THOUGHT LEADERSHIP

  • Making the Most of Big Data Opportunities to Increase Your ASC’s Revenue - Addressing challenges and taking advantage of big data will empower your ASC to succeed H. Jackson Brown, Jr., the American author who wrote Life’s Little Instruction Book, contends that “nothing is more expensive than a missed opportunity.” It’s an observation that healthcare leaders should take heed of – as there appears to be ample opportunity […]
  • Creating the ultimate patient experience while strengthening your revenue cycle: technology, consumer protections, and best practices - In the age of consumerism, the patient experience is key to maximizing your revenue cycle The patient collection process has moved beyond simply collecting patient co-payments and sending billing statements. 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 […]
  • Staying in step with contractual and coding changes - Manage cash flow and help your ASC adapt to change by following these important guidelines Change is never-ending for ambulatory surgery centers (ACSs). ASCs need to always stay on top of the seemingly nonstop influx of contractual and coding changes, which can have a direct impact on cash flow. Here are just some of the […]
  • 5 tips to maximize revenue for the 6 most commonly performed spine and pain procedures - Taking a proactive approach while coding spine and pain procedures will maintain compliance while maximizing revenue in the ASC setting. Coding spine and pain procedures can be a complex and confusing process for both new and veteran coders. During a June 6 webinar sponsored by National Medical Billing Services and hosted by Becker’s Healthcare, three […]
  • Shining a Light on the Value of Value-Based Care: ASCs are positioned to lead the way - As healthcare shifts to value-based care, ASCs need to not only deliver quality care at a reduced cost, they need to prove that they are doing so as well. Consumers are now paying for a greater percentage of their healthcare bills. The average annual out-of-pocket costs per patient rose almost 230 percent between 2006 and […]
  • Give Your Revenue Cycle a Tune-Up: Boost collections with transparency and up-front payments - Developing relationships with payers, diving into managed care contracts, informing patients of their paymetresponsibility and collecting payments up-front are key to increasing revenue Depending on specialty, geography, payer mix and technology, the critical components of an ASC revenue cycle can change, says Lindsay Miller, executive vice president of operations at National Medical Billing Services in […]
  • Applying Moneyball to Your ASC - Use meaningful KPIs to help drive your business forward Going . . . going . . . gone! Everyone wants the homerun hitting hero on their team. And, for many years, professional baseball teams paid big money to sign up the likes of Barry Bonds, Hank Aaron, Alex Rodriguez and Sammy Sosa. Michael Lewis’ 2003 […]
  • What is your ASC’s operational strategy for delivering excellence and getting paid for it? - As Q1 2018 comes to an end, the time is right for an operational check-up You have closed out your financials for 2017 and you probably set new goals to optimize your ambulatory surgery center (ASC) financials in 2018. A few months later, when the quarter draws to a close, it is time to assess […]
  • Maximizing Reimbursements and Compliance - Outlook for ASCs providing cardiology and vascular surgery care Historically, cardiology and vascular procedures were performed exclusively in a hospital setting. Nearly 20 years ago, however, many of these procedures began migrating to outpatient settings, such as renal dialysis centers, catheterization labs and endovascular labs, otherwise known as office-based vascular interventional laboratories (OBLs). The primary […]
  • Maximize your 2018 reimbursements: Know your health plans, know your market, and stay on top of trends - Optimizing key components of the outpatient revenue cycle are essential to maximizing reimbursement Maximizing claim reimbursements becomes more challenging every year. As the insurance market continues to transition to cost conscious care, ASCs are confronted with changes that add complexity to their front desk procedures, billings, and collections. Because these developments will continue indefinitely and […]
  • Creating the conditions for success: Capitalizing on the value of your employees - Before evaluating the effectiveness of your employees, it is important to understand who you are as a company. This is achieved by asking your leadership team a few key questions: (1) What are your core values? Do they accurately reflect your existing culture? (2) Do you convey who you are to existing employees? (3) Are […]
  • CMS Issues 2018 OPPS Rule - CMS issued its final rule CMS ruled Wednesday, November 1, 2017, on the Hospital Outpatient Prospective Payment System (PDF). The 1,133-page document contains the following key takeaways for ASCs: 3 new procedures added to the ASC covered procedure list- Cervical Artificial Diskectomy (CPT 22856) Second Level Cervical Diskectomy (CPT 22858) Total Laparoscopic Hysterectomy (Uterus over […]
  • Why Revenue Cycle Needs Millennials — And, Like, Now - Millennials, The Latest Generation In the Workforce – Get To Know Them Get ready, baby boomers, it’s actually happening. Millennials, or individuals born roughly between 1980 and 2000, now number 73 million in the United States, according to the polling firm Gallup. Another estimate by PwC puts millennials at roughly one-quarter of the total United […]
  • Creating a Competitive Edge at Your Facility: The Patient Experience - Changes In Out-Of-Pocket Expenses Have Meant Big Changes For Providers At The Point Of Service With nearly 500 global retail locations today, and more than $215 billion in annual revenue from its gadgets, streaming services, and other business lines, it’s hard to believe Apple just two decades ago faced an uncertain future. At the time, […]
  • 4 Vital Changes That Can Increase Your Net Worth (Infographic) - With proper planning, hard work, and strong leadership, these 4 vital changes can lead to more cash flow and increase your net worth. Click below to view the 4 Vital Changes That Can Increase Your Net Worth infographic.    
  • Increased Merger & Acquisition Activity in the ASC Market. What Does It All Mean? - High Profile Acquisitions Show That Analysts Believe Strongly In The Growth Prospects Of The ASC Market Merger and acquisition activity in the ambulatory surgery center (ASC) arena has drastically increased in the past two years. This flurry of activity has left many in the ASC market wondering what this might mean for their centers, as […]
  • The Importance of Relationships in the ASC Industry - Developing Relationships Can Help A Surgery Center Thrive In Today’s ASC Market Technology is remaking healthcare Patients today can track their heart rate and sleep patterns with wearable gadgets that once required expensive commercial diagnostic equipment. Smartphones and broadband also mean a doctor’s visit is now just a phone call away, as telehealth initiatives begin […]
  • What to Look for When Acquiring or Partnering with ASCs - With the recent slowing of the previously rapid growth in physician-owned ambulatory surgery centers (ASCs) nationwide, hospitals and health systems are increasingly seizing the opportunity to improve their preparedness for value-based care by acquiring or partnering with such ASCs Ambulatory surgery centers (ASC’s) have become known throughout the healthcare industry for providing a high quality, convenient and cost-effective experience […]
  • Why Your Revenue Cycle Affects Your Long-Term Net Worth More Than Your Financial Adviser - Achieve Long-Term Growth with Revenue Cycle Management With no intended slight to the fine financial advisers who help physicians and others manage their investment portfolios, Ambulatory Surgery Center physician owners concerned with long-term wealth creation often need to look no further than their own facilities to improve their net worth. Improving each component of a […]
  • Pain Management in 2017: Tips for Thriving Despite the Challenges - Pain Management Tips for Thriving The methodology and efficiency of reimbursement for pain management procedures have drastically changed over the past few years. Gone are the days when you could simply bill the procedure and get paid within 30 days. The industry has evolved to incorporate more stringent policies that regulate the use of pain […]
  • Surgery Center Coding & Your Bottom Line - Use audits and training to stay on top of contracts When it comes to evaluating your ASC’s billing processes and addressing its concerns, compliance is key. Incorrect coding can lead to increased claims denials, increased payroll costs, decreased reimbursement as well as legal action with potential penalties and fines. It is no secret that payors […]
  • Leveraging Technology to Minimize Denials - Minimize Claims Denials with Technology The U.S. healthcare system is experiencing an epidemic of claims denials. In 2011, the U.S. Government Accountability Office found that as many as 40 percent of all healthcare insurance claims made in one state were denied by commercial payers. While subsequent studies by various healthcare groups since then claim that […]
  • The 4 Proven Steps to Scale Your ASC Business - Scale Your ASC With These Proven Steps There are few challenges in business as difficult, and as thrilling, as truly scaling a company. We have had the good fortune of growing National Medical Billing Services by over 1,200% over the past six years, which is a similar growth trajectory we also experienced in our prior […]
  • Payers Increasing Scrutiny of Coding Compliance - Lack of Coding Compliance Awareness is a Continual Challenge for ASCs In September 2014, the U.S. Dept. of Health and Human Services’ Office of the Inspector General (OIG) published its audit of Tulare Regional Medical Center, an acute care hospital in California. In its findings, federal investigators determined the “hospital did not comply with Medicare […]
  • Current Challenges With Out of Network Patients - In his book “Better: A Surgeon’s Notes on Performance,” best-selling author Dr. Atul Gawande traces the origins of the first pricing method for surgical services all the way back to ancient Babylon, where surgeons were paid 10 shekels for “any lifesaving operation.” It wouldn’t be until three decades ago, however, that standardized pricing methods became […]
  • The complexities of properly staffing your ASC’s business office - Healthcare is a labor-intensive industry. And for many providers, payroll expenses can really add up. According to a 2014 Becker’s Hospital Review survey, more than half of the chief financial officers surveyed said personnel costs posed the biggest operational challenge to their organizations during the previous 12 months. When deciding what your operational business costs […]
  • How Technology Can Improve ASC Billing Reimbursement as Healthcare Dives into Value-Based Care - Technology has paved the way for more procedures to transition into the outpatient arena, and the growth of ambulatory surgery centers has surged in the last several years. With the additional business, surgery centers can accumulate more revenue. “The evolution of value-based care will benefit ASCs in a meaningful way. If payers begin to see […]
  • Addressing Front Desk Issues Helps ASCs Optimize Revenue Cycle - Keep patients happy, while making sure they pay their bills, on time & in full That’s the critical revenue cycle question today for ambulatory surgery centers (ASCs). While survey after survey shows patients overwhelmingly prefer the care they receive in ASCs and other outpatient facilities, more than one-quarter of bad debt, as a percentage of […]
  • Optimizing Patient Collections in the ACA Era - For the 50 years leading up to the enactment of the Affordable Care Act of 2009, total healthcare spending grew by more than 800 percent in the United States, ultimately accounting for nearly 20 percent of the nation’s economy by the end of the last decade, according to the consulting firm McKinsey and Company. Bending […]
  • ASC Revenue Cycle: Don’t Go it Alone - The concept was a success virtually from the outset. Today, there are approximately 5,500 ASCs across the United States, and these outpatient facilities increasingly play host to an ever-sophisticated array of surgical procedures made possible by clinical advances in anesthesia and medical technology. The business of ASCs also has changed dramatically in the more than […]
  • ASC Revenue Cycle: By the Numbers - When Dallas-based Tenet Healthcare Corp. announced a joint venture in March 2015 with United Surgical Partners International, it created the largest single ASC operator in the U.S. What’s more, with 250-plus outpatient surgical facilities and 20 imaging centers, once fully integrated, the combined entity — and its patients — will likely benefit from its unprecedented scale, […]
  • ASC cybersecurity: Developing an effective breach prevention program - Cybersecurity Breach Prevention for Surgery Centers In February 2015, Anthem, Inc. announced its computer systems were hacked — “a very sophisticated external cyber attack” that sent shockwaves throughout the healthcare industry. “These attackers gained unauthorized access to Anthem’s IT system and have obtained personal information from our current and former members such as their names, […]
  • Positioning your center for success with annual revenue cycle audits - Survival of the Fittest for ASCs The healthcare industry is experiencing change at a breakneck pace. As payor consolidation continues, ambulatory surgery center (ASC) reimbursement across the country is waning. With the recent transition to the 10th version of the International Classification of Diseases, coders and providers around the world are working with the first […]
  • Avoiding ASC Cash Flow Issues During Payor Mergers - Avoiding ASC cash flow issues during payer mergers For the health insurance industry, 2015 was the year of mega-mergers. Last July, Anthem announced its $54 billion offer for Cigna, while Aetna released details of its proposed $37 billion acquisition of Humana. Today, the four major payers insure at least 90 million Americans combined, according to […]
  • After the Storm: ICD-10 efforts to continue after fall deadline - If you’re reading this, the world didn’t end on Oct. 1. As expected, ICD-10 caused administrative headaches for healthcare providers across the United States. This was expected to be especially true for small practices and hospitals that were caught unprepared for the magnitude of transitioning to the 10th version of the International Classification of Diseases, […]
  • Out-of-Network Legal Battlefield Intensifies - Written by Nader Samii   The legal landscape for out-of-network (OON) billing in ASCs has never been more challenging, more complex or more active. Providers are closely evaluating the landscape in an attempt to determine whether they would be better served in- or out-of-network. At the same time, payers are incorporating new strategies to minimize […]
  • ICD-10 troubleshooting: Ounce of prevention worth a pound of cure - With less than one month to go until the Oct. 1 deadline, it’s a race against the clock for U.S. healthcare providers to transition to the 10th version of the International Classification of Diseases. In the coming weeks, hospitals and ambulatory surgery centers will make final preparations for the coding switch, implementing last-minute updates to […]
  • Are You Ready? Productivity, Cash Flow to be Hardest Hit by ICD-10 - On Oct.1, the U.S. Centers for Medicare and Medicaid Services will require all Health Insurance Portability and Accountability Act-compliant healthcare providers to transition to the 10th version of the International Classification of Diseases. The first update to the coding systems in more than three decades, ICD-10 includes 68,000 codes – roughly 50,000 more than its […]
  • Understanding the Art and Science of Pain Management Coding - Ambulatory surgery centers are on the front lines of the nation’s chronic pain epidemic. An estimated 100 million Americans live in chronic pain, a condition that is expected to cost as much as $635 billion in annual treatment expenses and lost productivity, according to the Institute of Medicine. Read More
  • Optimize Operations – Fine Tune Your Organization’s Information Technology Investments with Process Improvement Tools - Lewis Custer, Senior Vice President of Operations at National Medical Billing Services, discusses Optimizing Operations and how to fine tune your organization’s IT investments with process improvement tools. Click here for the full article.
  • PPACA implementation heightens importance of managed care contracts - Are managed care contracts complicating your ambulatory surgery center’s cash flow? Answering this question confidently is a prerequisite for success in today’s competitive ASC marketplace. In the past, managed care contracts were often filed away once the ink was dry, only to be unearthed again when it came time for renewal. Few, if any, staff […]
  • Eliminate Errors – Improve Your Bottom Line by Avoiding These Common Coding and Billing Mistakes - In today’s changing environment, revenue cycle management is more sophisticated and challenging than ever before. Successful billing teams place special emphasis on streamlining their processes, implementing best practices and focusing on continuously educating their staff. They consistently raise the bar as they watch their bottom line grow. In addition, the team must care, and demonstrate […]
  • Six Sigma methodology can improve ASC cash flow, patient satisfaction - When Jack Welch took over General Electric Co. in 1981, the Conn.-based firm’s annual revenues were roughly $27 billion. By the time he left it two decades later, GE’s revenues had reached almost $130 billion and its stock price had grown by 4,000 percent. A successful tenure, by any measure. Impressive growth, however, wasn’t the […]
  • 8 Critical Healthcare Law Issues for ASCs - In an Aug. 26 webinar hosted by Becker’s ASC Review, National Medical Billing Services President Lisa Rock and NMBS Director of Legislative Research and Advocacy Diana Hilliard, JD, discussed eight of the most pressing legal issues for ambulatory surgery centers. ASC Quality & Access Act (HR 2500/S 1137) “The ASC Quality & Access Act is one […]
  • Health Insurance Exchanges: A Big Challenge for ASCs - A major concern with the new state and federal healthcare exchanges is the uncertainty surrounding how the influx of insured people will change the market, said Lisa Rock, president of National Medical Billing Services, in a Becker’s ASC Review article. Registration for exchanges began Oct. 1, 2013, and the coverage went into effect Jan. 1, 2014. For […]
  • The New 2014 Medicare N1 Codes: How Will This Affect Your Ambulatory Surgery Center - According to Medicare, as of January 1, 2014, “ASCs should not report separate line item Healthcare Common Procedure Coding System codes or charges for items that are packaged into payment for covered surgical procedures and therefore not paid separately….ASCs are encouraged to not submit line items for packaged services.” Approximately 210 new procedure codes have […]
  • 5 Coding & Billing Changes to Anticipate in 2014 - The upcoming year of healthcare reform implementation signals tumultuous times for the healthcare industry and many anticipated changes stand to adversely affect ASCs’ revenue cycle reimbursements. Lisa Rock is the president of National Medical Billing Services, which specializes in freestanding outpatient surgery center coding and billing. Ms. Rock has more than 25 years of experience […]
  • 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 […]
  • Surgery Center Trends Today: 8 Thoughts on What Works And What Doesn’t - At the 11th Annual Orthopedic, Spine & Pain Management-Driven ASC Conference in Chicago on June 13, a roundtable of ambulatory surgery center industry experts discussed what works business-wise and clinically for orthopedics and spine in ASCs. The roundtable included Vice President of Acquisitions and Development at Ambulatory Surgical Centers of America Jeff Peo; CEO of […]
  • Tips for Proper ASC Quality Reporting - A recent National Medical Billing Services blog post discusses proper procedure for Medicare Quality Reporting for ambulatory surgery centers. More Articles on Surgery Centers: How Does Sequestration Impact ASC Medicare Reimbursement? 10 ASC Administrators Discuss How Their Centers Stand Out When ACOs Come to Town: Q&A on Options for ASCs With Jon Friesen of Nueterra […]
  • 9 Burning Trends in Healthcare Finance, Outsourcing and Transactions - Many forces influence a hospital or health system’s bottom line. When it comes to shoring up a healthcare organization’s finances, executives usually come back to two principles: cut costs or expand revenue. Outsourcing and transactions fit into both of those categories, and both financial strategies have been front and center in the hospital sector this […]
  • 7 Revenue Cycle Enhancements for ASCs - Here are seven tips from ambulatory surgery center revenue cycle management experts on ways to improve coding and billing cycles. 1. Obtain correct physician documentation Obtain full documentation for spine procedures, operative notes, anesthesia and medication lists before you begin coding. “You have to make sure all is in order before starting to code,” said […]
  • 5 Ways to Boost Profits at Cash-Strapped ASCs - Here are five recommendations from industry experts on ways to boost ambulatory surgery center profits, even amid tightening budgets and decreased reimbursements. 1. Create positive relationships with commercial payors Through building long-term relationships with your payors, and you will find it easier to get reimbursements increases in difficult years, said Reed Martin chief operating officer […]
  • 5 Coding Tips for Spine Surgery at ASCs - Here are five tips for billing and coding for spine procedures at surgery centers from National Medical Billing Service’s Senior Vice President, Coding Angela Talton. 1. Obtain correct physician documentation Obtain full documentation for spine procedures, operative notes, anesthesia and medication list before you begin coding. “You have to make sure all is in order […]
  • 5 Steps for Better Billing at ASCs - Here are five steps to better billing practices at ASCs. 1. Hire people who are subject matter experts for billing and coding Each member of the team should be an expert in their subject matter and continue following the market throughout their careers. “My payment people read EOBs all day long and figure out cash […]
  • 5 Steps on the Road to Higher Profits in ASCs - Here are five tips to improve profits this year. 1. Translate your vision into a hard operational structure Use budgeting to translate your vision into a hard operational structure. “You have to have a good capital structure to be financially solvent,” says Principal and Chief Financial Officer at The C/N Group Raj Chopra. “Strategy development […]
  • 5 Creative Ways for ASCs to Improve Profitability Next Year - Here are five creative ways ambulatory surgery centers can improve profitability in 2013. 1. Purchase devices designed for OR efficiency Chris Zorn, vice president of sales at Spine Surgical Innovation, said he has seen devices developed with an emphasis on making the healthcare system more efficient and less costly, particularly since reimbursement is under tremendous […]
  • 7 Tips for Better Benchmarking at ASCs - Here are seven tips for better benchmarking at ASCs. 1. Pick the most important metrics for your center’s improvement ASC administrators are faced with a barrage of benchmarks on a daily basis and are constantly examining data points in different ways. Examine the different metrics you collect and choose which ones are most urgent for […]
  • 10 Steps to Maximize Reimbursement for Total Joint Replacement at Surgery Centers - An upsurge has been noted recently in orthopedic and multispecialty surgery centers interested in adding high acuity cases — total joint replacements, for example — to their current case mix. Since shifting more complex procedures from the acute care arena to an ambulatory setting is relatively new, the window of opportunity is open for ASCs […]
  • 5 Tips for Building a Strong Foundation for a Surgery Center - Here are five tips for bringing new surgeons into the surgery center. 1. Hire the right administrator Give yourself enough time and create a good culture. The best administrator for your center will be attracted to your culture and environment because it matches his or her values, says Tom Jacobs, CEO and co-founder of MedHQ. […]
  • 7 Tips for a Financially Strong Surgery Center - Here are seven tips for financial success at ambulatory surgery centers. 1. Beware large debt When surgery centers have a high level of debt, they are under intense pressure to make debt service payments — this could mean financial distress, much like we saw in the housing market during the recent debt crisis for homeowners. […]
  • 5 Core Concepts for a Great Billing & Collections Business - Nader Samii, CEO, and Lisa Rock, president of National Medical Billing Services, discuss five core concepts for building a great billing and collections business. 1. Have employees in the right place Optimize the skills of each employee by putting them in the right place for your company. “Pay attention to each employee’s personality,” says Ms. […]
  • 3 Core Concepts for Building a Successful Business - Growing a great company is imperative to your business’s success, whether you are running a multi-national corporation or a standalone surgery center. “The most important thing to promote is a clear and singular vision for the company,” says Nader Samii, CEO of National Medical Billing Services. “Each employee should know what the objective is and […]
  • Tough Coding Issues Facing ASCs - There are several tough coding issues ambulatory surgery centers face every day, whether they arise from incomplete documentation, coding updates or technical challenges with capturing the right information for procedures performed. In a webinar presented titled “Tough Coding Issues Facing ASCs,” National Medical Billing Services President Lisa Rock, Vice President of Coding Tamara Wagner and […]
  • Conscious Sedation Guidelines in Surgery Centers: Thoughts From Tamara Wagner and Diana Hilliard - The AMA recently issued an opinion that all procedures whose description involves time (i.e. 99144: conscious sedation for the first 30 minutes intra-service time) must have an intra-service duration of more than 50 percent of the time interval to be billed. Therefore, conscious sedation for the first 30 minutes must span at least 16 minutes […]
  • 5 Ways to Make Surgery Centers Better - Here are five ways to make your surgery center better. 1. Discipline employees properly John Merski Jr., Managing Partner and Executive Director of Human Resources for MedHQ, says the number one rule of employee discipline is, “Act early.” Don’t wait until the twentieth time an employee shows up late to work to say something because […]
  • 7 Tips for Productivity with Orthopedic and Spine Cases at Surgery Centers - Here are six tips to improve productivity at orthopedic and spine surgery centers. 1. Train management appropriately John Merski Jr., Managing Partner and Executive Director of Human Resources for MedHQ, says the most common management problem he sees at surgery centers is a general lack of management training. He says surgery center administrators are frequently […]
  • 5 Tips for Building Strong Surgery Center - Here are five considerations for building a strong surgery center. 1. Define “start time” According to Larry Teuber, MD, president of Medical Facilities Corp., the company conducted a poll that asked surgeons to identify the correct definition of “start time” out of a list of five selections: Patient leaves pre-op Patient enters the room Anesthesia […]
  • 8 Common Coding Errors in Surgery Centers - Jessica Edmiston, coding manager, and Tamara Wagner, coding audit manager, with National Medical Billing Services, discuss eight common coding errors that create compliance problems and decrease revenue for surgery centers. 1. Open versus arthroscopic procedures Coders must read the entirety of an operative note to determine whether a procedure was open or arthroscopic, Ms. Edmiston […]
  • Third Party Payor Denial of Modifier -33 - Concerning screening colonoscopies, our ambulatory surgery center is having no problem using the -PT modifier for Medicare but third-party payors are not accepting the -33 modifier. Do you know why this would be happening and what we can do about it? Jessica Edmiston: The 33 modifier became effective Jan. 1 but wasn’t actually published until April […]
  • 5 Guaranteed Ways to Have Your Claim Denied - Lisa Rock, president, and Ryan Flesner, director of A/R, discuss five guaranteed ways to have your claim denied — and how to avoid those denials on the front end. 1. ID card errors According to Mr. Flesner, errors from the patient ID card that go through incorrectly on the claim form could mean an instant […]
  • 4 Ways to “Manage” Managed Care Contracts - Managed care contracting is often overlooked and is critical to the financial well being of your center. Here are four basic rules that you should know when negotiating with carriers. 1. Direction of care Knowing all of the different products a particular network offers is helpful in understanding how a potential contract will affect your […]
  • 6 Things Your ASC May Not Know About Billing & Coding - Lisa Rock is well-versed in the mistakes ASCs make concerning billing and coding. Here she discusses six things your ASC may not know about billing and coding that can prevent rejected claims and save you money. Billing 1. HIPAA-exempt carriers don’t have to use standard codes Ms. Rock says your ASC should be aware of […]
  • Using New Processes & Technologies to Maximize ASC Patient Collections - Many surgery centers attempt to collect the patient portion of a payment for services performed at a surgery center after the patient has left the ASC. This is clearly a recipe for bad debt, says Lindsay Miller, vice president of internal auditing. “Our experience has shown that expected collections decline dramatically once a patient leaves […]
  • 3 Tips for Coding Orthopedics Procedures in Surgery Centers - Coding meniscectomies and synovectomy during left knee arthroscopy During left knee arthroscopy surgery, the surgeon performs both a medial and lateral meniscectomy along with an extensive synovectomy, including the patellofemoral compartment. The coding would be reported as ‘29880-LT’ for the meniscectomies and ‘29875-59, LT’ for the synovectomy performed in the patellofemoral compartment. The synovectomies for […]
  • 2 Common Mistakes in ENT Coding and How to Correct Them - Jessica Edmiston, CPC, vice president of professional coding at National Medical Billing Services, shares two common mistakes in coding ENT procedures and discusses how they can be corrected. 1. Not reporting tympanoplasty graft harvested from a separate incision as a separate procedure code. As of Aug. 2008, the AMA now allows the harvesting of graft […]
  • 16 Coding, Billing and Collections Best Practices - 2 Tips for Using Modifier -50 Modifier -50 is used to indicate that a procedure has been performed on both sides of the body during the same operative session. However, the modifier can present challenges to coders who are unsure about which specific procedures its use applies to. Dawn Waibel, director of operations at Serbin […]
  • 3 Best Practices for Reducing Electronic Claim Rejections - Lisa Rock, president and CEO of National Medical Billing Services, says that rejection of claims due to errors in the electronic submission process can be reduced by three simple practices. 1. Know the electronic pathway of claim submissions to every payor Ms. Rock recommends that billing managers chart the path of electronic claim submissions for […]
  • 5 Best Practices to Help Address Increasing Patient Out-of-Pocket Expenses - The number of Americans enrolled in health plans with high deductibles is on the rise and is expected to continue as employers look for ways to cut costs in this tough economy. This trend creates challenges for ASCs and hospitals as they begin to see more and more patients who are responsible for significant out-of-pocket […]
  • ASC Claims Matching: Practical Guidance to Ensure Fair Reimbursement - If you don’t know what it means for a carrier to “claims match,” then your facility is probably losing revenue. Did you know that most large carriers match (prospectively or retrospectively) your ASC CPT codes to the professional CPT codes and the anesthesia crosswalk codes billed? What happens when the three claims don’t match? If […]

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