services
Unique Challenges of ASC Medical Billing
Unlike physician- surgeon or hospital billing, there are some things that you as well as your billing department need to know before filing a claim for services rendered through an ASC. Medicare often has different guidelines than some payers, for one thing, and the payers themselves often differ regarding medical necessity, approved procedures, or other filing requirements. Following are few challenges of Ambulatory Service Center (ASC) Medical Billing:
- The Medicare Carriers Manual defines an ASC as a separate and distinct institution. Under these rules, Medicare requires that ASCs enter into a participating-provider agreement with CMS to be eligible for payments.
- To be “approved” by Medicare, CMS has determined that a given procedure does not pose a significant safety risk nor of incurring an overnight admission following the procedure.
- A modified (and somewhat confusing) payment methodology is used for device-intensive procedures i.e., procedures done specifically to insert a device, such as a pacemaker. The ASC will get paid for the device, but does not submit a separate line item for the device. The ASC would instead include the cost of the device in the procedure code and submit one line item. ASCs are not allowed to base price on the allowable code from the Medicare Physician Fee Schedule (MPFS).
- One of the most common coding mistakes is coding based on a procedure’s headings instead of the actual surgical report. Many ambulatory surgical centers and other freestanding outpatient facilities wisely wait for the complete surgeon’s report rather than bill immediately for what were scheduled services, as sometimes fewer (or different) procedures are actually noted in the final report. This is bound to result in a denial once it reaches the payer.
- Other common errors include misreporting open and arthroscopic techniques as one procedure. This happens when a procedure is started arthroscopically then for whatever reason is converted to an open procedure. Many coders mistakenly bill for both, when only the open procedure is the correct procedure that needs to be coded.
Our Solutions
Ambulatory Service Center (ASC) medical billing is not like medical specialty billing, where you have to learn a few highly specialized guidelines or rules to make sure you are reimbursed for your services. ASC medical billing isn’t centered on a specific medical specialty. It does not revolve around specific types of services, procedures, or diagnoses. ‘E2E Medical Billing Services’ as one of the leading ASC medical billing company in the nation, has leveraged its significant and unique experience to develop a proprietary revenue cycle methodology that has resulted in unparalleled financial results for ASCs across the nation.
- First, we aid our clients in the managed care contract analysis and negotiation process. From there, our highly skilled and specialized coders, all of whom are certified, help ASCs properly capture all revenue to ensure that they maximize their cash flow in a highly compliant fashion.
- Our claims experts then navigate the electronic submission process to ensure rapid payment of claims, and our payment posters possess an incredible ability to decipher payer contracts and payer trends, which enables them to preserve the integrity of the financial data.
- Finally, our talented receivables management, appeals, denial management, and patient collections specialists work to maximize our clients’ cash flow by aggressively pursuing all outstanding accounts receivable.
- ’E2E Medical Billing Services’ also furnishes custom-tailored analytics each month that contain detailed key performance indicators. These KPIs highlight all of the critical aspects of a surgery center’s revenue cycle in order to provide insightful analysis regarding its overall financial performance.
Medical Billing Service Fee
Our average billing fee ranges from 2.5% to 7%. We offer add-on services like provider credentialing, old AR clean-up, and patient collection. We don’t have any start-up fee or software setup fee. We don’t use restrictive, long-term contracts. You can cancel your agreement at any time with only 30 days’ notice. You can call us at 888-552-1290 or request a customized quote by submitting the inquiry form below.
Billing Software
Our billing team has great expertise in following billing softwares. If you choose our billing services, you don’t have to change your current billing software. We will continue from the point where your last biller had left. So no claims or denials will remain unattended. In simple words, peace of mind for you.
- AdvancedMD
- Allscripts
- Athena
- ChiroTouch
- eClinicalWorks
- Greenway Prime Suite
- IMS – Intelligent Medical Software
- Kareo
- Lytec
- Medisoft
- Office Ally
- Practice Fusion