ASC Billing & Hospital Outpatient Billing – Understanding The Differences

1
ASC Billing Hospital Outpatient Billing -
Understanding the Differences
HTTPS//WWW.247MEDICALBILLINGSERVICES.COM/
2
ASC Billing Hospital Outpatient Billing -
Understanding the Differences
Medical billing consists of hundreds of pages of
updated rules, regulations, and legislation, not
to mention thousands of billing codes. And,
navigating them is already a challenge for
practices. Over the last few years, patients and
insurers have continued to pressure the health
system and hospitals to move towards ambulatory
surgery centre (ASC) billing from hospital
outpatient department billing (HOPD). The reason
is ASCs billing can be a cost-saving procedure.
But to understand how it can be cost-saving, one
needs to understand the difference between ASC
and HOPD.
HTTPS//WWW.247MEDICALBILLINGSERVICES.COM/
3
ASC Billing Hospital Outpatient Billing -
Understanding the Differences
The Difference between ASC HOPD The primary
difference between ASC and HOPD is based on the
regulations that apply to the centres. For
instance, a stand-alone surgery centre can still
be termed as HOPD when it falls under the same
administrative and financial contracts as a
hospital that is within a 35-mile radius. On the
other hand, a facility can have the ASC status
despite being operated by a hospital facility if
it has an independent administrative and
financial standing and its own agreement with
Medicare. How Is Payment Different Between ASC
HOPD? There is a difference in the methodology
between ASC and HOPD operations, which leads to
the payment difference. Both use Medicare
however, when a surgery shifts to ASC from HOPD,
the Medicare payment method changes to the ASC
fee schedule from Outpatient Perspective Payment
System (OPPS).
HTTPS//WWW.247MEDICALBILLINGSERVICES.COM/
4
ASC Billing Hospital Outpatient Billing -
Understanding the Differences

• While several payment mythology differences
  result in ASC being cheaper than HOPD, three main
  factors contribute to the differences.
• The Value System Relative weight
• Change in Conversion Factor
• The Wage Index

HTTPS//WWW.247MEDICALBILLINGSERVICES.COM/
5
ASC Billing Hospital Outpatient Billing -
Understanding the Differences

• How To Handle the Differences?
• We understand that you are already neck-deep in
  keeping up with all the coding and billing
  changes while attending to the patients. However,
  understanding and calculating the difference
  between ASC and HOPD can be challenging for
  practice. Moreover, frequent changes in the rules
  and regulations can add to the woes.
• Let 24/7 Medical Billing Services help you with
  the ASC and HOPD billings. Our team of experts
  has in-depth knowledge of both ASC medical
  billing services and Hospital medical billing
  services and understand the difference between
  the two to ensure you have a regular flow of
  revenue for the procedures done. In addition, we
  can assure you that you will have little to no
  claim rejections, thus helping you focus on
  providing better services to the patients.

HTTPS//WWW.247MEDICALBILLINGSERVICES.COM/
6
ASC Billing Hospital Outpatient Billing -
Understanding the Differences
About Us We are a medical billing company that
offers 24/7 Medical Billing Services and
support physicians, hospitals, medical
institutions and group practices with our end to
end medical billing solutions. We help you earn
more revenue with our quick and affordable
services. Our customized Revenue Cycle Management
(RCM) solutions allow physicians to attract
additional revenue and reduce administrative
burden or losses.
HTTPS//WWW.247MEDICALBILLINGSERVICES.COM/
7
ASC Billing Hospital Outpatient Billing -
Understanding the Differences
Media Contact 24/7 Medical Billing
Services Georgia 3001 Greenfield Drive, Marietta
GA Ohio 28405 Osborn Road, Cleveland, OH
4414030068 Texas 2028 E Ben White Blvd,
240-1030 Austin TX, 78741 Delaware 16192
Coastal Highway, Lewes, Delaware 19958, United
States Phone no / Fax [phone]
Email us info_at_247medicalbillin
gservices.com
HTTPS//WWW.247MEDICALBILLINGSERVICES.COM/