Ambulatory Surgery Medical Billing basics you ought to know - PowerPoint PPT Presentation

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Ambulatory Surgery Medical Billing basics you ought to know

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From the outset ASC billing (Ambulatory Surgery Center) is totally different than any other type of medical billing specialty. And as an Ambulatory Surgery Center biller and coder, it’s important to understand what the basics are. – PowerPoint PPT presentation

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Title: Ambulatory Surgery Medical Billing basics you ought to know


1
  • Ambulatory Surgery Medical Billing basics you
    ought to know

2
Ambulatory Surgery Medical Billing basics you
ought to know
From the outset ASC billing (Ambulatory Surgery
Center) is totally different than any other type
of medical billing specialty. And as an
Ambulatory Surgery Center biller and coder, its
important to understand what the basics
are. Basically, ambulatory surgery center is a
facility that specializes in outpatient
treatments. Some of these procedures are meant to
be surgeries, while others are pain management or
diagnostic procedures like colonoscopies.
Usually, the procedures done at an ASC are more
extensive than those performed at the typical
medical providers office. However, they are not
so involved that they require a hospital
stay. In order for an ASC facility to bill for
its services, it first needs to qualify certain
requirements. Plus, they also need to enter into
a written agreement with CMS. Another vital
point of ASCs to get paid is to determine the
medical necessity, and the process to claim
reimbursement. However, the medical procedure
doesnt have to be performed at an ASC facility
and it is up to both the provider and the
patient.
Medical Billing Services in Oregon
3
Ambulatory Surgery Medical Billing basics you
ought to know
  • Is ASC a medical specialty or not?
  • Do remember that Ambulatory Service Center
    billing and coding isnt centered on a specific
    medical specialty. And in such a scenario it
    doesnt revolve around specific kinds of
    services, procedures, or diagnoses. What this
    means is that ASC billing is not like medical
    specialty billing, where you have to learn a few
    highly specialized guidelines or rules to make
    sure you are reimbursed for your services.
  • ASC billing is completely different than either
    regular medical billing or specialty billing!
  • Nevertheless this doesnt mean that to be an ASC
    biller you have to learn a completely new set of
    codes or billing techniques. Keep in mind that
    ASC billing does use all of the same codes,
    billing techniques, and many of the same billing
    and coding guidelines by the entire medical
    industry.
  • What makes ASC billing so different is that its
    like billing hospital codes through a CMS claim
    form, which is not a facility claim form
  • While hospitals use the UB-04 claim form,
    doctors facility and other outpatient healthcare
    providers use the CMS-1500 form. In this case,
    ASCs are no different, and use the typical
    provider form
  • An easy way to think of it is like this
    Ambulatory Service Centers are like having every
    medical specialty all rolled into one

Medical Billing Services in Oregon
4
Ambulatory Surgery Medical Billing basics you
ought to know
  • You can go there for a cast, a colonoscopy, or
    for surgical dressings. But, you cant go there
    for a sick visit and get a diagnosis from a
    primary care physician
  • ASCs only provide services to those who already
    have a diagnosis from a primary care physician,
    and who need medically necessary procedures
    performed.
  • Types of services covered under ASC reimbursement
  • To be precise while conducting ASC claims filing
    remember that the services covered depends on the
    type of facility. Much of what is or isnt
    covered under ASC guidelines depends on the ASC
    facility status.
  • There are also some services that can be provided
    by an ASC which are considered covered, even
    though theyre not considered ASC services
  • Non-Implantable Durable Medical Equipment
  • Leg, Arm, Back and Neck Braces
  • Physicians Services
  • Prosthetic Devices
  • Independent Laboratory Services
  • Ambulance Services

Medical Billing Services in Oregon
5
Ambulatory Surgery Medical Billing basics you
ought to know
  • Artificial Legs, Arm, and Eyes
  • Implantable Durable Medical Equipment
  • Are you looking for ASC medical billing services?
    You can reach out to Medisys billing manager at
    info_at_medisysdata.com
  • About Medisys
  • We are a group of medical billing experts who
    offer comprehensive billing and coding services
    to doctors, physicians hospitals. We provide
    end to end billing and coding solutions. Medisys
    Data Solutions RCM solutions ensures that the
    providers recover every they are entitled to.
    Our vision for the providers is You Cure. We
    ecure.

Medical Billing Services in Oregon
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