An ASC claim is high value and narrow margin.
One denied surgical case outweighs a day of clean visits. We bill ASC work with the global period, the implants and every modifier in place before the claim is filed, and we bill the facility and professional sides together.
- 97%Coding accuracy on audit
- 50+Specialties covered
- 4.9/5Average client rating
Three ways ASC claims quietly lose value
Review these issues against the documentation, remittance and policy that applied on the date of service. They can appear as denials or underpayments.
- Implants billed after the case, if at all
Device and supply charges have to be on the claim with the correct codes. Left to a busy nurse, they surface as a where did this go question at month end.
- The global period swallows the rest
Post operative visits inside a global period are bundled unless coded as unrelated. Most centers eat the denial instead of fighting the line.
- Assistant and co surgeon roles miscoded
The modifier decides whether a second surgeon gets paid. Coded loosely, the facility pays and the professional side does not.
What we bill for surgery centers
If something you do is not on this list, ask. We will tell you honestly whether we have the depth for it.
How ASC accounts are actually run
The worklist connects each claim to its documentation, payer requirements and next follow-up date.
- An ASC coder, not a general one
The coder assigned to your account works ASC every day. They already know which of your payers do what, and they are watching global periods, implant and supply invoicing, and assistant at surgery modifiers.
- Charges checked against the note
Before anything goes out, the charge is read against the documentation. A code the note does not support is a recoupment waiting to happen, and in ASC it is usually the highest value code on the claim.
- Eligibility and authorization ahead of the visit
Coverage is confirmed and any approval is in place before the service, not discovered afterwards when the work has already been done.
- Denials worked to cause, not just refiled
Every denial is tagged by payer and reason code. When a pattern shows up in your ASC claims we change the upstream step so it stops recurring.
- Reporting you can act on
Monthly numbers by procedure family and payer, with the one decision they imply, rather than an export nobody opens.
Included for surgery centers
- Coders who work ASC daily
- Charge review against documentation
- Eligibility and benefit verification
- Prior authorization management
- Denial management by payer and reason code
- Aged A/R worked oldest first
- Patient statements and balance follow up
- Monthly reporting by procedure family
These describe how we run the service. They are commitments about our process, not a guaranteed outcome on any individual claim.
We work inside the system you already use
We agree user permissions, claim queues, reporting access and escalation contacts in your current system before work begins.
Ambulatory Surgery Centers billing across the country
These state guides explain local Medicaid programs and payer administration. They cover general billing requirements, rather than a separate ASC service in each state.
Arizona payer guideAHCCCS and 7+ plans
Washington payer guideApple Health and 7+ plans
Texas payer guideTexas Medicaid and 8+ plans
New York payer guideNY Medicaid and 8+ plans
California payer guideMedi-Cal and 8+ plans
Ohio payer guideOhio Medicaid and 8+ plans
Florida payer guideFlorida Medicaid and 8+ plansWhat surgery centers ask
Do you bill both the facility and the surgeon side?
Yes, together wherever possible, because the professional and technical split changes what is payable on each line.
Who tracks implants?
We reconcile the implant log to the claim before submission, so hardware is billed with the case instead of being discovered at month end.
Our cases are authorization heavy.
We run prior authorization ahead of the case instead of finding out afterwards, which is when the cost has already been incurred.
What happens to our aged surgical A/R?
We take it, separate what is still inside filing windows from what is not, and work oldest first.
Have an ASC coder read your last ninety days
Tell us your specialty and the billing issue you want reviewed. We will agree the scope and arrange a secure way to share any records needed.