Read the blog and know about the five common billing errors to ensure you do not lose out on revenue in your ASC services.

1. 5 Common Errors With ASC Billing
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In the last few years, Ambulatory Surgical Centres (ASC) has become
one of the fastest-growing medical services. However, the ASC billing
and coding is different from the physician, surgeon, or hospital billing.
Hence, the billing department of an ASC facility has to be aware of the
various guidelines that Medicare often uses compared to the other
payers. Furthermore, different payers differ regarding the approved
procedures, medical necessity, and other requirements for filling out the
forms for reimbursement.
The lack of awareness of all these and the regular updates published by
CMS every quarter on the lists of surgical procedures covered, the
ancillary services covered for establishing payment indicators, and
payment rates can be challenging for ASC billing. Added to this, the
newly created Category III CPT codes and Level II HCPCS make the
billing and coding process difficult, resulting in some common billing
errors.

2. 5 Common Errors With ASC Billing
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3. 1. Lack of Understanding of the Managed
Care Contract
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The biller of your facility must understand in detail and have a copy of all
the managed care contracts. The knowledge of the contract must
include:
• The time you will get for submitting the claim
• How long the payer will take to review the claim and make the
payment
• What is the methodology of payment?
• When and why a payer can reduce the payment and reduce multiple
procedures
How to appeal the claim that has been denied or rejected.
The knowledge of all these and post payments and follow-up can
improve your revenue cycle management. For instance, when you know
the managed care contract in detail, you can avoid taking an implant
case that would charge $3,000 when the carrier won't reimburse the
implant more than $2,000.

4. 2. Medicare and the SNF Condition
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Even when you have all the proper paperwork, you need to know the
Skilled Nursing Facility (SNF). Medicare will refuse to reimburse for any
ASC services conducted within the SNF. The patient will not get any
reimbursement for treatment in such a case, so be aware of the SNFs in
the area before you take the patient in.
3. Getting Appropriate Authorization &
Verification
Before conducting a procedure, you need to understand the coverage a
patient receives and determine the party's responsibility. Part of it also
includes verifying the edibility of the claim and the address of the claim.
Failure to get the verification and the appropriate authorization often
results in reimbursement delays. Hence, all the paperwork must be done
before undertaking the correct procedures and ensuring whether costly
implants are covered.

5. 4. Non-HIPAA Carriers
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Like any other healthcare service provider, ASC also depends on
standardized codes set by Medicare and CPA to get paid. However,
several non-HIPAA carriers will not pay you when Medicare standardized
codes are used. Therefore, you need to know the codes of these small
carriers exempt from HIPAA so your reimbursement is not rejected.
5. Coding Errors
One of the top five reasons ASC claims get rejected is wrong coding and
the failure to put the correct codes in order. When you put codes in the
bill, always ensure to place the highest reimbursement code and then
gradually lower it. If there is any cut on the second or following code
reimbursement, you would like to get it for a lower reimbursement
amount than the higher one. For instance, if there are two codes in the
bill, one for $1,000 and another for $500, where the second procedure
will get paid half in the list, you would want the cut on $500 instead of
$1,000.

6. How to Deal with these Errors?
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Undoubtedly, there are many ASC who have dedicated billing
departments and staff. But the complicated billing procedures with the
ever-changing codes and regulations put a question mark on their
revenue. In such a case, the best way to beat these errors and any
pitfalls in ASC billing is by partnering with the experts of 24/7 Medical
Billing Services.
This outsourced Ambulatory Surgical Centres billing company has
a specialized and dedicated ASC billing staff who can help overcome
these errors and put the best revenue management cycle in place for
improving the practice's outcome.

7. About Us
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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.

8. Contact Us
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Media Contact:
24/7 Medical Billing Services
Georgia
3001 Greenfield Drive, Marietta GA
Ohio
28405 Osborn Road, Cleveland, OH 4414030068
Texas
2028 E Ben White Blvd, #240-1030 Austin TX, 78741
Delaware
16192 Coastal Highway, Lewes, Delaware 19958, United States
Phone no / Fax : +1 888-502-0537
Email us: info@247medicalbillingservices.com