6 Critical Things to Know Ambulatory Surgery Center Billing & Coding Services

1. 6 Critical Things to Know Ambulatory Surgery Center Billing & Coding Services www.ecareindia.com

2. Introduction • Many Providers and healthcare organizations partner with experienced medical billing companies in the hopes that they would be offered ASC billing services as well. • However, most US medical billing companies lack the skill to process ambulatory surgical center billing. • ASC medical billing and coding are not like processing normal physician billing claims. It has so many differences and is quite complicated in terms of billing and coding. www.ecareindia.com

3. As there is room for huge claim denials, the in-house medical billing team cannot tackle both normal and ASC billing independently. • Therefore, partnering with an offshore vendor that is skilled in Ambulatory surgical center billing would be the best solution. • In this article, let’s learn about the 6 critical things about ASC billing and coding services and how offshore vendors help in tacking them: www.ecareindia.com

4. Facts about ASC Billing • In what way ASC medical billing and coding is different from normal physician billing? To know the answer, first, we have to understand how ambulatory surgical centers work. • According to Medicare, ASC is an independent organization that provides outpatient surgical services exclusively to its clients. • Sometimes, it can be run as a part of a huge healthcare facility and called as a ‘provider-based department of the hospital’. ASC do not provide office visits, laboratory services or run diagnostic tests www.ecareindia.com

5. New Trends • To be eligible for reimbursements, Medicare expects ASCs to sign up a participating-provider agreement with CMS. • To reduce huge patient bills, CMS is planning to make ASCs into ‘bed-less hospitals.’ This way, patients can get their surgeries done and discharged the same day. • They can recuperate at the comfort of their own homes by getting in touch with their Providers via phone. www.ecareindia.com

6. How is Ambulatory Surgical Center Billing Done? • Unlike normal physician billing, ambulatory surgical centers use a combination of both hospital and physician billing • Most of the ASC billing services are billed using CPT and HCPCS Level II codes. However, some insurance companies allow ASC services to be billed using ICD-9-CM codes • ASC claims should be filed using the CMS 1500 form as per Medicare guidelines • Medicare also requires the usage of CG modifier to distinguish between ASC bill and physician bill www.ecareindia.com

7. Approved Surgical Procedures According to CMS, only certain approved procedures can be done under an ASC setting. The list includes, • Non-emergency and life-threatening procedures • Procedures that cannot be done in a physician’s office safely • Elective procedures • Urgent procedures www.ecareindia.com

8. Best Practices to avoid Critical Errors • Some of the best practices to avoid critical errors in ambulatory surgical center billing are as follows, • It is always advisable to read the complete surgical report instead of just considering the procedure heading while coding • Sometimes, a procedure started arthroscopically might have been changed to an open procedure due to complications. It should be considered as an open procedure only during billing. Many coders mistakenly bill for both procedures, which is wrong www.ecareindia.com

9. About e-care India • For those companies who are on the lookout for an experienced ASC billing vendor, e-care India will be the prudent choice for medical billing services. • It has expertise in working for over 25 medical specialties and with more than 30 billing software, which most billing companies in other nations lack. • It has all the necessary security certifications including the SSAE 18, which is an added advantage. • To know more about e-care and its services, log on to www.ecareindia.com. www.ecareindia.com

10. Thanks! Any Queries? Call us: 1-813-666-0028 Email us: info@ecareindia.com Visit us: www.ecareindia.com