Medical Billing Blogs

  It’s the outpatient surgical services that are primarily provided by ASCs (Ambulatory Surgery Centers). Such services can be a part of big hospitals or operate as standalone surgical centers. Although Ambulatory Surgery Center (ASC) Billing claims seem to be alike regular medical claims, they are quite different in terms of filing. ASC billing claims are filed on the HCFA 1500 or 837P, whereas  UB-04 or 837I  is used to file the hospital outpatient surgical claims. ASC billing requires extra caution as even minor errors can result in massive claim denials. Here we discuss about ASC billing ensure accuracy in bills and smoothness of claim reimbursement. Let’s take a look at the different ways to improving Ambulatory Surgery Center Billing: Clarify the Collections Process Communication with patients must be open and transparent if  ASC medical claims billing efforts are to be more efficient. Make sure that new patients are aware of their financial respo...

  Making a choice between in-house and outsourced revenue cycle management (RCM) has been a long topic of discussion. As an Ambulatory Surgery Center leader, you would have probably realized that the billing process is the lifeblood of your center. When it's working properly, everything seems to fall into place. Otherwise, you would have either witnessed or dealt with issues involving partial or non-collected payment, delayed payment, or finding (and retaining) capable local talent. This perplexing question has no one-size-fits-all solution. While both approaches have proven to be successful for many healthcare centers, your decision should be based solely on the age and size of your center, the costs associated with running the practice, volume metrics, and what your center requires. Are you still perplexed? Let's have a look at both the approaches: In-house ASC Medical Billing Pros ●         Flexibility You are in a better position t...

  Medical billing consists of hundreds of pages of updated rules, regulations, and legislation, not to mention thousands of billing codes. And, navigating them is already a challenge for practices. Over the last few years, patients and insurers have continued to pressure the health system and hospitals to move towards ambulatory surgery centre (ASC) billing from hospital outpatient department billing (HOPD). The reason is ASCs billing can be a cost-saving procedure. But to understand how it can be cost-saving, one needs to understand the difference between ASC and HOPD. The Difference between ASC & HOPD The primary difference between ASC and HOPD is based on the regulations that apply to the centres. For instance, a stand-alone surgery centre can still be termed as HOPD when it falls under the same administrative and financial contracts as a hospital that is within a 35-mile radius. On the other hand, a facility can have the ASC status despite being operated by a hospi...

    The total healthcare expenditure has seen an exponential increase in recent years. Seeing this growth, the Centers for Medicare and Medicaid Services initiated new programs and payment systems that can help reduce overall costs while enabling physicians and healthcare providers to offer cost-effective care to their patients.   Over the years, the healthcare infrastructure has also seen an increase in outpatient procedures that were conducted in ambulatory surgical centers (ASCs). ASCs exclusively provide outpatient surgeries which are a same-day or 24hour stay, typically focusing on a small subcategory of regular procedures and treatments. This approach allows ASCs to reduce the overall costs of surgery and those linked with post-operative care while allowing healthcare providers to receive similar outcomes and ensure quality patient satisfaction.   Since the Affordable Care Act, reimbursements in ASCs have reduced approximately to 42%   as compar...

  Whether to choose the in-house or the outsourced revenue cycle management (RCM) is a long-standing dilemma many healthcare practices face. As an ASC leader, you must not have an iota of doubt about how the billing process is the lifeline of your practice. When it is working well, everything fits well. But if and when any complication arises that is related to the billing, like non-collection of the payment or any executive dysfunction, your perception is bound to change. Outsourcing the Ambulatory Surgical Centre billing process  is one easy way to deal with the complexities of successful ASC operations. When you outsource, you allow a third party to handle the revenue cycle management on your behalf. It sounds like a no-brainer, but outsourcing is not the only solution for all healthcare operations. So let’s take a quick look at the top-most reasons for the ASC billing process outsourcing. 1 . Low Costs, More Revenue-  It might initially look like outsourcing is an...

  The ambulatory surgical center (ASC) market has seen rapid growth in the last few years. Increasing health costs along with insurance limitations are turning more people towards the outpatient setting when it comes to quality surgery at an affordable cost.  Outsourcing ASC medical billing  can help you address your financial concerns and also increase your profit rates. However, as per the recent reports, the ASCs are constantly facing many challenges when it comes to improving their revenue generation. Cancellations One of the major causes of concern has been the cancellations. High costs of elective surgeries often keep the patients away from rescheduling if a surgery gets canceled. Same-day cancellations of the scheduled surgeries can often negatively impact your finances since you wouldn’t be able to fill the open OR with another surgery. But that doesn’t stop the labor and the overhead costs for your practice. ASCs must identify the cancellation causes and ta...