ASC Billing Services

ASC BillingThe ClaimCare Medical Billing Company has significant experience and expertise in ASC billing that can generate a major increase in collections for your facility. Medical billers and medical billing services are the financial backbone of a medical facility. Facilities that do not have the right medical billing expertise in their corner can easily lose more than 20 percent of their potential revenue.

Medical billing outsourcing is a growing trend that medical practices and facilities are employing to level the playing field with insurance companies. Potential outsourcing options start with individual medical billers working from their home to medical billing companies with thousands of clients.

Medical billing is a highly complex area and it requires experience-based knowledge and expertise to contend with insurance companies. When it comes to ASC billing, the situation gets even more complex. Such complexity can be handled only by a company that is staffed with well trained ASC billing professionals. The medical billing specialist must be familiar with the specific codes and rules that make up the world of ASC billing.

As the cost of providing ASC related healthcare services continues to rise, medical facilities cannot afford to leave revenue uncollected by billing companies or freelancers that are not knowledgeable in ASC billing. It is also important to keep in mind some billing companies may promote themselves as large ASC billing service providers but in reality they sub-contract the ASC billing to freelancers who work from home. Hiring such companies will lead to lost revenue because of the lack of proper process, controls, and training.

Deep familiarity and comfort with ASC procedures and terminology does not come from serving one or two facilities. ASC billing success requires both broad and deep expertise in order to collect all of the money owed the facility and successfully appeal claims which have been denied or answer questions the payers may have about a claim.

A typical shortcoming with medical billing services that do not specialize in ASC billing is the inability to properly track and pursue insurance underpayments. These underpayments cost most facilities about 10% of their potential income. If a medical billing company does not understand the multi procedure rules and have a system that can track underpayments (and does not flag every payment on a second procedure as underpaid), they will find it difficult to capture this lost revenue is a systematic manner.

Inexperienced billing companies also do not typically understand the proper way to bill for (or track underpayments for) implants. Improper billing of implants can lead to significant revenue loss for a facility.

Another issue, especially for new ASCs that are not fully contracted, is billing out-of-network. Medical billing companies that do not have a deep familiarity with how to bill out-of-network can cost a facility hundreds of thousands of dollars. Your medical billing service needs to experienced with how to negotiate the out-of-network payments, what level of payments they should be able to achieve, and how to deal with patients that receive an out-of-network payment directly from the payer

It is not only insurance billing that is more complicated for ASCs (especially if they are out-of-network); patient billing is also more difficult. The patients often have high balances, complicated explanations from their payers and do not understand all of the invoices they are receiving from the facility. A billing company that has strong ASC billing experience has spoken with patient about such statements many times before. A less skilled patient collection effort could leave the ASC with less money and unhappy patients.

The bottom-line: It is not worth the risk for a facility to use a billing company that does not focus on ASC billing.

To learn more about how ClaimCare Medical Billing Services can help your ASC please fill out the form to the left or contact a local ClaimCare office.