Outsourcing ASC billing
services streamline the complexities and challenges involved, resulting in a
higher ROI. Outsourcing can qualify medical billing enterprises in the United
States for more benefits and profitability. In charting out the claim and
processing it with the insurance payor, ambulatory surgical centres have more
requirements and speciality-based complexities, making it difficult and
time-consuming to manage internally. To appreciate why outsourcing has become
the newest fashion in ASC specifically, let's try to comprehend the
difficulties associated with billing for ASC.
Challenges in ASC Billing
Services
·
ASC billing uses codes from the Healthcare
Common Procedural Coding System (HCPCS) and Current Procedural Terminology
(CPT).
·
Although the same principles and protocols are
followed, billing and coding for ASC billing
services can be completely different and flexible because ASCs cover most
hospital-based treatments yet are billed on the physician billing claim form.
·
CMS and Medicare only permit a limited number
of surgical procedures to be performed at an ASC, which makes insurance billing
and reimbursement challenges due to limitations on OON coverage.
·
ASC must deliver services based on diagnoses
made by primary care physicians (PCP).
·
The frequent release of updates in coding rules
and billing regulations can further complicate billing and coding for ASC,
necessitating an expert billing and coding team with knowledge of ASC claims to
process.
Why ASCs outsource their
billing?
Ambulatory surgery centres opt
to outsource their revenue
cycle management to a separate contracted business for a variety of
reasons. The following are the top three reasons:
1.
Constantly evolving security and compliance
concerns.
To
minimise non-compliance, the ASC's business office must keep up with changes in
Medicare, Medicaid, OIG, HIPAA, and various state laws. Government rules are
growing in number and complexity. Experienced revenue cycle management firms
may lessen this strain and guarantee that billing, collections, and coding are
performed in line with current laws.
2.
Average accounts receivable exceed industry
standards.
Maintaining
an acceptable number of days in accounts receivable necessitates continual
attention to, and enforcement of, third-party payer responsibilities. Most
business offices have just one employee for ASC billing and coding who is
responsible for collecting payer and patient balances. This is likely to lead
to flaws when you consider that thorough collection processes necessitate:
·
Monitoring changes in third-party payers
continuously.
·
Evaluating payments in relation to contractual allowances.
·
Prompt follow-up on erroneous payments.
·
Follow-up on unpaid invoices.
·
Follow-up on claims that were submitted
erroneously.
·
Inquiries for more information.
·
Identifying patient accountability.
·
Submitting patient statements.
·
Checking on unpaid patient balances.
·
A refund.
·
Writing off.
·
Modifications; and
·
Collection agency judgments.
Days in accounts receivable
frequently continue to rise as a result of all of these duties, in addition to
telephone answering and filling other office roles.
A team of ASC-experienced
employees with the sole duty of effortlessly delivering these collection
services and maintaining your accounts receivable at or below industry
standards are provided by qualified revenue cycle management businesses.
3.
Decreased Revenue
Any or
all the factors mentioned in reason #2 above may lead to uneven cash flow,
which restricts the ASC's capacity to fulfil regular financial obligations like
the following:
·
Payments for rent/lease
·
Salaries and benefits
·
Supplies
·
Utilities
·
Other overhead costs
Wrapping Up
One of the most effective
methods to improve patient satisfaction and the efficiency of your ASC is to
outsource your medical billing and coding. You will constantly be aware of the
financial state of your company thanks to access to analytical reports and AR
data. This enables you to make wise plans to raise the standard of patient
care, expand the ASC, and increase profitability. You'll be able to optimise
earnings with an ASC that runs smoothly and frees you up to concentrate on what
you do best while also improving your health, happiness, and level of stress.
About Plutus Health
As a top provider of ASC
billing services, we rely on knowledgeable and skilled ASC billers to deliver
state-of-the-art ASC medical
billing services. We use cutting-edge software to automate some steps in
the billing process. We can streamline processes and reduce coding errors as a
result. As a result, we promise to pay our clients' ASC bills in full.
Find out more about how
outsourcing your billing might help you earn more money and worry less.
Schedule a consultation right now.