• How do medical billing services work?
  • What about specialty billing?
  • Jumping to the costs
  • What is the best billing solution for your ASC?

When it comes to ambulatory surgery center billing services, it is entirely different from all other types of billing. First, let’s quickly recap what ambulatory surgery centers are. Initially, ASC revolves around outpatient processes. Partially, these include surgical procedures, diagnostic procedures, pain management, and the like. Generally, when you execute one of the procedures at ASCs, they’re more complicated than the ones at the office and less than a hospital.

If you have a facility and would like to bill for ASC services, you need to qualify for the requirements and write an agreement with CMS.

Moreover, ASC services are only paid if the service determination implies medical necessity. However, the necessary medical process doesn’t always happen at an ASC. Both the patient and the provider decide the circumstances.

Do you want to learn first about medical billing services?

Here you’ll find out how ambulatory surgery center billing services work by peaking at medical billing services. Generally speaking, medical billing is the submission and follow-up on ASC claims with health insurance to get payment. The payment is related to the services healthcare provides. With medical billing, healthcare services transform into a billing claim submission. Yet, who’s the medical biller? A medical biller is the one inside ASC facilities who pursues the claim. So, they ensure the healthcare facility gets reimbursement for the work performed by the providers.

On top of this, it would be helpful to know the following. Generally, billing and coding are confusing. Yet, Medical billing is not the same as medical coding. The initial responsibility of a medical coder is to review the statements. Also, standard codes should be assigned using CPT, ICD-10-CM, and the HCPCS Level II classification system. However, medical billers follow up and process claims that are sent to health insurance. This is done to reimburse the healthcare provider for the services rendered.

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What about specialty billing?

Before discussing how do ambulatory surgery center billing services work, let’s take a look at specialty billing. As an ASC service provider, the procedure should be necessary if you want to get your reimbursement. ASC Documentation Requirements play a crucial role in this aspect. Certain requirements are essential for the medical procedure to be performed. The provider and patient mutually decide that matter. Proper documentation ensures that all necessary details are captured, making the billing process smoother and more accurate.

Additionally, charging is not focused on a designated medical specialty in the ASC setting. In fact, it doesn’t focus on specific services, procedures, and diagnoses. Thus, ASC billing doesn’t resemble any medical specialty billing. However, center billing within ASC uses the same codes, techniques, and guidelines as different medical entities. For example, ASC relies on CMS-1500 claim forms. On the other hand, hospitals use UB-04 claim forms to achieve reimbursement.

Besides, the types of services covered in this scenario depend on the status of the ASC guideline. If your ambulatory surgical center is credentialed, you can perform multiple procedures. Therefore, it is the fastest-growing healthcare service.

The ASC doesn’t cover:

  • Prosthetic devices
  • Neck, leg, back, and arm braces
  • Ambulance services
  • Independent laboratory services
  • Physician services
  • Artificial leg, arm, and eyes
  • Non-implantable durable medical devices

Jumping to the costs

We clarified how do ambulatory surgery center billing services work, but what about the cost of medical billing services? Here we go. Medical billing services cost approximately from $875 to $10,300. This depends on the size of the enterprise. As well as on-site servers’ needs or the absence of it. Honestly, choose whether you need cloud or web-based software that runs on off-site servers. If implemented, you might want to save an additional 27 to $127 per month.

What is the best billing solution for your ASC?

Follow our tips to make the best out of your search for medical billing services for ASC:

1- Ask questions about the staff: before selecting a billing company, research. You want to find a company with minimum turnover. You should choose a company with no offshore services.
2- Search for coders with ASC experience: coding with ASC differs from that of a physician’s office. Search for companies with certified coders who obtained ASC experience.
3- Don’t form unrealistic expectations: your results won’t be instant when you move towards a billing services company. So, try to appreciate the learning curve when working together. Of course, you are advised to share your expectations.
4 –Team approach: the billing services company is an extension for your team and the opposite. Therefore, communication is key to reducing issues.
5-Order monthly reports: you can solve any issue with visibility.
6-Remember to benchmark: determine the value of your provider through benchmarking analysis. Plus, it’ll help you with successful billing.

Finally, you arrived at the other side of knowledge regarding ASC billing services. We hope that you found this helpful with your decision-making and management.

Now, if any questions are still hanging, do not hesitate to communicate with the Ambula Healthcare team: (818) 308-4108! And now check out what is medical billing and coding in ASC?

Published On: April 14th, 2023Categories: Medical Billing

About the Author: Khalil

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