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✔ 15 days free trial.
✔ Dedicated staff for every process of ASC for your account
✔ Monthly analytics to evaluate your trend on payments and fee trending.
✔ Immediate resolution of rejections and denials.
✔ 100% HIPAA compliant operations and processes
✔ Data Security
✔ Accelerated reimbursements
✔ Increase your revenue by 5-15% of your collections
✔ 15-20% of increase in your net revenue.
✔ Reduced overhead and increased profitability
✔ AR of below 40 days
✔ 97% of the claims get paid within 40 days.
Ambulatory Surgery Center coding and billing is complex. When it comes to billing of ASC, we may
need to understand that some payers use CMS 1500 form and some allow UB 04 form for
submission of the claims.
Medicare rules and regulations of ASC payments are different from that of the commercials. Many a times, Medicare includes the payment of the implants into the APC rate; this is because of the fact that the procedures are packaged when it comes to ASC payments.
Majority of the commercial payers follow Medicare guidelines and some do not, this makes the billing for ASC even more cumbersome than other specialities.
Rely On Us Healthcare services can partner with your ASC to ease the process of revenue cycle management by keeping current with the payer regulations and ensuring the fees are maximum at the allowable reimbursement.
Our Rely On Us Team will work with your ASC staff and share the best practices to maximize the reimbursement in a compliant way and minimize the denials.
Coding from Procedure headers: Many a times, the coders tend to abstract the information for coding from the procedure headers. It is very essential that the coders match the procedure headers with the actual procedure note that is documented in detail. Avoiding the detailed description and coding only from the headers is not advisable, as we can always see a lot of information regarding the correct usage of the modifiers, bundled procedures etc in the detailed description.
Appeals: When it comes to same day surgery, insurances may deny one or more services performed as per the coverage policy determinations. The practices would have to refer to the individual payor rules for appealing process. Use of correct forms and ensuring which information to be included to support the payment of the claim is very important.
Payments for implants: Taking an analytical approach for the payments of the implants is vital to determine the trends of the payment from the payers. If the payer includes the payment of the implants to the global APC rate, then we may need to ensure the payment of the APC covers the cost of the implant.
Patient responsibility: Collection of the patient responsibility may often be a problem with the ambulatory surgery centers. In most of the cases, the front desk personnel calls the patient and leaves a message and never gets to hear back from the patient. It is very essential to inform the patient ahead of time of the encounter and communicate the financial responsibility and possible payment plans prior to the surgery.
Orthopaedic Surgeries: Coders must ensure reading the operative report to determine the approach of the procedure performed. Surgeons may start a procedure via an arthroscopic approach and may eventually convert to open procedures. The detail of conversion of arthroscopic to an open approach is found only in the description of the procedure. There are at times, the physician may perform a procedure arthroscopic ally and another distinct procedure via an open approach, the coder would have to comprehend the report properly in order to assign the correct set of codes.
Staying ahead of the Rejections: Sometimes, a few claims are rejected by the clearing houses. If the practice does not review the rejections timely, the claims may sit on the clearing house for weeks together and would be frustrating to find out at the end that the claim never reached the payer. It is imperative that the billing department always reviews the rejections and fill out the necessary details in the claim and resubmit them on time.
Insurance Policies: Managed care policies are always different from that of the commercial insurance policies. Billing team will always need to keep in track of the billing policies. Policies keep changing and remembering all the policies for billing managed care claims may be overwhelming.
Rely On Us Coding and billing team is equipped with decades of experience in working with many ASC over the past years. Our dedicated team can help you proactively analyse your denials and take necessary measures to prevent them occurring for the future which would constantly reduce the AR days and thereby maximize your revenue flow.
Dedicated Account managers and staff to pay individual attention to each ASC account. Our proven strategies and processes in place help you eliminate the confusion and reduce your hassles of getting reimbursed.
We are very particular in defining the processes and operations from the transition phase to the implementation and assign dedicated workforce who are adept in pioneering and streamlining the process.
We proactively analyze the denials and take necessary measures to ensure that the denial rate is constantly reducing and thereby maximizing the revenue flow for a practice. Our proven analytics fetches information on data patterns and improvement strategies for a practice.
Communication and transparency from the start of the project is our strength which makes us standalone from our peers.