{"id":1546,"date":"2021-04-08T07:29:57","date_gmt":"2021-04-08T07:29:57","guid":{"rendered":"https:\/\/www.ecareindia.com\/blog\/?p=1546"},"modified":"2023-07-20T08:40:26","modified_gmt":"2023-07-20T08:40:26","slug":"common-billing-mistakes-drive-down-asc-revenue-cycle","status":"publish","type":"post","link":"https:\/\/www.ecareindia.com\/blog\/common-billing-mistakes-drive-down-asc-revenue-cycle\/","title":{"rendered":"Common Billing Mistakes That Drive Down ASC Revenue Cycle"},"content":{"rendered":"
<\/g:plusone><\/div>\n
\"ASC<\/a>
Common Billing Mistakes That Drive Down ASC Revenue Cycle<\/figcaption><\/figure><\/div>\n\n\n\n

Ambulatory Surgical Centers (ASC) have to abide by certain rules and regulations under CMS and Medicare to ensure they are reimbursed. ASC is not a separate specialty of medical services. ASC\u2019s provide services to various medical specialty-based procedures like minor surgery, Colonoscopy, Biopsy, Cataract surgery, Arthroscopy, Ambulance Services, Implantation of Durable Medical Equipment, Prosthetic Devices and some Physician Billing Services<\/a><\/strong> are performed in ASC. However, the services are billed on claim form CMS 1500. <\/p> <\/p>\n\n\n\n

This explains why ASC pay rates are mostly different from that of hospital billing or facility billing as the services or procedures done at an ASC is more extensive than the service performed at a physician\u2019s practice, at the same time it does not require a hospital stay. These differences make Billing for ASC<\/strong> more challenging and complex. <\/p>\n\n\n\n

Let us look in detail on the billing mistakes that drive\ndown ASC Revenue Cycle<\/strong><\/p>\n\n\n\n

Missing on Insurance Eligibility and Benefit Verification<\/strong><\/h2>\n\n\n\n

Verifying Insurance Eligibility<\/a> <\/strong>and Benefits prior to the services coverage is essential to determine the payment responsibilities, avoid unnecessary confusion and follow-ups post services. This will also help curb significant delays in reimbursement due to insufficient or incorrect claim information. <\/p>\n\n\n\n

Failure to obtain Prior Authorization and Referral<\/strong><\/h2>\n\n\n\n

Ensuring to receive appropriate Authorization and Referral numbers as and when required as per the policy should be part of the streamlined billing process to enhance the quality billing process<\/p>\n\n\n\n

Delayed Claim Submission<\/strong><\/h2>\n\n\n\n

The complexities involved in billing for ASC might result in delayed claim submission, however, it is essential to ensure the files are worked on and submitted within the Turnaround Time (TAT). This can be achieved by having a streamlined billing process along with a trained and experienced team assigned to handle ASC claims.<\/p>\n\n\n\n

Lack of Streamlined Billing Process<\/strong><\/h2>\n\n\n\n

ASC billing<\/strong> can be more challenging and complex than billing for other specialties, however, a streamlined billing approach with appropriate guidelines and process protocol can help avoid billing glitches and ensure smooth and faster billing. <\/p>\n\n\n\n

Neglecting Critical Information<\/strong><\/h2>\n\n\n\n

Understanding payer contract nuances, coding specific guidelines and abiding by CMS contract rules and regulations will help enhance your bottom line. In addition, ASC billers should also be updated with Managed Care Contracts payment methodology and carries based policies to ensure your process is intact at every point of Revenue Cycle Management<\/a><\/strong><\/p>\n\n\n\n

Ignoring Medicare payment guidelines for ASC Billing<\/strong><\/h2>\n\n\n\n

Medicare has listed some guidelines on payments for ASC billing services according to which ASC services is paid under Medicare part B and requires the claim to be submitted in Claim form CMS 1500 only. There are some commercial payors who also accept ASC claims in CMS 1500 while other insurances also allow the usage of UB04 claim form.  Below listed the Medicare ASC billing<\/strong> and claim submission guidelines.<\/p>\n\n\n\n

  1. ASC must not include separate line item or HCPCS Level II codes as separate bills for procedures, services, drugs, devices, DME, etc.<\/li>
  2. ASC will be paid for these but will be inclusive as a package in the allowed payment. For example: the allowance for surgical procedure itself will cover for all service, drug, device, post op pain management and other items. <\/li><\/ol>\n\n\n\n

    Outsourcing ASC Medical Billing<\/strong><\/h2>\n\n\n\n

    With all the above-mentioned complexities involved, Billing and Coding for Ambulatory Surgical Centers (ASC) needs a professional and streamlined approach to ensure maximized productivity. Outsourcing ASC Medical Billing to an offshore-based Medical Billing Company<\/a> with excellent client retention and expertise in handling different specialties can improve your overall financial health. <\/p>\n\n\n\n

    About e-care<\/strong><\/h3>\n\n\n\n

    ecare is one of the leading Medical Billing Companies<\/a> providing complete Revenue Cycle Management Services for more than 2 decades. With more than 100+ clients across various states in US and being a multi-specialty billing company, ecare can provide dedicated and focused billing services to all our clients. ecare has experienced billers and coders who are well versed with ASC billing nuances. To know more about our ASC billing expertise log on to Ambulatory surgical center (ASC) Billing Services | e-care India<\/a><\/p>\n\n\n\n\n

    <\/g:plusone><\/div>","protected":false},"excerpt":{"rendered":"
    <\/g:plusone><\/div>

    Ambulatory Surgical Centers (ASC) have to abide by certain rules and regulations under CMS and Medicare to ensure they are reimbursed. ASC is not a separate specialty of medical services. ASC\u2019s provide services to various medical specialty-based procedures like minor surgery, Colonoscopy, Biopsy, Cataract surgery, Arthroscopy, Ambulance Services, Implantation of Durable Medical Equipment, Prosthetic Devices … <\/p>\n

    Continue reading “Common Billing Mistakes That Drive Down ASC Revenue Cycle”<\/span><\/a><\/p>\n

    <\/p>\n

    <\/g:plusone><\/div>","protected":false},"author":3,"featured_media":0,"comment_status":"closed","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[158,33,31],"tags":[209,210,160,205,99,3,98,167],"class_list":["post-1546","post","type-post","status-publish","format-standard","hentry","category-ambulatory-surgical-centre-billing","category-healthcare-revenue-cycle-management-2","category-medical-billing-and-coding","tag-ambulatory-surgical-centers-billing","tag-ambulatory-surgical-centers-medical-billing","tag-asc-billing","tag-asc-billing-services","tag-medical-billing-companies-in-india","tag-medical-billing-services","tag-revenue-cycle-management","tag-revenue-cycle-management-solutions"],"yoast_head":"\nCommon Billing Mistakes That Drive Down ASC Revenue Cycle - ecare India Blog<\/title>\n<meta name=\"description\" content=\"Identifying current process and workflow weaknesses and improving clean claim percentage maximizes ASC efficiency and profitability.\" \/>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/www.ecareindia.com\/blog\/common-billing-mistakes-drive-down-asc-revenue-cycle\/\" \/>\n<meta name=\"twitter:card\" content=\"summary_large_image\" \/>\n<meta name=\"twitter:title\" content=\"Common Billing Mistakes That Drive Down ASC Revenue Cycle - 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