Ambulatory Surgery Center Billing Service Providers

Ambulatory Surgery Centers or ASC as we all know are same day surgery centers or outpatient surgery centers and deals with patients whose surgery does not require him or her to stay overnight at the hospitals. These but obviously are surgeries that are not complicated and do not require the hospitalization of the patient. This results in a lot of cost saving for the party paying for the surgery of the patient. ASCs offer surgeries including pain management and surgeries like colonoscopy in a typical outpatient setting and services offered by these centers are often termed as procedures. These procedures of course are more intensive than what is done at a general clinic of doctors but less than the ones that require staying at the hospital.

Ambulatory Surgery Center Billing

How ambulatory surgery center billing is done? This is a common question that many people ask. The payment to ASCs is done on the basis of various rules and regulations as set under the Medicare program. These rules and regulations have been set by Medicaid and fall under contractual agreements made with health insurers.

There are certified medical coders whose work is to review the medical records of the patients and the assign proper codes as per the Healthcare Common Procedural Coding System. These codes describe the procedures performed so that the bill can be made according to it.

Trained and certified medical coders and billers are hired by ASCs and sometimes this is also outsourced to other medical billing companies as well. One needs to be trained and one need to acquire proper formal education to be in this field as dealing with medical codes is not easy. Many people opt for programs available online to get a job as a medical coder or a medical biller. They obviously have to be certified in order to get the job.

There are many medical billing companies that can handle ASC billing in the proper way. These medical coders and medical billers do not only understand the codes for various procedures but they also are required to have sound knowledge about the language in which contracts, legal statutes and regulations are written. A normal medical biller or coder would be able to deal with the codes of ASC and this required special training and education. Many physical practice management companies also offer these services. There are companies those properly train ASC staff so that they can handle codes and deal with the billing in a profitable way. Some of the services that these companies offered include:

• Reimbursement maximization: Many a times, ASCs are forced not take money as they do not understand how to deal with underpayments, denials etc. as caused by the insurance companies. These teach your staff to deal with such situations and overcome these obstacles.
• Third party negotiation: These companies also deal with discount brokers and negotiate on your behalf on claims that so that your ASC gets the maximum reimbursement levels it deserves.
• Under payment: These companies also handle cases when you are not paid the entire bill amount so that you get paid in full for the services you offered.
• Medical stalls / denials / appeals: These companies have highly trained professionals fight cases on your behalf until you get paid when insurance companies deny or stall a payment.

These companies also train your staff so that they work and adjust to a new setup or the changing environment of ASC. There are many such companies and it is important that you go for one that is experienced and has been in this field since the very inception of ASC.