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Why ASC Billing Has Been Popular for Outsourcing

Thomas John
Why ASC Billing Has Been Popular for Outsourcing

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.

Thomas John
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