Our experienced billers and Certified ASC Coders leverage advanced software to streamline key aspects of the ASC billing process. This enables us to streamline the workflow and minimize coding and billing errors for our clients. We offer ASC billing services to healthcare practices that offer same-day surgical care to patients, such as minor surgeries, gastroenterology, orthopedics, ophthalmology, pain management, ENT, and more. Here is how we help you:
- Integrate electronic health records (EHRs), electronic data interchange (EDI), electronic health records (EMRs), and Practice Management Software (PMS) into the existing billing network to facilitate highly efficient and accurate electronic claims processing.
- Standardize billing procedures to ensure all the necessary information (patient demographics, insurance provider information, effective data, expiration date, coverage details, etc.) collected is complete and accurate.
- Confirm pre-authorization requirements and secure approval from payers. This involves clarifying the extent of ASC service reimbursement that insurance payers are willing to do.
- Maintain code and insurance payer guidelines specificity while executing various billing models for ASC services, including fee-for-service billing, value-based billing, episode-of-care billing, anesthesia billing, pharmacy and medication billing, and diagnostic services billing, among many others.
- Align our billing practices with updated codebooks, which include ICD-10, CPT, and HCPCS Level II coding, code modifiers, and revenue codes.
- Promptly submit claims to the appropriate payers, such as government programs, commercial or private insurance (Aetna, Humana, Anthem Blue Cross Blue Shield), Third-Party Administrators (TPAs), Veterans Affairs (VA), Self-Pay Patients, and Secondary Payers.
- Review claims by analyzing Explanation of Benefits (EOBs), identifying reasons for denials, resolving disputes, and initiating appeals.
- Analyze EOBs to clarify premiums, coverage periods, deductibles, and co-pays for subscribers, policyholders, and beneficiaries.