Surgery Center Billing Services

Our certified inpatient coders (CIC) and professional billers (CPB) have a clear understanding of the surgical center billing guidelines and a proven track record in managing insurance claims. We help you with our end-to-end surgery center billing services covering areas like general surgery, pediatric surgery, cardiovascular surgery, plastic surgery, orthopedic surgery, obstetric and gynecological surgery, among others through the application of accurate codes for maximum revenue. Here is how we do the process for your practice:

• Integrate digital capabilities like electronic health records (EHR), electronic medical records (EMR), and electronic data interchange (EDI) into the existing surgery center billing technology ecosystem to digitize various facets of the billing tasks.
• Ensure that patient data (demographics information, procedure details, charges, dates of services, and insurance provider information) is collected for accurate and timely electronic claims submissions.
• Determine and address any pre-authorization needs from insurance payers to avoid last-minute billing confusion for the medical practice and patients.
• Adhere to regulatory requirements while handling various surgery center billing models (Fee-for-Service Billing, Value-Based Billing, Global Billing, Telemedicine Billing, and more) and using the right one for our client's needs.
• Implement stringent multi-tier quality checks to guarantee the accuracy of surgery center billing codes such as CPT codes, ICD-10-CM codes, HCPCS Level II Codes, revenue codes, anesthesia codes, and modifier codes.
• Align claims documentation with insurance payer-specific fee schedules and payment guidelines. We have expertise in dealing with payers such as government programs (Medicare or Medicaid), private health insurance companies such as Aetna and UnitedHealthcare, self-pay patients, workers' compensation insurance, etc.
• Analyze the explanation of benefits (EOB) to identify reimbursement discrepancies and support you through the appeals process.
• Assist in verifying details from EOB, including premiums, coverage periods, deductibles, and co-payments for subscribers, policyholders, and other beneficiaries.