Ambulatory billing is an essential component of any outpatient medical facility. It entails filing insurance claims and receiving reimbursements for procedures or services performed in the ASC or doctor’s office. Several procedures are involved in adequately submitting claims for ambulatory billing, so that the process can be confusing and time-consuming.

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ASC Reimbursement Guide: Simplified For
Ambulatory Surgical Centers
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2. Ambulatory billing is an essential component of any outpatient medical facility. It entails filing insurance
claims and receiving reimbursements for procedures or services performed in the ASC or doctor’s
office. Several procedures are involved in adequately submitting claims for ambulatory billing, so
that the process can be confusing and time-consuming. It is critical to ensure that all claims are
accurate and include all required information to avoid delays in receiving payment.
Knowledge of ambulatory billing processes is critical for the smooth operation of any outpatient
healthcare facility and to enhance reimbursements. The ambulatory billing procedure must be
simplified for ambulatory surgical centers by including the following steps:
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reimbursement-guide-simplified-for-ambulatory-surgical-centers/
HTTPS://WWW.247MEDICALBILLINGSERVICES.COM/
ASC Reimbursement Guide: Simplified For
Ambulatory Surgical Centers

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Ways to Enhance ASC Reimbursement
Create an Effective Insurance Verification Process
One of the first and most critical phases in your ASC reimbursement process is determining
whether a patient has active, legitimate insurance. If a patient receives services at your
center but does not have an active insurance plan, you may be unable to file a claim and may
not be reimbursed.
Having an insurance verification process mechanism in place at your ambulatory surgical center
might help you detect any inactive plans before a patient arrives for treatment. Consider
doing batch eligibility checks a week or two ahead of time and creating follow-up processes
for patients with no longer active plans.
ASC Reimbursement Guide: Simplified For
Ambulatory Surgical Centers

4. Inefficient Systems and Processes
Using inefficient procedures, such as manual tasks, paper, and different systems, not only
complicates operations but also results in laborious and error-prone billing and revenue cycle
management processes. In many circumstances, inefficiencies force DME providers to increase
staffing to match workload needs, which raises overhead and affects profitability. As a result, they
must devote more time and effort to back-office tasks rather than client service and strategic
development.
Inadequate Knowledge
Commercial and government payers make it challenging to bill DME-related claims. Due to varied
payer requirements like documentation, compliance, and EDI submission procedures, billing DME
claims can be complicated. How can healthcare providers keep their knowledge base up to date on
everything from prior authorizations to HCPCS and modifier combinations to state Medicaid
waivers? It’s hardly surprising that many claims contain errors.
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ASC Reimbursement Guide: Simplified For
Ambulatory Surgical Centers

5. Send Patient Estimates to Increase Upfront Collections
Another best method to improve payer reimbursement is to collect it before you begin the claim process.
This can be accomplished by sending payable estimates before the patient’s appointments. Patients are
more willing to pay a balance for services if they are aware of the charges ahead of time.
If you select a communication channel your patient likes, you can improve upfront collections. This
includes investigating solutions for SMS text and email statements and estimates. Reaching patients
where they are and improving the patient billing experience increases trust and incredible patient-
provider relationships. That means greater payments and revenue for your practice in the end.
Organize and Double-Check Payer Details
It is critical that your in-house team understands your payer contracts and processes – this is the
foundation of a successful claim and reimbursement process. You are unlikely to get paid for claims filed
if your payer information is disorganized or erroneous.
HTTPS://WWW.247MEDICALBILLINGSERVICES.COM/
ASC Reimbursement Guide: Simplified For
Ambulatory Surgical Centers

6. Here are some key payer details and measures to consider while enhancing
the ASC reimbursement process:
Ensure that your provider credentials are correct and up to date. You may be unable to file claims for
services provided by a new provider if you have not credentialed them at your center. You may also
be denied reimbursement if you submit claims for uncredentialed providers.
Don’t forget to verify your insurance (see above!) and make sure your team always sends claims to the
correct insurer. This also applies to patients who have secondary insurance — double-checking
which insurance is primary vs. secondary as it is crucial to avoiding claim rejections or denials.
Confirm whether your claim submission software is linked to the proper payers and payer IDs. Payers
who accept electronic claims have a five-digit ID number.
ASC Reimbursement Guide: Simplified For
Ambulatory Surgical Centers
HTTPS://WWW.247MEDICALBILLINGSERVICES.COM/

7. Make Claim Corrections and Submit Reconsiderations
When a payer declines one of your claims, it does not always imply the process is done, and you
have lost the refund. In other words, you are not always required to write off a denied claim.
Create a method for correcting claims and submitting reconsiderations rather than adding to your
write-offs. If you make the necessary changes and submit them together with detailed medical notes,
the payer may decide to reimburse your claim after all.
Along with your claim repair and reconsideration procedure, ensure that your team understands the
importance of collecting accurate evidence for each patient. This includes documentation of every
patient encounter, test, treatment, and procedure, as well as any pre-authorization or pre-
certifications required before treatment. This documentation can aid in reconsidering your claim and
raise the likelihood of full payment.
ASC Reimbursement Guide: Simplified For
Ambulatory Surgical Centers

8. Outsource Your Difficult ASC Collections
As a community service provider for many years, you may hesitate to consider outsourcing ASC billing
and reimbursement. However, keeping an open mind is vital, especially when the effectiveness of your
revenue cycle is at stake. Working with a third-party revenue cycle management services provider, such
as 24/7 Medical Billing Services, frees your team by delegating more difficult collections to
professionals.
They will use compassion and empathy to assist your patients in dealing with outstanding bills, such as
setting up a payment plan. Your in-house team will no longer bear the weight of disgruntled patients
who cannot pay their bills, and your cash flow should increase.
See also: Navigating The Path To Success In Medical Billing: Expert Insights For Physician Practices
ASC Reimbursement Guide: Simplified For
Ambulatory Surgical Centers
HTTPS://WWW.247MEDICALBILLINGSERVICES.COM/

9. About 24/7 Medical Billing Services:
We are a medical billing company that offers ‘24/7 Medical Billing Services’
and support physicians, hospitals, medical institutions and group practices
with our end to end medical billing solutions. We help you earn more
revenue with our quick and affordable services. Our customized Revenue
Cycle Management (RCM) solutions allow physicians to attract additional
revenue and reduce administrative burden or losses.
Contact:
24/7 Medical Billing Services
Tel: +1 888–502–0537
Email: info@247medicalbillingservices.com
HTTPS://WWW.247MEDICALBILLINGSERVICES.COM/
About 24/7 Medical Billing Services