3 Tips for Reviewing Insurance Exchange Contracts at Surgery Centers
Health insurance exchanges will be fully operational by Jan. 1, 2014.
In light of the rapidly approaching date, National Medical Billing Services’ Vice President of Managed Care Contracting, Scott Allen, offers ambulatory surgery center leaders and staff three tips for reviewing HIE contracts.
Know all of the rules and regulations for your ASC’s state HIE
Understand the difference between these specialized contracts and traditionally managed care contracts
Be fully aware of the terms of rates and fee schedules
National Medical Billing Services is a national healthcare revenue cycle management company with a sophisticated, boutique-like approach to operational delivery and client service. The company focuses solely on servicing ambulatory surgery centers (ASCs) and their affiliated surgeons.
This post was first published October 11, 2013 and was updated July 29, 2020.
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OUR CLIENTS SAY IT BEST
Our clients are typically bold, ambitious leaders within the surgery market. They share our passion for results and are prepared to act decisively to achieve them.
Read below to see what our clients think about us and our performance. And we highly encourage you to speak with them so that you can hear it first hand.
“They are us and we are them. National's approach since being with us has been as a partner or better yet a family who cares about our success and does everything in its power to assist us in being successful."
DIRECTOR OF NURSING | LOS ALAMITOS, CALIFORNIA
OUR CLIENTS SAY IT BEST
Our clients are typically bold, ambitious leaders within the surgery market. They share our passion for results and are prepared to act decisively to achieve them.
Read below to see what our clients think about us and our performance. And we highly encourage you to speak with them so that you can hear it first hand.
"National Medical’s coding audit identified that our previous billing partner was coding and billing our ASC claims improperly. We were actually losing money on some cases because costly implant charges were not being coded and billed correctly. National Medical was able to go back and capture significant lost revenue. Their specialized, ASC expert coders have maximized our revenue and compliance."
MEDICAL DIRECTOR | CLEVELAND, OHIO
OUR CLIENTS SAY IT BEST
Our clients are typically bold, ambitious leaders within the surgery market. They share our passion for results and are prepared to act decisively to achieve them.
Read below to see what our clients think about us and our performance. And we highly encourage you to speak with them so that you can hear it first hand.
“I can already tell the difference in the quality of work compared to our previous billing company. The responses and willingness to help us be successful shows in how fast we receive a response, resolution and the wealth of knowledge you share with us. Thank you!”
ASC ADMINISTRATOR | FREMONT, CA
OUR CLIENTS SAY IT BEST
Our clients are typically bold, ambitious leaders within the surgery market. They share our passion for results and are prepared to act decisively to achieve them.
Read below to see what our clients think about us and our performance. And we highly encourage you to speak with them so that you can hear it first hand.
"National Medical’s expertise in the ASC market revealed that our contracts were reimbursing less than Medicare and in some cases only 38% of Medicare. Due to their expertise and experience, they were able to renegotiate better contracts and increase our contract reimbursement by 305%. We’re now able to bring additional cases to our center."
ASC ADMINISTRATOR | BALTIMORE, MARYLAND
OUR CLIENTS SAY IT BEST
Our clients are typically bold, ambitious leaders within the surgery market. They share our passion for results and are prepared to act decisively to achieve them.
Read below to see what our clients think about us and our performance. And we highly encourage you to speak with them so that you can hear it first hand.
"Before we hired National Medical, we were handing billing in house and were averaging $811 for each surgery. In our very first year with National Medical, with the same number of cases, we have increased our cash per case to $1,400. That represents an increase of approximately $600 per case, or 73 percent, all of which is pure profit for us. In absolute terms, that means an additional $90,000 per month to us on the same number of cases."
OWNER AND CEO, SURGERY CENTER | BAKERSFIELD, CALIFORNIA
OUR CLIENTS SAY IT BEST
Our clients are typically bold, ambitious leaders within the surgery market. They share our passion for results and are prepared to act decisively to achieve them.
Read below to see what our clients think about us and our performance. And we highly encourage you to speak with them so that you can hear it first hand.
“We have not second guessed our decision to switch billing companies once since transitioning to National Medical. Their team seems to remind us constantly why it was such a good decision!
ASC ADMINISTRATOR | SOUTHLAKE, TX
OUR CLIENTS SAY IT BEST
Our clients are typically bold, ambitious leaders within the surgery market. They share our passion for results and are prepared to act decisively to achieve them.
Read below to see what our clients think about us and our performance. And we highly encourage you to speak with them so that you can hear it first hand.
"National Medical consistently exceeds our expectations by going above and beyond every day. Their team is proactive, highly attentive and smart. To top it off, their detailed analytics team provides us with powerful insights into our business, allowing us to make informed decisions. In short, they are the perfect partner for all of our revenue cycle needs."
CHIEF OPERATING OFFICER, SURGERY CENTER | PORTLAND, OREGON
