Outsourcing Billing services for Ambulatory Surgical Center (ASC) simplifies the complexities and challenges involved and results in higher ROI. Offshore Outsourcing can qualify the US-based Medical billing companies for greater benefits and profitability. Ambulatory Surgical Center have more specifications and specialty-based nuances in charting out the claim and processing them with the insurance payor; which makes it cumbersome and laborious to be handled In-house. Let us try to understand the complexities involved in billing for ASC to know why Outsourcing has become the latest trend in ASC specifically.
What is Ambulatory Surgical Center?
Ambulatory Surgical Centers are organizations that provide outpatient Surgical Services as a part of a huge medical group, hospitals or has as an independent facilities. CMS has mandated only certain surgical procedures can be done within an ASC setup. Such distinctions and specifications from CMS and Medicare protocols make ASC different from other specialties. For this reason, the medical billing process for ASC can be complicated and intricate comparatively.
Challenges in ASC Medical Billing and Coding
Medical Billing and Coding for ASC can be completely different when compared to other medical specialties or the usual physician billing or facility billing as they majorly are a combination of Hospital and Physician Medical Billing claimed on the professional claim form CMS 1500.
- ASC Billing uses Current Procedural Terminology (CPT) and Healthcare Common Procedural Coding System (HCPCS) codes.
- Since ASC’s cover most of the hospital-based services but are billing on the physician billing claim form billing and coding for ASC services can be entirely different and versatile though the same guidelines and protocols are used.
- CMS and Medicare allow only certain surgical procedures can be done in ASC, which makes the billing and reimbursement from Insurance difficult with restrictions on OON coverage.
- It is mandatory that ASC provides services that have been diagnosed by Primary Care Physicians (PCP).
- Frequent release of upgrades in coding guidelines and billing regulations can add up to the complexities involved in billing and coding for ASC furthermore; which necessitates an experienced billing and coding team with knowledge on ASC claims processing
Sourcing and retaining highly experienced ASC billers and coders can be a pain point with the increasing attrition ratio and the staffing issues with the recent pandemic. Inadequate or inexperienced staff can affect the revenue cycle management and monthly collection. Offshore Outsourcing can mean you have an expertise team to rely on at times of hardship or uncertainty. Outsourcing ASC billing can be beneficial in many ways as listed below:
- Skillful handling of claims understanding the specialty-based and client-based nuances.
- Insightful approach with the insurance carriers knowing how to deal with claim rejections, denials and low payments ensuring to close the claim with maximum reimbursement.
- Uninterrupted service coverage unlike in in-house billing when staff absenteeism and attrition can take a toll on your billing process.
- Completely eliminates the overhead cost of hiring, recruiting, training, staffing, infrastructure, upgrading to advanced technological tools and adapting your team on them.
- Dedicated team and account managers to ensure smooth and stress less functioning of complete Revenue Cycle Management focusing on your bottom line.
About ecare
Ecare is one of the leading Medical Billing Companies providing complete Revenue Cycle Management Services for more than 2 decades. With more than 80+ clients across various states in US and being a multi-specialty billing company, ecare can provide dedicated and focused billing services to all our clients. ecare has experienced billers and coders who are well versed with ASC billing nuances. To know more about our ASC billing expertise call 1-813-666-0028 log on to www.ecareindia.com