Ambulatory Surgical Centers (ASC)

Ambulatory Surgical Centers (ASC’s) are some of the fastest growing medical services today. ASC reimbursements are comprehensive, complex and ever-changing. According to the Medicare Carriers Manual, ASC’s are defined as a separate and distinct institutions, with the sole purpose of providing outpatient surgical treatment and services.

ASC’s use a combination of physician and hospital/clinical billing, employing the CPT and HCPCS level codes (alike most physicians), and some insurance carriers permit an ASC to bill using ICD-10 procedure codes.

Medicare currently requires that ALL ASC charges to be filed electronically, using the CMS-1500 form. Medicare also requires the use of the modifier SG when submitting charges to indicate that services were performed from an ASC.

Most ambulatory surgery centers lose additional revenue of 10-30 percent because they do not have the time or the required expertise to renegotiate contracts with insurance payers.

Here at Medorizon, we understand the legal regulations placed on ASC’s, including the specialized required coding, accreditation, documentation, and negotiated ASC provider insurance and managed care contracts needed for maximum reimbursement.

Medorizon has a billing Policy & Procedure Manual, which addresses regulatory compliance implications such as credit balances, coding, problem resolution, system integrity, and appeals. Additionally, this manual documents the entire revenue cycle and is reviewed annually. The financial policies of Medorizon address the process for following up on claims, correspondence, appeals, write offs, bad debt, and self-pay collections.

What we can bring to the table:

  • Evaluate and manage ASC workflow
  • Certified medical coders and billers that specialize in ASC’s distinct set of coding and reimbursement guidelines
  • Professional ASC coding services
  • Increase efficiency
  • Improve Cash Flow
  • Personal Injury expertise
  • Workers Comp billing
  • Court Appearances
  • Contracting
  • Compliance

At Medorizon, our billing specialists can manage all aspects of your ASC’s billing and revenue cycle management. We will work in conjunction with your facility to ensure you receive the appropriate reimbursement.

We take pride in keeping up to date with the latest CMS Medicare, Medicaid billing and documentation requirements, certifications and regulations. We make sure that each claim is tracked from start to finish by our trained and certified staff members. We have dedicated ASC staff members to follow up with payers and patients.

Our internal processes are laid out to expedite collections and ensure follow through for each and every claim. Out practice management consultants are highly trained and specialized to maximize ASC revenues all while maintaining accuracy and HIPPA compliancy.