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  • 2023 Payer Trends: Navigating Advanced Payment Models - 2023 Payer Trends: Navigating Advanced Payment Models Scott Allen, Senior Vice President of Managed Care Contracting, National Medical In today’s rapidly evolving healthcare landscape, ambulatory surgical centers (ASCs) are facing new payer trends that are reshaping the way they are reimbursed for their services. One of the most significant is the move towards value-based care […]
  • CPT Coding Changes Every ASC Needs to Know - Five Key Coding Updates for 2023   During a Becker’s Webinar, Paul Cadorette, National Medical’s Director of Training and Education for Coding outlined five key coding changes for 2023, including new CPT add-on codes.   CPT coding topics included: • Lumbar disc arthroplasty • Minimally invasive SI joint fusions • Repair of nasal vestibular stenosis […]
  • Spine Code Changes You Can’t Afford To Miss - Published on Beckers ASC Review By Paul Cadorette, CPC, COC, CPC-P, COC, CASCC, Director, Training and Education, Coding, and Alison Kuley, CPC, Senior Spine Coder, National Medical Billing Services. Much like the spine itself, medical coding constitutes the backbone of your revenue cycle. As more spinal procedures are performed on an outpatient basis in ambulatory surgery […]
  • Orthopedics and ASCs: Renegotiate Payer Rates to Maximize Profitability - Review ASC managed care contracts to achieve higher reimbursement rates for orthopedics The ASC Association lists orthopedics as the most common specialty for ambulatory surgery centers (ASCs) nationwide. According to VMG Health’s 2022 “Multi-Specialty ASC Benchmarking Study,” orthopedic surgeries bring in more revenue than any other specialty – up to $4,009 per case. With higher […]
  • How to Improve Your Surgery Center’s Prior Authorization Process - Strategies to Reduce Prior Authorization Errors Do you know what your prior authorization error rate is or the financial impact it has on your overall revenue? During a Becker’s Hospital Review webinar, National Medical’s President Lisa Rock explains why accuracy within front-end operations is critical for the financial success of surgery centers. In one example, […]
  • Want to improve patient satisfaction? 3 front end processes surgical organizations should review - Stacie Fults, Senior Vice President of Client Services at National Medical Billing Services – Tuesday, September 13th, 2022 on Beckers ASC Review In today’s competitive healthcare environment, building a successful ASC begins with creating a patient experience that differentiates your surgery center from the competition. Establishing a process to address patient expectations and improve patient […]
  • Review Key Revenue Cycle Metrics as Your ASC Grows - Consider improving processes in these four areas as your center adds more complex procedures to its list Driven by continuous successful outcomes in the outpatient setting, ASCs have emphasized incorporating more complex procedures into their repertoires as a formative growth strategy. However, adding complex procedures like total joint replacement, cervical disc replacement or implantable cardioverter-defibrillator […]
  • How Will The 2022 CMS Rule Affect My ASC? - The Impact of The 2022 CMS Rule Changes on Your ASC and How to Navigate the Change. In recent years, more and more complex surgical procedures have migrated to the ambulatory surgery center (ASC). Advances in technology and surgical technique, strategic patient selection, and payer policy updates have aided in this migration. The recent reversal […]
  • New Year, New Goals: Strategies for Maximizing Your ASC’s Revenue Cycle Success in 2022 - Published on Beckers ASC Review By Kylie Kaczor, MSN-RN, CPCO, CPHRM, CMPE, CASC, CLSSBB, ACHE, Senior Vice President — Clinical and Regulatory Affairs, National Medical Billing Services, and Aaron Davis, PMP, ICGB, CLSSGB, Vice President — Client Operations, National Medical Billing Services As the healthcare industry strives to financially recover from the coronavirus pandemic and […]
  • Increasing the Profitability of Orthopedics in ASCs - With advancements in medical technology and high-quality outcomes, CMS has steadily allowed more orthopedic procedures to be performed in outpatient settings such as ambulatory surgery centers. However increasing the profitability of orthopedics in ASCs can be a challenge. During a December Becker’s Hospital Review webinar sponsored by National Medical Billing Services, experts discussed strategies for making orthopedics […]
  • Key Considerations When Bringing Cardiology Procedures to the Ambulatory Surgery Center - Published on Beckers ASC Review By Kylie Kaczor, MSN-RN, CPCO, CPHRM, CMPE, CASC, CLSSBB, ACHE, Senior Vice President — Clinical and Regulatory Affairs, National Medical Billing Services, and Aaron Davis, PMP, ICGB, CLSSGB, Vice President — Client Operations, National Medical Billing Services Over the past several years, ambulatory surgery centers have experienced and championed the […]
  • Price Transparency: The Business of Front-End Operations - Originally published in ASC Focus Author: Kylie Kaczor, MSN-RN, CASC, CPCO, CPHRM, CLSSBB, CMPE, ACHE, SVP, Clinical & Regulatory Affairs Kelsey Moore, CPCO, Manager, Ancillary Services, Regulatory Affairs Specialist The growth of consumerism and the need for healthcare cost-containment has resulted in the Department of Health and Human Services hospital price transparency ruling which went […]
  • Improving the Patient Experience Post-Pandemic – How to Incorporate New Technology and Front-End Offerings - Published in Beckers ASC Review Author: Kylie Kaczor MSN-RN, CPCO, CPHRM, CASC, CMPE, CLSSBB, ACHE Senior Vice President, Clinical and Regulatory Affairs. Kelsey Moore, CPCO, Manager, Ancillary Services, Regulatory Affairs Specialist The Covid-19 pandemic has accelerated the adoption of healthcare technologies focused on improving the patient experience while delivering on the expectation of accessible healthcare. […]
  • The Rise of the Orthopedic Supergroup - Originally published on Becker’s ASC Review In 1966, Eric Clapton, Jack Bruce, and Ginger Baker formed the band Cream. Each member was a star in his own right, leading most music historians to crown Cream as the very first “supergroup,” coining the now popular phrase. Today, it’s orthopedic supergroups that are on the rise. Orthopedic […]
  • The Business of Spine Surgery: ASC Success Strategies for Surgeons - Alexandre Rasouli, MD, Cedars Sinai, and Aaron Davis, National Medical Billing Services – Thursday, May 6th, 2021. Originally published on Becker’s ASC Review. CMS Releases Proposed 2021 Medicare Hospital Outpatient and ASC Rule Spine surgeons interested in investing in an ASC have the opportunity to realize significant profit over the next five years. Not only is spine […]
  • The Business of Unlisted Codes: Strategies to Avoid Rejections, Denials, and Audits - By Jessica Edmiston, Senior Vice President of Coding at National Medical Billing Services Surgeons embrace new technology and highly complex or rare cases. While these challenges help surgeons excel in their field, they can also create coding and billing dilemmas. New services or procedures that do not have an accurate, descriptive CPT or HCPCS code […]
  • The Business of Orthopedics: Strategies to Maximize Revenue - By Bill Hazen, CEO, Surgery Center at Pelham and Aaron Davis, Vice President of Operations, National Medical Billing Services Nearly all ASCs suffered a loss when elective surgeries paused in the spring of 2020. ASCs with highly functioning business operations have not only overcome those losses, but will benefit from a rebounding and growing market. […]
  • The Business of Cardiology in Surgery Centers - Nader Samii, JD/MBA, Chief Executive Officer, National Medical Billing Services. Originally published at Becker’s ASC Review. Cardiology is one of the fastest-growing ambulatory surgery center specialties as it is following in the footsteps of the hypergrowth specialties of orthopedics and spine. Strong reimbursement rates, an increase in covered procedures, and a high percentage of complex […]
  • 7 Financial Management Tips to Help ASCs Capitalize on a Rebounding Surgery Market - Nader Samii, JD/MBA, Chief Executive Officer, National Medical Billing Services Lindsay Gross, Executive Vice President, Operations, National Medical Billing Services In mid-March, hospitals across the country halted elective surgeries due to the SARS-CoV-2 pandemic. While many ASCs did experience initial shock—volume across the nation dropped 80% between February and April—most ASCs have now rebounded to […]
  • Considerations for managing remote employees beyond the 2020 public health emergency - Kylie Kaczor, MSN-RN, CPCO, CASC, CPHRM, CMPE, CLSSBB, ACHE; Senior Vice President, Clinical and Regulatory Affairs at National Medical Billing Services Matt Litzelfelner; Senior Vice President, Finance at National Medical Billing Services According to Time magazine, the coronavirus pandemic has created “the world’s largest work-from-home experiment.” Every industry and all employers who may have been slower to […]
  • The Business of Moving Spine Cases to Surgery Centers [Part Two] - Nader Samii, JD/MBA, CEO, National Medical Billing Services; Alison Kuley CPC, Member NASS Coding Committee 2019-2022 – Senior Spine Coder at National Medical Billing Services How to Effectively and Profitably Move Spine into Your ASC In Part I of this article series, we discussed the trends that are driving numerous spinal procedures to the ambulatory surgery center […]
  • The Business of Moving Spine Cases to Surgery Centers [Part One] - Nader Samii, JD/MBA – Chief Executive Officer at National Medical Billing Services and Alison Kuley, CPC, Member NASS coding Committee 2019-2022 – Senior Spine Coder at National Medical Billing Services – Tuesday, May 26th, 2020   “Every success story is a tale of constant adaptation, revision and change.” – Richard Branson Never has this Richard Branson quote been more […]
  • CMS to Offer Financial Relief – Three Month Advance to Providers - On Saturday, March 28th, through the expansion of its accelerated and advanced payment program, CMS announced that providers can now apply for a three month advance on Medicare payments in an effort to ensure all Medicare providers are supported during the COVID-19 emergency. CMS is accepting Payment Requests immediately and anticipates making payment within 7 […]
  • Maximizing Reimbursements in ASCs: A Review of Reimbursement Methodology - By Scott Allen, Vice President, Managed Care Contracting, National Medical Billing Services With the shift to value-based healthcare, more procedures are being performed in ambulatory surgery centers (ASCs). In fact, according to the United States Ambulatory Surgery Center Market Report 2019, from 2015-2022, the proportion of outpatient cases performed in ASCs is expected to increase […]
  • Improve the Patient Experience - Use technology, reimbursement and marketing strategies By Kylie Kaczor, RN, CASC, is the Vice President of Clinical and Regulatory Affairs and Michael Winkleman is the Vice President of Marketing at National Medical Billing Services Telehealth, wearable health tracking devices, cloud-based services and a seemingly unending list of technological innovations dominate today’s headlines, and all areas […]
  • Looking to Experience Financial Success with an Outpatient Total Joint Replacement Program? - Clear these nine hurdles first By Nader Samii, CEO, National Medical Billing Services Outpatient total joint replacement (TJR) procedures are decidedly good for many patients. Instead of spending time in the hospital, outpatient TJR patients are typically discharged three to four hours after the surgery and recover in the comfort of their own homes. Because […]
  • Avoid Unnecessary Rework and Expenses by Improving the Patient Registration Processes - 5 steps for front desk staff By Lewis Custer, Senior Vice President, Administration, National Medical Billing Services With the continued shift of financial liability from the third-party payers to patients, it is critical to have effective, efficient and consistent processes and procedures for patient registration and intake. The back-end processes to remediate patient demographic errors, […]
  • Bolster Your ASC’s Bottom Line by Incorporating New and Complex Procedures - By Scott Allen, Vice President, Managed Care Contracting, National Medical Billing Services The outlook for the ambulatory surgery center (ASC) market continues to be positive. According to the 2018 Ambulatory Surgery Center Market Report by the Health Industry Distributors Association, the Surgery Market is on track to increase more than 15% through 2026. Additionally, every […]
  • CMS Released Their CY 2020 PFS and OPPS Final Rulings - CMS Adds Total Knee Arthroplasty to the ASC-payable List: The following codes have been approved in the CMS OPPS final ruling and these codes will become payable in the ASC setting beginning January 1, 2020: 27447 (Total knee arthroplasty) 29867 (Allgrft implnt knee w/scope) 92920 (Prq cardiac angioplast 1 art) 92921 (Prq cardiac angio addl […]
  • CMS Proposed Rulings July 29, 2019 - On July 29, 2019, CMS released both CY 2020 proposed rulings for the Physician Fee Schedule and Outpatient Prospective Payment System. The proposals echo the messaging that we’ve heard from CMS and the current administration over the past few years with great focus on improved quality of care, price transparency, ease of use, and lowering […]
  • Performing TJR in the ASC Setting - As Seen in ASC Focus Careful planning, patient selection and billing are key By Nader Samii “ You have to change your thinking if you desire to have a future different from your present.” ― Germany Kent, print and television journalist, author, actor Not long ago, when a patient needed total joint replacement (TJR) surgery, […]
  • Discounts and waiving co-payments and deductibles: The compliance risk for ASCs - By Kylie Kaczor MSN-RN, CASC, CMPE, CPHRM, ACHE, CPCO, CLSSBB, Vice President, Clinical and Regulatory Affairs, National Medical Billing Services   In today’s healthcare environment, providers and their office staff are faced with the daunting challenge of reframing business practice to help maximize reimbursement from not only health insurers but from patients as well. Continuously […]
  • Moving Toward Success with Outpatient Total Joint Replacement Surgeries - Written by: Frank Armocida, MD, Surgery Center at Pelham, Bill Hazen, Administrator/CEO, Surgery Center at Pelham and Nader Samii, CEO, National Medical Billing Services At the Surgery Center at Pelham, careful patient management leads to successful total joint replacement surgeries in the outpatient setting, while payer management leads to profitable financial outcomes. “Walking is the […]

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