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ASC Billing & Hospital Outpatient Billing -
Understanding the Differences
HTTPS://WWW.247MEDICALBILLINGSERVICES.COM/
ASC Billing & Hospital Outpatient Billing -
Understanding the Differences
HTTPS://WWW.247MEDICALBILLINGSERVICES.COM/
Medical billing consists of hundreds of pages of updated rules,
regulations, and legislation, not to mention thousands of billing codes.
And, navigating them is already a challenge for practices.
Over the last few years, patients and insurers have continued to
pressure the health system and hospitals to move towards ambulatory
surgery centre (ASC) billing from hospital outpatient department billing
(HOPD). The reason is ASCs billing can be a cost-saving procedure. But
to understand how it can be cost-saving, one needs to understand the
difference between ASC and HOPD.
ASC Billing & Hospital Outpatient Billing -
Understanding the Differences
HTTPS://WWW.247MEDICALBILLINGSERVICES.COM/
The Difference between ASC & HOPD
The primary difference between ASC and HOPD is based on the
regulations that apply to the centres. For instance, a stand-alone surgery
centre can still be termed as HOPD when it falls under the same
administrative and financial contracts as a hospital that is within a 35-
mile radius.
On the other hand, a facility can have the ASC status despite being
operated by a hospital facility if it has an independent administrative and
financial standing and its own agreement with Medicare.
How Is Payment Different Between ASC & HOPD?
There is a difference in the methodology between ASC and HOPD
operations, which leads to the payment difference.
Both use Medicare; however, when a surgery shifts to ASC from HOPD,
the Medicare payment method changes to the ASC fee schedule from
Outpatient Perspective Payment System (OPPS).
ASC Billing & Hospital Outpatient Billing -
Understanding the Differences
HTTPS://WWW.247MEDICALBILLINGSERVICES.COM/
While several payment mythology differences result in ASC being
cheaper than HOPD, three main factors contribute to the differences.
• The Value System – Relative weight
• Change in Conversion Factor
• The Wage Index
ASC Billing & Hospital Outpatient Billing -
Understanding the Differences
HTTPS://WWW.247MEDICALBILLINGSERVICES.COM/
How To Handle the Differences?
We understand that you are already neck-deep in keeping up with all the
coding and billing changes while attending to the patients. However,
understanding and calculating the difference between ASC and HOPD
can be challenging for practice. Moreover, frequent changes in the rules
and regulations can add to the woes.
Let 24/7 Medical Billing Services help you with the ASC and HOPD
billings. Our team of experts has in-depth knowledge of both ASC
medical billing services and Hospital medical billing services and
understand the difference between the two to ensure you have a regular
flow of revenue for the procedures done. In addition, we can assure you
that you will have little to no claim rejections, thus helping you focus on
providing better services to the patients.
ASC Billing & Hospital Outpatient Billing -
Understanding the Differences
HTTPS://WWW.247MEDICALBILLINGSERVICES.COM/
About Us:
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.
ASC Billing & Hospital Outpatient Billing -
Understanding the Differences
HTTPS://WWW.247MEDICALBILLINGSERVICES.COM/
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

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ASC Billing & Hospital Outpatient Billing - Understanding the Differences.pdf

  • 1. ASC Billing & Hospital Outpatient Billing - Understanding the Differences HTTPS://WWW.247MEDICALBILLINGSERVICES.COM/
  • 2. ASC Billing & Hospital Outpatient Billing - Understanding the Differences HTTPS://WWW.247MEDICALBILLINGSERVICES.COM/ Medical billing consists of hundreds of pages of updated rules, regulations, and legislation, not to mention thousands of billing codes. And, navigating them is already a challenge for practices. Over the last few years, patients and insurers have continued to pressure the health system and hospitals to move towards ambulatory surgery centre (ASC) billing from hospital outpatient department billing (HOPD). The reason is ASCs billing can be a cost-saving procedure. But to understand how it can be cost-saving, one needs to understand the difference between ASC and HOPD.
  • 3. ASC Billing & Hospital Outpatient Billing - Understanding the Differences HTTPS://WWW.247MEDICALBILLINGSERVICES.COM/ The Difference between ASC & HOPD The primary difference between ASC and HOPD is based on the regulations that apply to the centres. For instance, a stand-alone surgery centre can still be termed as HOPD when it falls under the same administrative and financial contracts as a hospital that is within a 35- mile radius. On the other hand, a facility can have the ASC status despite being operated by a hospital facility if it has an independent administrative and financial standing and its own agreement with Medicare. How Is Payment Different Between ASC & HOPD? There is a difference in the methodology between ASC and HOPD operations, which leads to the payment difference. Both use Medicare; however, when a surgery shifts to ASC from HOPD, the Medicare payment method changes to the ASC fee schedule from Outpatient Perspective Payment System (OPPS).
  • 4. ASC Billing & Hospital Outpatient Billing - Understanding the Differences HTTPS://WWW.247MEDICALBILLINGSERVICES.COM/ While several payment mythology differences result in ASC being cheaper than HOPD, three main factors contribute to the differences. • The Value System – Relative weight • Change in Conversion Factor • The Wage Index
  • 5. ASC Billing & Hospital Outpatient Billing - Understanding the Differences HTTPS://WWW.247MEDICALBILLINGSERVICES.COM/ How To Handle the Differences? We understand that you are already neck-deep in keeping up with all the coding and billing changes while attending to the patients. However, understanding and calculating the difference between ASC and HOPD can be challenging for practice. Moreover, frequent changes in the rules and regulations can add to the woes. Let 24/7 Medical Billing Services help you with the ASC and HOPD billings. Our team of experts has in-depth knowledge of both ASC medical billing services and Hospital medical billing services and understand the difference between the two to ensure you have a regular flow of revenue for the procedures done. In addition, we can assure you that you will have little to no claim rejections, thus helping you focus on providing better services to the patients.
  • 6. ASC Billing & Hospital Outpatient Billing - Understanding the Differences HTTPS://WWW.247MEDICALBILLINGSERVICES.COM/ About Us: 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.
  • 7. ASC Billing & Hospital Outpatient Billing - Understanding the Differences HTTPS://WWW.247MEDICALBILLINGSERVICES.COM/ 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