5 Common Errors With ASC Billing

1. In the last few years, Ambulatory Surgical Centres (ASC) has become one of the fastest-growing medical services. However, the ASC billing and coding is different from the physician, surgeon, or hospital billing. Hence, the billing department of an ASC facility has to be aware of the various guidelines that Medicare often uses compared to the other payers. Furthermore, different payers differ regarding the approved procedures, medical necessity, and other requirements for filling out the forms for reimbursement. The lack of awareness of all these and the regular updates published by CMS every quarter on the lists of surgical procedures covered, the ancillary services covered for establishing payment indicators, and payment rates can be challenging for ASC billing. Added to this, the newly created Category III CPT codes and Level II HCPCS make the billing and coding process difficult, resulting in some common billing errors. 5 Common Errors With ASC Billing HTTPS://WWW.247MEDICALBILLINGSERVICES.COM/

2. 5 Common Errors With ASC Billing HTTPS://WWW.247MEDICALBILLINGSERVICES.COM/

3. The biller of your facility must understand in detail and have a copy of all the managed care contracts. The knowledge of the contract must include: • The time you will get for submitting the claim • How long the payer will take to review the claim and make the payment • What is the methodology of payment? • When and why a payer can reduce the payment and reduce multiple procedures • How to appeal the claim that has been denied or rejected. • The knowledge of all these and post payments and follow-up can improve your revenue cycle management. For instance, when you know the managed care contract in detail, you can avoid taking an implant case that would charge $3,000 when the carrier won't reimburse the implant more than $2,000. 1. Lack of Understanding of the Managed Care Contract HTTPS://WWW.247MEDICALBILLINGSERVICES.COM/

4. Even when you have all the proper paperwork, you need to know the Skilled Nursing Facility (SNF). Medicare will refuse to reimburse for any ASC services conducted within the SNF. The patient will not get any reimbursement for treatment in such a case, so be aware of the SNFs in the area before you take the patient in. 3. Getting Appropriate Authorization & Verification Before conducting a procedure, you need to understand the coverage a patient receives and determine the party's responsibility. Part of it also includes verifying the edibility of the claim and the address of the claim. Failure to get the verification and the appropriate authorization often results in reimbursement delays. Hence, all the paperwork must be done before undertaking the correct procedures and ensuring whether costly implants are covered. 2. Medicare and the SNF Condition HTTPS://WWW.247MEDICALBILLINGSERVICES.COM/

5. Like any other healthcare service provider, ASC also depends on standardized codes set by Medicare and CPA to get paid. However, several non-HIPAA carriers will not pay you when Medicare standardized codes are used. Therefore, you need to know the codes of these small carriers exempt from HIPAA so your reimbursement is not rejected. 5. Coding Errors One of the top five reasons ASC claims get rejected is wrong coding and the failure to put the correct codes in order. When you put codes in the bill, always ensure to place the highest reimbursement code and then gradually lower it. If there is any cut on the second or following code reimbursement, you would like to get it for a lower reimbursement amount than the higher one. For instance, if there are two codes in the bill, one for $1,000 and another for $500, where the second procedure will get paid half in the list, you would want the cut on $500 instead of $1,000. 4. Non-HIPAA Carriers HTTPS://WWW.247MEDICALBILLINGSERVICES.COM/

6. Undoubtedly, there are many ASC who have dedicated billing departments and staff. But the complicated billing procedures with the ever-changing codes and regulations put a question mark on their revenue. In such a case, the best way to beat these errors and any pitfalls in ASC billing is by partnering with the experts of 24/7 Medical Billing Services. This outsourced Ambulatory Surgical Centres billing company has a specialized and dedicated ASC billing staff who can help overcome these errors and put the best revenue management cycle in place for improving the practice's outcome. How to Deal with these Errors? HTTPS://WWW.247MEDICALBILLINGSERVICES.COM/

7. We are a medical billing company that offers ‘24/7 Medical Billing Services’ and support physicians, hospitals, medical institutions and group practices with our end to end medical billing solutions. We help you earn more revenue with our quick and affordable services. Our customized Revenue Cycle Management (RCM) solutions allow physicians to attract additional revenue and reduce administrative burden or losses. About Us HTTPS://WWW.247MEDICALBILLINGSERVICES.COM/

8. Media Contact: 24/7 Medical Billing Services Georgia 3001 Greenfield Drive, Marietta GA Ohio 28405 Osborn Road, Cleveland, OH 4414030068 Texas 2028 E Ben White Blvd, #240-1030 Austin TX, 78741 Delaware 16192 Coastal Highway, Lewes, Delaware 19958, United States Phone no / Fax : +1 888-502-0537 Email us: info@247medicalbillingservices.com Contact Us HTTPS://WWW.247MEDICALBILLINGSERVICES.COM/