ASC (Ambulatory Surgical Centre) is a distinct facility developed to treat outpatient surgical services. ASC billing differs from physicians that offer visiting facilities and consultation times, making it different from other billing services. For ASC billing, the facilities provider must enter in agreement with the centres for Medicare and Medicaid Services (CMS).

“ASC billing critically requires the coders to be more alert than any other billing, where we have specific criteria about the specialty we work on. ASC billing is one of the areas where LHS is continuously improving.”

– ASC Billing Expert at Legion Healthcare Solution

ASC uses a combination of physicians and hospital codes employing both CPT and HCPCS level codes. CMS has different rules wherein the provider must enter an agreement before billing, while some payers do allow providers to use ICD-10 procedure codes. The coding facility is maintained, even for many of the packaged services.

ASC does require various equipment during the surgery, and it can be confusing for any ASC facility to determine which of them would be out of pocket or insurance paid. LHS deals with many such situations 24/7, many device can be called inline equipment while other will have to coded separately.

Medicare is one of the biggest ASC payer, it requires modifiers like SG to be included. SG helps to distinguish between the facility bill and physician. Legion continuously improves its billing service by contacting insurers to determine their billing requirements.

LHS conducts regular audits of ASC billing services provided, to get maximum pay-out we code based on surgical report heading. The providers get maximum reimbursements when the coders wait for the surgical report.

Certified and experienced ASC coders.

Weekly updates on ASC billing rules, as the billing and coding regulations change regularly.

ASC coding and billing audit conducted regularly to deal with rising complexity.

LHS conducts regular audits of surgical documentation to improve reimbursement of ASC facility.

Complete or part caseload coding and billing facility available for ASC.

Backlog coding services to improve current reimbursement.

Packaged and per-case pricing model for affordable ASC billing.

API-led and RPM-driven technology for ASC billing.

Data-driven reporting for facilities to determine the number of claims in pipeline and reimbursement amount.