The market research study states, “The U.S. ambulatory surgical centers market is predicted to expand at a CAGR of 6.5% within the forecasted period, with an estimated market size of USD 58.85 billion by 2028”.
This study highlights the importance and growing demand for ambulatory surgery centers in healthcare. Today, as the healthcare industry is growing and bringing luxury to care, patients expect greater affordability, efficiency, and convenience in their care. However, hospitals and healthcare are investing in ambulatory surgery centers to fulfill these demands. Ambulatory surgery centers are modern healthcare facilities that provide same-day and cost-effective surgery to patients. As demand for these centers increases, the need for accurate billing also increases; therefore, such centers need to adopt effective medical billing procedures for accurate and timely reimbursement.
But what practices should practitioners follow?
Let’s discuss this in detail.
In this blog, we will see what an ambulatory surgery center is and its importance. Towards the end, we will see best practices for billing success at an ambulatory surgery center.
Ambulatory Surgery Centre (ASC) billing refers to submitting claims for medical treatments performed in an ASC to insurance companies and other payers. This includes submitting claims, monitoring pending claims, appealing refused claims, and verifying the patient’s insurance coverage and eligibility. It takes great expertise to ensure that the reimbursement is done appropriately because of its billing process and always-changing rules. In the context of increasing patient responsibility, declining revenues, and rising operational expenses, surgery centres must employ efficient and precise billing practices to ensure that no remuneration is overlooked.
Ambulatory surgery center is known for its exceptional patient care and top-notch service. However, its financial stability depends on accurate and efficient billing practices. Suppose there is a lack of process in medical billing. In that case, it may lead to financial losses, ultimately affecting its quality of service, top-notch patient care, and the investment in advanced medical technology and equipment.
Additionally, non-compliance with medical billing policy leads to penalties and financial losses. Therefore, healthcare companies need to follow proper medical billing procedures and invest in an outsourcing medical billing agency that looks after their revenue cycle and brings more revenue. Proper ASC billing not only ensures timely reimbursement but also helps maintain compliance with regulatory standards, thereby safeguarding the center’s reputation and operational viability.
In the process of billing, accurate coding is an essential component that plays a significant role in determining the claim’s accuracy and the reimbursement amount. Therefore, it is of the utmost importance that your ASC hires RCM professionals who have received training, are already familiar with the most recent coding principles, and can appropriately assign the correct codes to each procedure.
In order to proceed with any procedures, it is essential first to verify if the patient is covered by insurance. Additionally, ensuring that claims are submitted to the appropriate payer helps to safeguard the patient against unexpected shocks. Therefore, healthcare practitioners should invest in software verifying insurance coverage and all necessary documents. Leveraging technology enhances accuracy and efficiency in ASC billing. This reduces the manual error and ensures timely reimbursement.
Regarding medical billing, various factors affect claim submission and timely reimbursement. However, one of them is the timely submission of the claim. Delay in claim submission or a missed deadline can delay claim denial or payment. To prevent this, your billing staff should encompass all necessary resources and tools to automate documentation and coding processes. This exercise will reduce the chances of claim denial and ensure timely payment.
Negotiating favourable contracts with insurance directly impacts the revenue of healthcare practices. Therefore, to strengthen this, healthcare should analyze the payer reimbursement trends by identifying discrepancies and areas for improvement; they should ensure competitive reimbursement rates. Additionally, they can regularly assess contracts to align with changing financial needs. This will enhance contracting and negotiating processes with the payer and ensure maximum reimbursement.
Denial prevention and management are key to maintaining revenue integrity. To achieve this, healthcare practitioners should implement a robust denial management system. It is helpful to identify patterns to address problem areas while tracking denials. It also ensures maximum reimbursement is obtained through an effective appeal process.
FAQ
It is a process of submitting and managing claims for medical procedures performed at an ambulatory surgery center to ensure accurate reimbursement.
ASC billing ensures high patient care, which results in financial stability and revenue flow in your hospitals.
ASCs can reduce denials by ensuring proper coding, timely claim submissions, proactive denial management, and using advanced billing technology.
Outsourcing can improve revenue cycle management, reduce administrative burden, and enhance billing accuracy, making it a strategic choice for ASCs.
Efficient ASC billing is essential for financial sustainability and operational success. Implementing effective revenue cycle management, utilising advanced billing technologies, ensuring precise coding, negotiating advantageous payer contracts, and proactively addressing denials can enhance the financial health of ASCs. Partnering with a specialised billing service such as EZ Settle Solutions can improve revenue collection and decrease administrative burdens, enabling ASCs to concentrate on providing high-quality patient care.
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