Ambulatory Surgical CentersRevenue Cycle Management (RCM)

ASC Medical Billing: Key Points to Note

ASC stands for Ambulatory Surgery Centers or Outpatient Surgical Center that is a healthcare facility where patients need not be admitted. The patient is simply taken in, treatment is provided and after-care procedures are levied; after which he can leave. ASC is perfect for minor injuries or treatments and is cost-effective, safe, and easy and is widely practiced in many countries. ASC billing procedures are also covered by Medicare; thus ensuring an outsourced medical billing company looks after the costs of the same.

Although ASC and ASC medical billing services has become very common these days and the entire process is simplified in terms of rendering treatment and billing. Also, there are some key points that come in handy and should be followed while undertaking any ASC treatments.

Listed below are some of the points to bear in mind during ASC and outsourced ASC medical billing:

The ASC facility service reimbursement rate comprises of the following:

The use of an ASC facility, operating and recovery rooms along with good preparation area, emergency equipment, and observation room, plus the use of a waiting room or lounge by the patients and relatives

Administrative services such as scheduling, record keeping, housekeeping, and related items as well as coordination for discharge, utilities, and rent

Services connected to the procedure and other related amenities provided by nurses, orderlies, technical staff and others involved in the patient’s care

ASC cannot be levied to patients under the following conditions:

 

  • If they are not emergent or life-threatening (for example, in case of a heart transplant or reattachment of a severed limb)
  • They cannot be performed safely in a physician’s office
  • They can be optional
  • They can be critical
  • Procedures that do not involve key blood vessels or result in major blood loss, and cannot involve extended invasion of a body cavity.

A great number of modifiers are used on ASC billing. These include the following:

  • Repeat procedure or service by the same physician
  • Repeat procedure by another physician
  • Unplanned return to the operating/procedure room for a related procedure on the same day
  • Unrelated procedure or service by the same physician on the same day
  • Bilateral procedure
  • Numerous procedures (not for Medicare)
  • Reduced services
  • Staged or related procedure or service by the same physician on the same day
  • Distinct procedural service
  • Discontinued outpatient procedure prior to administration of anesthesia
  • Discontinued outpatient procedure after administration of anesthesia

Services covered under ASC:

  • Ambulance Services
  • Artificial Legs, Arm, and Eyes
  • Implantable Durable Medical Equipment
  • Non-Implantable Durable Medical Equipment
  • Leg, Arm, Back, and Neck Braces
  • Physician’s Services
  • Prosthetic Devices
  • Independent Laboratory Services

Going ahead, it is also important to ensure that the outsourced medical billing services are taken care of in the right manner and at the right time. A good way to look at it is to ensure your billing processes are efficient and correct since ASC is much quicker than regular hospitalization and leaves you little time to make important decisions; making it necessary to get it right.

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