Ambulatory Surgery Center (ASC) Services in USA
The Ambulatory Surgical Center (ASC) stands as a prime example of progress in the healthcare industry, providing surgical care without the necessity of hospitalization. These entities focus solely on delivering outpatient surgical services. However, the exclusive nature of their operations also contributes to a more intricate coding and billing system. If you’ve encountered challenges in navigating these complexities, it’s opportune to reevaluate your Ambulatory Surgical Center (ASC) Billing Services.
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End-to-End Medical Billing Services provider across entire US.
Streamlining Revenue Cycle Management Amid Rising Costs and Shrinking Reimbursements
eClaim Solution LLC USA provides substantial benefits to Revenue Cycle Management (RCM) in the USA, encompassing improved Revenue Performance, heightened visibility, tangible value, and streamlined processes. With a comprehensive suite of services, eClaim Solution LLC USA effectively addresses billing complexities, contributing to enhanced revenue for ambulatory surgery centers.
Out-of-Network Reimbursement Rate Negotiation
While reimbursements from insurance networks and government payers may lack flexibility, a significant avenue for enhancing ASC revenue lies in negotiating favorable rates as an out-of-network provider. This process is challenging, given the formidable negotiators on the payer side. With eClaim Solution LLC USA, our expert negotiations team is well-versed in the intricacies of the process, ensuring that our ASC billing services secure optimal reimbursements
Patient Scheduling
The medical revenue cycle begins with patient scheduling, and good payment results depend on getting this initial phase right. Our team of trained ASC billing professionals will make sure the intake and scheduling process captures all required information and that it is correctly documented.
Benefits Verification
While practitioners at an ASC may conduct similar procedures to those performed in a hospital, ambulatory surgery center billing faces limitations on reimbursable treatments. If a procedure is not on the approved list, the ASC won't receive payment, underscoring the crucial role of benefits verification. eClaim Solution's team of trained professionals ensures that proposed actions align with the patient’s benefits, guaranteeing that the provided services are eligible for reimbursement.
Unique Coding Requirements
While all medical facilities adhere to the same ambulatory surgical center billing codes outlined by the Centers for Medicare and Medicaid Services (CMS), the inclusion of specific modifiers is often necessary for surgical procedures. Any omission or incorrect application of modifiers can lead to claim denials. At eClaim Solution, our standard procedure involves meticulous scrutiny by an expert medical biller, ensuring accurate coding details for each claim before submission to prevent denials.
Dedication to Revenue Cycle Management
Over the past decade, eClaim Solution has cultivated extensive expertise in ambulatory surgery medical billing and coding, expanding into comprehensive medical revenue cycle management (RCM). Our consistent growth and successful track record can be attributed to the development of standardized procedures followed by our highly trained staff, ensuring that every client receives excellent ambulatory services. We adhere to accurate coding practices in line with CMS guidelines to assist you in attaining maximum revenue.
Continual Electronic System Updates
Medical billing codes change annually, and various payers and insurers change their policies on an ongoing basis. Functioning effectively in today’s medical billing and coding environment requires use of the latest EHR/EMR software and technology. Our ASC billing company works closely with programmers and security developers to ensure that our software is always up to date and our system protects patient information at the highest security level available.
Special attention to the rehabilitation Therapy billing process:
The ever changing federal regulations, restricted number of visits, pre-approvals and referrals, out-of-pocket costs, and duration of service are the factors that need special attention in the rehab billing process. eClaim Solutions, with its team of adept professionals, offer streamlined solutions for your medical institute to reimburse insurance claims against rehabilitation therapies and its procedures.
End-to-end Support from Data Collection to Payment:
We collect patients’ and insurance details and enter the data into your billing system. Our team then confirms the patient’s insurance coverage for Rehabilitation services including:
- the type of coverage,
- number of allowable visits,
- plan exclusions and co-pays,
- co-insurance and deductibles
Stages of Collection process:
We have professionals to handle every stage of the coding, billing, claim submission and collection process:
- Our AAPC-certified coders apply the proper codes and modifiers including,
- evaluation and management codes,
- payer-specific and outpatient therapy modifiers.
- The charge team creates charges as per reimbursement rules.
- Our audit team ensures the accuracy of codes and charges.
- Our payment posting team enters the payment against each patient’s account while resolving over/lower costs and denials as quickly as possible.
- Our A/R team tracks and collects past due payments, thereby enhancing collections.
Rehabilitation in emergencies:
Natural hazards such as earthquakes or disease outbreaks and human- induced hazards including conflict, terrorism or industrial accidents can generate overwhelming rehabilitation needs due to injury or illness. They also simultaneously disrupt existing services and significantly impact on the most vulnerable populations and the weakest health systems.
While rehabilitation’s critical role in emergencies is recognized in clinical and humanitarian guidelines, it is considered as part of health system preparedness and early response. The result is that pre-existing limitations in rehabilitation services are magnified, health service delivery is less efficient, and people directly affected are at risk of increased impairment and disability.
The global need for rehabilitation:
Globally, about 2.4 billion people live with a health condition that benefits from rehabilitation. With changes taking place in the health and characteristics of the population worldwide, this estimated need for restoration will only increase in the coming years.
People live longer, with the number of people over 60 years of age-predicted to double by 2050, and more people living with chronic diseases such as diabetes, stroke and cancer. At the same time, the ongoing incidence of injury (such as a burn) and child developmental conditions (such as cerebral palsy) persist. These health conditions can impact an individual’s functioning and link to increased levels of disability, for which rehabilitation can be beneficial.
Global rehabilitation needs continue to be unmet due to multiple factors, including:
- Lack of prioritization, funding, policies and plans for rehabilitation at a national level.
- Lack of available rehabilitation services outside urban areas and long waiting times.
- Lack of trained rehabilitation professionals, with less than ten skilled practitioners per 1 million population in many low- and middle-income settings.
- Lack of resources, including assistive technology, equipment and consumables.
- We need more research and data on rehabilitation.
- Lack of Ineffective and under-utilized referral pathways to rehabilitation.
eClaim Solutions for Rehabilitation Therapy Billing Services in USA
We understand all the categories and types of therapy billing services that require medical insurance reimbursements. With our professionals that are well versed in rehabilitation medical insurance, we streamline your revenue cycle management.