• 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 recap quickly what Ambulatory Surgery Centers are. Initially, ASC revolves around outpatient processes. Partially, these include surgical procedures and, on another hand, they involve 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 requirements. Also, you’ll have to write an agreement with CMS.

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

Care to learn first about Medical Billing Services?

Here you’ll find out how ambulatory surgery center billing services work by having a sneak-peek 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, you see the healthcare services transform into a billing claim submission. Yet, who’s the medical biller? A medical biller is the one inside ASC facilities to pursue 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, to assign standard codes with the usage of CPT, ICD-10-CM, and HCPCS Level II system of classification. But medical billers follow-up and process claims that are sent to health insurance. This is done for reimbursement of services the healthcare provider renders.

What about specialty billing?

Before discussing how do ambulatory surgery center billing services work, let’s take a look at specialty billing. If you want, as an ASC service provider, to get your reimbursement, the procedure should be necessary. Certain requirements are essential for the medical procedure to be performed. In fact, the provider and patient mutually decide that matter.

Additionally, ASC setting charging is not focused on a designated medical specialty. 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 makes usage of the same codes, techniques, and guidelines as different medical entities. For example, ASC relies on CMS-1500 claim forms. On the other hand, hospitals make use of 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 entirely credentialed, you can perform multiple procedures. Therefore, lead the fastest healthcare service in growth.

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 their cost of medical billing service? Here we go. Medical billing services cost approximately from $875 to $10,300. As a matter of fact, this depends on the size of the enterprise. As well as on-site servers’ need 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 company for billing, research. You want to find a company with minimum turnover. It’s better that you choose a company with no offshore services.
2- Search for coders with ASC experience: coding with ASC is different 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 make a move towards a billing services company. So, try to appreciate the learning curve when working together. Of course, it’s advised that you share your expectations.
4 –Team approach: the billing services company is an extension for your team and the opposite. Therefore, communication is key that will reduce issues.
5-Order monthly reports: you will be able to 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 when it comes to 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, 2023 / Categories: Medical Billing /

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