With patients bearing more financial responsibility for their healthcare, outpatient settings are becoming more appealing\u2014driving demand for optimized Ambulatory Surgical Center Collections. A research report from Bain & Co. estimates that procedures in these centers will increase from 23 million in 2018 to 27 million in 2021.<\/p>\r\n
As per the same report, out of all outpatient surgeries done in the year 2017, half were performed by ASCs. Now, as things are settling down after the coronavirus pandemic, these numbers are again looking realistic. Before getting prepared for this growth potential, you have to streamline your current ASC billing process. <\/span><\/p>\r\n In this blog, we discussed Ambulatory Surgical Center (ASC) billing challenges and ways to counter them. We are confident that these tips will help in improving your Ambulatory Surgical Center (ASC) collections.\u00a0<\/span><\/p>\r\n Prior to the date of surgery, always verify eligibility and benefits to understand coverage and determine the party responsible for payment. Always call the insurance company and as per your discussion with the insurance representative, if required, obtain prior authorization. Obtain pre-determination if prior authorization is not required. <\/span><\/p>\r\n An insurance company may not process the pre-determination request or try to take approval for pre-determination based on medical necessity. In the absence of prior authorization, an insurance company may not pay for offered services. Prior authorization is such a key element of ASC billing<\/a> that you should have a dedicated team for doing eligibility verification and prior authorization.\u00a0\u00a0<\/span><\/p>\r\n The best option in out-of-network billing is to call an insurance representative and ask specific questions about insurance coverage to determine the case\u2019s profitability. If the payer is UHC, ask if it is a maximum non-network reimbursement plan and if payment is based on the Medicare fee schedule. If the payer is Aetna, ask if payment is based upon reasonable and customary fees or the Medicare fee schedule<\/a>.\u00a0<\/span><\/p>\r\n Re-negotiate coverage with adjusters for any uncovered procedures and\/or implant(s) and also ensure that you will get commitments in writing. Creating a hybrid out-of-network and in-network strategy will help in improving your ambulatory surgical center collections.\u00a0<\/span><\/p>\r\n Always track the claims, and even after thirty days, if the claim is unpaid, then start taking follow-up and find the root cause. Understand how the claims were processed; they may be unpaid because everything was applied toward the patient’s out-of-network responsibility.<\/span><\/p>\r\n Ambulatory surgery center (ASC) administrators face a variety of challenges when it comes to successfully managing their payer contract negotiations. But with careful preparation, ASC administrators can keep more money to reward and boost ASC growth by negotiating payer contracts. <\/span><\/p>\r\n Tracking KPIs keeps surgery center staff accountable and motivated. If you are evaluating these KPIs on a daily, weekly, and monthly basis, it will definitely help in improving your Ambulatory Surgical Center (ASC) collections. <\/span><\/p>\r\n MedicalBillersandCoders (MBC) offers complete transparency and control of the ASC revenue cycle along with key analytics, actionable insights, recommendations, and proven strategies. Such offerings will maximize the ASC\u2019s efficiency, profitability, and physician disbursements. <\/span><\/p>\r\n To know more about Ambulatory Surgical Center (ASC) medical billing and coding services, contact us at info@medicalbillersandcoders.com<\/a>\/888-357-3226<\/a><\/span><\/p>\r\n Prior authorization ensures that insurance will cover the procedure, helping avoid denials or delays in payment for services rendered.<\/p>\r\n<\/div>\r\n Develop a hybrid strategy by negotiating coverage with insurers, ensuring you understand reimbursement rates, and getting commitments in writing for any uncovered procedures.<\/p>\r\n<\/div>\r\n Follow up promptly to investigate the root cause, as claims may be unpaid due to errors, lack of prior authorization, or issues with how they were processed.<\/p>\r\n<\/div>\r\n Track accounts receivable days, net collection percentage, bad debt, and clean claim rates to evaluate performance and identify areas for improvement.<\/p>\r\n<\/div>\r\n MBC provides comprehensive ASC billing services that include analytics, actionable insights, and strategies to enhance efficiency and maximize profitability.<\/p>\r\n<\/div>\r\n<\/div>\r\n","protected":false},"excerpt":{"rendered":" With patients bearing more financial responsibility for their healthcare, outpatient settings are becoming more appealing\u2014driving demand for optimized Ambulatory Surgical Center Collections. A research report from Bain & Co. estimates that procedures in these centers will increase from 23 million in 2018 to 27 million in 2021. As per the same report, out of all […]<\/p>\n","protected":false},"author":1,"featured_media":25655,"comment_status":"closed","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[662],"tags":[3625,782,3626,3624,3621,3623,3622],"class_list":["post-14156","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-ambulatory-surgical-centers","tag-ambulatory-surgical-center-asc-medical-billing-and-coding-services","tag-asc-billing","tag-asc-medical-billing-and-coding-services","tag-asc-revenue-cycle","tag-improving-asc-collections","tag-medicare-fee-schedule","tag-tips-for-asc-to-improve-the-patient-collections-process"],"yoast_head":"\nTips for Improving Ambulatory Surgical Center Collections Process<\/h2>\r\n
Always Take Prior-Authorization<\/span><\/h3>\r\n
Focus on Out-of-Network Billing<\/span><\/h3>\r\n
Track Unpaid Claims<\/span><\/h3>\r\n
Some of the common reasons for a claim to remain unpaid are as follows:\u00a0<\/span><\/h4>\r\n
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Poor Payer Contracting<\/span><\/h3>\r\n
Some payer contracting tips are as follows:\u00a0<\/span><\/h4>\r\n
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Track Key Performance Indicators<\/span><\/h3>\r\n
Managing the following KPIs regularly will lead to simplified goal-setting for staff:<\/span><\/h4>\r\n
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FAQs:<\/h2>\r\n\r\n