Gaya Healthcare

Ambulatory Surgical Centers (ASC)

&nbsp Ambulatory Surgical Centers (ASC) billing refers to the comprehensive process of managing and submitting medical claims for services provided by Ambulatory Surgical Centers. ASCs are healthcare facilities that specialize in performing same-day surgical procedures, and efficient billing practices are crucial to ensure proper reimbursement for the services rendered

Patient Registration:

&nbsp The billing process begins with accurate patient registration, including demographic details and insurance information.

&nbsp Verification of insurance coverage is essential to determine patient eligibility and coverage for the planned surgical procedure.

Coding for Procedures:

&nbsp Trained coders assign accurate Current Procedural Terminology (CPT) codes to the surgical procedures performed at the ASC.

&nbsp International Classification of Diseases (ICD-10) codes are used to describe the patient's diagnosis.

Charge Capture:

&nbsp Charges for each procedure, including facility fees, surgeon fees, and anesthesia fees, are accurately captured for billing.

&nbsp Proper documentation of all services provided during the surgical visit is crucial for billing accuracy.

Claim Generation:

&nbsp Claims are generated with detailed information about the patient, procedures performed, and associated charges.

&nbsp Claims may be submitted electronically to insurance carriers or through traditional paper methods, depending on payer preferences.

Claim Submission:

&nbsp Timely submission of claims to various insurance carriers, including Medicare, Medicaid, and private insurance providers.

&nbsp Claims must adhere to the specific requirements and guidelines of each payer.

Insurance Follow-Up:

&nbsp Regular follow-up is conducted to track the status of submitted claims.

&nbsp Any issues or denials are addressed promptly through appeals or corrections.

Payment Posting:

&nbsp Payments received from insurance companies are recorded, and adjustments are made based on contractual agreements.

&nbsp Unapplied payments or denials are investigated and resolved.

Patient Billing:

&nbsp Patient responsibility, including deductibles, copayments, and coinsurance, is calculated and billed accordingly.

&nbsp Clear and detailed statements are provided to patients for transparency.

Accounts Receivable Management:

&nbsp Monitoring and managing outstanding accounts receivable to optimize revenue cycle management.

&nbsp Timely resolution of outstanding balances to ensure a steady cash flow for the ASC.

Regulatory Compliance:

&nbsp Ensuring compliance with healthcare regulations, such as the Health Insurance Portability and Accountability Act (HIPAA).

&nbsp Staying updated on coding changes, billing regulations, and payer policies.

&nbsp Outsourcing ASC billing services to specialized medical billing companies can help ASCs streamline their billing processes, reduce errors, and improve overall revenue collection, allowing them to focus on providing high-quality patient care.

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