Ambulatory Surgical Center (ASC) Billing Services
Streamline the billing workflow, from coding to claim submission, and ensure compliance with the latest coding standards with Invensis's ASC billing services. Our experts handle payer follow-ups and appeals, using their expertise to expedite reimbursement and allow healthcare practices to concentrate on patient care.
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Streamline Outsourced Ambulatory Surgical Center Billing Services with Invensis
ASC billing is the specialized process of managing financial transactions and reimbursements for Ambulatory Surgery Centers (ASCs), including outpatient surgeries and procedures. Billing in these centers involves several key components: accurate coding and documentation of services, submission and management of insurance claims, and handling patient billing and collections. ASC billing also requires adherence to various regulatory and compliance standards to avoid penalties and ensure accurate financial reporting.
However, ASC service providers face billing challenges, such as maintaining coding accuracy, which can lead to claim denials or delays affecting revenue. Additionally, managing insurance claims is complex, involving numerous payer-specific requirements and frequent follow-ups to address denials and rejections. Compliance with evolving regulations adds another difficulty, as a failure to adhere to specified legal standards can lead to costly penalties. Furthermore, ASC providers often struggle with patient billing and collections, especially when dealing with high-deductible plans or uninsured patients, leading to revenue leakage.
Invensis, as a leading ASC billing service provider, streamlines and simplifies the complex billing process in the following ways:
- Collecting patient information, verifying insurance eligibility, and securing preauthorization for procedures to ensure coverage.
- Documenting all services and additional charges, including supplies and medications, during the patient's visit.
- Using appropriate CPT codes, ICD-10 codes, and modifiers to represent the services and diagnoses accurately.
- Entering all charges and coded information into the billing system, ensuring accuracy and completeness.
- Reviewing claims for errors using scrubbing software and addressing issues before submission to reduce claim denials.
- Submitting claims to insurance payers, including considerations for global periods, bundled payments, and confirming receipt.
- Tracking claims and resolving issues, including requests for additional information or documentation.
- Posting payments from payers and patients to accounts, adjusting for ASC payment adjustments as necessary.
- Analyzing and addressing claim denials, including those related to global periods and out-of-network billing, and filing appeals to recover revenue.
- Managing outstanding balances and following up on overdue accounts to improve surgery center payment collections.
- Generating and sending detailed patient bills, managing collections, and offering flexible payment options.
- Reviewing explanation of benefits to understand payment details and resolve discrepancies with patient billing.
- Producing reports, including ASC quality reporting and financial performance metrics, to guide decision-making.
- Ensuring compliance with healthcare regulations and conducting regular ASC billing audits to maintain billing accuracy.
- Reviewing and negotiating payer contracts to secure favorable terms and address issues related to out-of-network billing.
- Continuously assessing and enhancing ASC billing processes based on performance data and feedback to ensure efficiency and accuracy.
Our Comprehensive ASC Billing Services
- Insurance Verification and Eligibility Checks
- Pre-Authorization and Pre-Certification
- ASC CPT and ICD-10 coding and Documentation
- Charge Capture
- Claims Management
- Appeals and Denial Management for ASCs
- Payment Posting
- Account Reconciliation
- Patient Billing and Collections
- Patient Statements and Communication
- ASC Revenue Cycle Management Services
- Revenue Leakage Prevention
- ASC Accounts Receivable Management
- ASC Insurance Claims Management
- Contract Management
- Compliance and Regulatory Adherence
- Technology Integration
- Customizable ASC Billing and Coding Solutions
- Financial Reporting and Analytics
- Custom Reporting
- Benchmarking and Performance Metrics
- Audit Support
- Staff Training and Support
- Patient Financial Counselling
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Local Client Testimonials
During the consultation, some of the issues we can discuss are:
- Current ambulatory surgery center billing processes, challenges, and inefficiencies and their impact on your practice's revenue and overall operations.
- Proven strategies to manage claim denials, reduce rejection rates, and secure the highest possible reimbursements.
- Targeted measures to optimize your ASC billing KPIs and drive better financial performance and operational efficiency.
- Best ways to improve coding accuracy and ensure HIPAA compliance.
Invensis - The Most Trusted Ambulatory Surgical Center (ASC) Billing Company
For over 25 years, Invensis has established itself as a leading provider of ASC billing services, expertly serving various facilities, including single-specialty, multi-specialty, hospital-affiliated, and physician-owned ASCs. Our comprehensive billing solutions are supported by a team of highly skilled ASC billing professionals, including certified coders, certified billers, claims processors, collections specialists, and denial management experts. This team brings extensive expertise to ASC billing, ensuring accuracy and efficacy in the billing process. Their specialized knowledge helps our clients achieve a clean claims rate of approximately 98% and a reduction in accounts receivable (A/R) days by up to 45 days.
The benefits of outsourcing ambulatory surgical center billing services include:
1. Increased Revenue Cycle Efficiency: ASC billing processes handled internally result in inefficiencies and a lack of advanced tools, causing delays in claim processing and managing accounts receivable. These inefficiencies can also lead to increased administrative costs and longer days in accounts receivable.
Outsourcing ASC billing services employs advanced Revenue Cycle Management (RCM) systems to streamline claims and optimize the revenue cycle. This reduces delays, accelerates cash flow, and enhances overall billing efficiency.
2. Improved ASC Claim Submission Process: In-house billing teams in healthcare practices struggle with complex payer-specific requirements and submission errors, leading to increased claim rejections and denials. These errors can result in significant revenue loss and an administrative burden for reprocessing claims.
Outsourcing medical billing and coding services for ASCs ensures accurate and compliant claim submissions by leveraging expertise in payer requirements. This reduces rejections and speeds up reimbursement, enhancing the claims process's efficiency.
3. Expert Handling of Complex Billing Issues: The internal team finds managing complex ambulatory surgery center billing scenarios and payer disputes challenging, which can delay reimbursement and affect cash flow. This often requires extensive follow-ups and additional resources, further straining internal operations.
Outsourcing to an ASC medical billing company enables healthcare practices to manage complex issues such as payer follow-ups and appeals efficiently. This approach accelerates resolution times, enhances revenue collection, and boosts overall billing effectiveness.
4. Enhanced Data Security: Protecting sensitive patient and financial data can be difficult for internal teams to manage effectively. They fail to implement appropriate security measures, which increases the risk of data breaches and regulatory non-compliance.
Outsourcing ambulatory surgery center billing services ensures robust data security measures are implemented, safeguarding sensitive information and ensuring compliance with privacy regulations. Thus, the risk of data breaches is reduced, and data protection is enhanced.
5. Optimized Financial Performance: Internal billing operations lack the necessary focus and resources for optimal financial performance. This can lead to missed opportunities for revenue enhancement and inefficient use of financial resources.
Ambulatory surgery center ASC billing services utilize advanced analytics to monitor KPIs, including Days in Accounts Receivable (AR) and denial rates. This provides actionable insights to improve financial performance and ensure effective revenue management.
6. Expertise in Payer Relations: Managing relationships with various payers can be complex and time-consuming for in-house teams, often leading to reimbursement delays. This complexity can also lead to inconsistent payment rates and prolonged resolution times.
Outsourcing ASC billing services offers access to experts skilled in managing payer relationships. An ASC surgery center medical billing company utilizes its negotiation skills and knowledge of payer policies to expedite payments and resolve issues efficiently.
Here are the latest trends in ASC billing:
- Value-Based Care Transition: ASCs increasingly adopt value-based care models focusing on patient outcomes and cost efficiency. This trend requires billing practices to align with quality metrics and performance-based reimbursements, impacting coding and claims management to reflect value-based performance.
- Integrated Practice Management Systems: Integration of practice management systems with ASC billing software is on the rise. This trend facilitates seamless data exchange between patient records, billing, and revenue cycle management, improving accuracy and efficiency in handling claims and financial reporting.
- Patient Financial Assistance Programs: ASCs are expanding patient financial assistance programs to address rising out-of-pocket costs. This trend involves offering financial counseling, payment plans, and sliding scale fees to support patients in managing their healthcare expenses and improving collections.
- Outsourcing Growth: Many ASCs are turning to outsourcing for billing and revenue cycle management. This trend offers access to specialized expertise, advanced technology, and cost-effective solutions, allowing ASCs to focus on core operations while ambulatory surgery center billing specialists handle billing complexities.
- Real-Time Eligibility Verification: ASCs increasingly use real-time eligibility verification tools to confirm patients' insurance coverage instantly. This trend reduces claim denials and administrative delays by ensuring accurate verification before services are rendered and improving billing and collections accuracy.
- Advanced Denial Management: Enhanced denial management strategies are emerging. These strategies utilize analytics to identify the primary causes of claim denials and develop targeted solutions. This approach involves proactive monitoring, detailed root cause analysis, and systematic appeals processes to reduce the frequency and impact of claim denials.
What Our Customers Say
We have been working with Invensis for the past two years, and they have helped us overcome many revenue cycle management challenges. The team often walks the extra mile to ensure that our needs are met.
Invensis has been our revenue cycle management healthcare outsourcing partner for the past 5 years. They have always delivered on their commitments, whether it is meeting our Service Level Agreement (SLA) or improving our billing process.
Invensis has been a great partner providing quality medical coding and billing services. The team is extremely responsive to every query we pose, and the turn-around time for deliverables is always as committed.
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