Know about ASC Billing Challenges

The ambulatory surgical center (ASC) market has seen rapid growth in the last few years. Increasing health costs along with insurance limitations are turning more people towards the outpatient setting when it comes to quality surgery at an affordable cost. Outsourcing ASC medical billing can help you address your financial concerns and also increase your profit rates. However, as per the recent reports, the ASCs are constantly facing many challenges when it comes to improving their revenue generation.

Cancellations

One of the major causes of concern has been the cancellations. High costs of elective surgeries often keep the patients away from rescheduling if a surgery gets canceled. Same-day cancellations of the scheduled surgeries can often negatively impact your finances since you wouldn’t be able to fill the open OR with another surgery. But that doesn’t stop the labor and the overhead costs for your practice.

ASCs must identify the cancellation causes and take the necessary steps to handle the problem. Constant tracking of the patient’s medical status and open communication with the patient can often cut down cancellations. Or you can offer patient financing options too. Providing a secured loan to the patients for covering their surgical costs can often reduce the cancellations and decrease the AR. Needless to mention that it can also help in the growth of the surgical volume along with a better cash flow.

Surprise billing

Patients often receive additional bills from the out of the network providers even after complete repayment of the copays and the deductibles. Surprise billing is a common problem nationally, and many states have laws to handle such incidents. ASCs must also be careful about these laws or risk losing their patients. Here are some steps that you can take to protect your patients from surprise billing:

  • Check that the pathologists, anesthesiologists, and lab professionals, are in-network.
  • If these specialists are not available within the network, make sure to inform the patients about the same. These will add on with their bills, and the patients must be aware of the same.

Managing and keeping up with the payer contracts

ASCs often face challenges with managing the payer contracts, which often change. Payers have their own set of rules and conditions with the care plans and the local coverage determinations, bundled payments, and preventive care. Tips for handling such payers include:

  • Consider combining the direct commercial payer agreements with the primary and the secondary, complementary payer agreements.
  • Breakthrough the closed networks by informing the payers about having a surgical center in their network. Highlight the unique services that you offer, along with the geographical advantages and the clinical benefits.
  • Focus on the language of the contracts
  • Periodically review the contracts to keep track of the changes and the expiry dates.
  • Understand and learn about the payer’s rules and conditions.

Keep track of the coding changes

Keep constant track of the changes in CPT codes and the ICD-10 codes. ASCs must be aware of yearly updates and changes and implement them. ICD-10 codes are usually updated every October. ASCs must update their software with these new codes. Partnering with an experienced ASC medical coding company can take the burden off your shoulders. The medical coding companies ensure error-free claim submission and offer optimal reimbursements.

Conclusion

You can expect comprehensive support from the medical coding companies if you outsource ASC billing tasks to 24/7 Medical Billing Services. We can process claims faster and reduce the AR days. We have trained billers and coders who are specialists in claim submissions. We will review the accounts, identify issues with the claims, and get them rectified as soon as possible. Our team will also review the denials and file the appeals. Experienced billing and coding companies like us also offer business intelligence reports and performance-driven analytics to better understand your practice position. With the ever-changing healthcare practices and higher patient deductibles, it is wise to seek external support experts for ASCs medical billing and coding for overall improvement in revenue collections.

Read More : Why Outsourcing Ambulatory Surgical Center (ASC) Billing Works

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