ASCs vs HOPDs – Understanding Payment Difference

ASCs vs HOPDs: When performing outpatient procedures, many orthopedic surgeons operate in ASCs or hospital-based outpatient departments (HOPDs). Although some of the workflows and services offered may appear similar between the two, the background operations are substantially different from a business and regulatory perspective. An HOPD is owned by and typically attached to a hospital, […]

Deciphering 2021 CPT Code Changes for ASC

The American Medical Association (AMA) announced the release of the 2021 Current Procedural Terminology (CPT®) code set containing identifiers and descriptors assigned to each medical, surgical, and diagnostic service available to patients. Trusted since 1966 as the health system’s common language, the CPT code set enables accurate reporting, measurement, analysis, and benchmarking of medical services […]

Basics of Medicare Payment for Ambulatory Surgical Services (ASCs)

Medicare covers surgical procedures provided in freestanding or hospital-operated ambulatory surgical services centers (ASCs). In January 2008, Medicare began paying for facility services provided in ASCs— such as nursing, recovery care, anesthetics, drugs, and other supplies—using a new payment system that is primarily linked to the hospital outpatient prospective payment system (OPPS). (Medicare pays for […]

Ambulatory Surgical Center Terminated Procedures

Ambulatory Surgical Center Terminated Procedures The following guidance determines the appropriate ambulatory surgical center (ASC) facility payment for a scheduled surgical procedure that is terminated due to medical complications, which increase the surgical risk to the patient. Payment is denied when an ASC submits a claim for a procedure that is terminated before the patient […]

Understand Payment Rates and Basics of ASC Billing

Basics of ASC Billing The Basics of ASC billing encompass the financial processes associated with Ambulatory Surgical Centers (ASCs). CMS defines an Ambulatory Surgical Center (ASC) as a facility that provides outpatient surgical services to patients. ASC is a facility that, very simply, specializes in outpatient procedures. Procedures at an ASC are more extensive than […]

Prominent Ambulatory Surgery Center Medical Billing Functions are Affecting Your Practice Revenue

Compliance guidelines that govern the Ambulatory Surgery Center’s reimbursement are wide-ranging, complex, and ever-changing. Hence, it’s important for ASCs to hire or partner with Ambulatory Surgery Center medical billing and coding management consultants who understand the legal rules placed on ASCs, including specialized coding, accreditation, documentation, and reimbursement care contracts. Here are Prominent Ambulatory Surgery […]

How Your AR Determines Your Ambulatory Surgery Center’s Financial Future

How-to-get-paid-faster-in-ASCs-and-reduce-days-in-AR

AR is the average number of days it takes practice to collect payments due. This metric provides valuable insight into the overall efficiency of your revenue cycle. A lower AR implies faster payment—a necessity in today’s self-pay and high-deductible health plan environment. Physicians need to collect every dollar that’s due to them as quickly as […]

ASC Coding And Billing: Knowing What’s Important

The basics of ASC Coding And Billing aren’t hard to master, but they do differ from physician and facility requirements. The following overview will help you know what’s most important in the ASC setting. ASCs use a combination of hospital and physician billing. Although ASCs use CPT and HCPCS Level II codes to bill most of […]

CMS-Proposed Rule: Changes to the Ambulatory Surgical Center Payment

The Center for Medicare and Medicaid Services (CMS) proposed a new rule that will update the payment policies and rates. The update will specifically cater to Hospital Outpatient and Ambulatory Surgical Centers (ASC). The rules will set forth a motion to promote efficient service and promote higher quality service for all the Medicare beneficiaries. The […]

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