Challenges of Ambulatory Surgical Centre Billing
Ambulatory Surgical Centre billing and coding are completely different from the rest of medical specialties or the usual physician billing or even facility billing as they majorly are a combination of hospital and physician medical billing. Plus Ambulatory Surgical Centre billing involves specialties like orthopedics, pain management, bariatric surgery, podiatry, ophthalmology, obstetrics, gynecology, endoscopy, and dental.
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 out-of-network coverage. Frequent release of upgrades in coding guidelines and billing regulations can add up to the complexities involved in billing and coding for ASC. Sourcing and retaining highly experienced ASC billers and coders can be a pain point and outsourcing Ambulatory Surgical Centre billing could be the only solution.
Benefits of Outsourcing Ambulatory Surgical Centre Billing
Outsourcing ASC billing offers a lot of benefits over in-house billing, some of which are listed below:
Inadequate or inexperienced staff can affect the revenue cycle management and monthly collection. Offshore Outsourcing can mean you have an expert team to rely on at times of hardship or uncertainty. Outsourcing ASC billing can be beneficial in many ways as listed below:
1. Adhering to Billing Compliances
A medical billing company provides in-depth guidance on how to bill accurately during in-network and out-of-network (OON) billing. Ambulatory Surgical Centres (ASC) are legally responsible for keeping up-to-date with all billing and coding guidelines and reimbursement policies.
Billing errors can happen for various reasons, from miscommunication to administrative errors, but when they are chronically made, red flags get thrown to insurance carriers. Over time, these errors could leave you open to external payer audits and penalties. Medical billing companies stay up to date with these continuous changes that happen without notice.
2. Realize Uncollected Revenue
Poor claims management plays a negative role in uncollected revenue. Due to fear of external payer audits, in-house coders might downcode certain procedures. Coding experts from medical billing companies are well-versed with reimbursement policies for various insurance carriers in your geographical area.
This clearly helps in sighting additional revenue collection opportunities for delivered services. Outsourcing Ambulatory Surgical Centre (ASC) billing also reduces time gaps to make necessary changes and respond to medical claim appeals that are needed to recoup reimbursements.
3. Collect 100% Billed Charges
Medical billing company offers to streamline billing and coding operations which ensures 100 percent collection of billed charges. As the in-house billing team might be burdened with other administrative tasks, it might delay claim submission or appealing process.
An outsourced medical billing company takes follow-up on every single submitted claim. It will help ASC not only to receive quick reimbursements but also helps to track denied claims. Medical billing companies will review ERAs/EOBs for every single submitted claim and will take necessary action like posting the payments or appealing a denied claim.
4. Receive Reimbursement for OON Billing
It’s natural that insurance carriers provide the lowest reimbursement amounts for out-of-network (OON) services in multiple ways, sometimes unknowingly to the provider. This can happen because a patient’s policy has limited benefits, drastically lower rate agreements, or a specific bill reduction issue due to a previous clause.
A medical billing company can work with ASC directly to create a strategy to increase its revenue from OON. Medical billing companies can identify which insurance providers potentially have been underpaying for services and send out appeals to recoup OON reimbursements. Medical billing companies can work with ASC facilities to develop best practices to collect maximum from OON billing.
5. Its Cost Efficient
Outsourcing Ambulatory Surgical Centre (ASC) billing could seem expensive at first glance, but the reality is quite different. As a matter of fact, the billing fees charged by the medical billing company are a fixed percentage of monthly collections of the ASC facility. It’s obvious that experts from medical billing companies will work towards every rightful opportunity to collect reimbursements.
Your in-house billing team comes with lots of operational costs like hiring and retaining employees, employment insurance, training charges, hardware & software charges, and many other day-to-day operational charges. Together, these costs usually exceed the total amount that can be paid for billing outsourcing.
There is no doubt that outsourcing Ambulatory Surgical Centre (ASC) billing offers lots of benefits over in-house billing. With medical billing assistance, you can focus more on quality patient care and can expand quickly if provided the opportunity. Medical Billers and Coders (MBC) is a leading medical billing company providing complete medical billing and coding services.
Our industry-leading ASC billing services ensure accurate insurance reimbursement collection so that you can focus on delivering quality patient care. To know more about our Ambulatory Surgical Centre (ASC) billing services, contact us at 888-357-3226 or drop an email at: info@medicalbillersandcoders.com.
FAQs
1. What makes ASC billing different from other medical billing?
ASC billing combines hospital and physician billing for various specialties, including orthopedics, ophthalmology, and bariatrics, making it more complex.
2. How does outsourcing ASC billing help with compliance?
Outsourcing ensures that ASC billing adheres to ever-changing coding and reimbursement regulations, reducing the risk of errors and audits.
3. Can outsourcing ASC billing help recover lost revenue?
Yes, outsourcing billing can identify missed revenue opportunities and help recover funds by effectively managing claim appeals and denials.
4. How does outsourcing ensure 100% collection of billed charges?
A dedicated billing team follows up on all claims, submits necessary appeals, and tracks payments to ensure no charges go uncollected.
5. Is outsourcing ASC billing cost-effective?
Although outsourcing may seem costly initially, it often reduces operational costs and increases revenue collection, making it more cost-efficient than in-house billing.
