Ambulatory Surgical Center Billing

Did you know that for Medicare patients, Ambulatory Surgical Center (ASC) should report bilateral procedures as a single unit on two separate lines or with “2” in the unit’s field on one line in order for both procedures to be paid? CMS will not recognize the use of the -50 modifier for payment purposes and may result in incorrect payment to ASCs. The multiple procedure reduction of 50 percent will apply to all bilateral procedures subject to multiple procedure discounting.
ASC billing is highly complex, ever-changing and requires a high level of knowledge to ensure proper reimbursement. With surgery centers facing increasing operational costs, continuing downward pressure on revenues and increasing patient responsibility, ASCs cannot afford to leave any money on the table, which is why they require efficient and accurate billing procedures.

Our Value

• Our biller’s conjunction with ASC’s received the appropriate reimbursement
• Proficient in correct use of modifiers, evaluate underpayments and manage all aspects of your ASC’s billing
• Our core team of medical billing specialists have many years of experience with ICD-9, CPT and HCPCS coding systems
• We will work hand in hand with your ASC to provide education on best-in-class billing practices and procedures
• Our medical coders are certified by the American Association of Professional Coders

EMS and Ambulance Billing

The quality and success of your services heavily relies on your ability to maintain and manage both cash flow and expenses. Complex Medicare and private insurance provider requirements, combined with municipal budgetary constraints and rising costs, often leads to understaffed billing departments that lack the necessary resources and technology to maximize EMS reimbursement.

At Claim Resolutions, we understand that balancing EMS and ambulatory services with business and cash flow needs can be a difficult task. To help EMS systems succeed given the intricacies and demands of our industry, Claim Resolutions provides a simplified EMS billing alternative with proven cost effectiveness, streamlined efficiency and unparalleled customer service.

Our billing and support services are custom tailored to each client. From subscription plans to fiscal reporting, everything we provide is exclusively designed with the customer in mind. Our state-of-the-art technology and dedicated support staff ensure high performance-driven results. Our professional management eliminates the need for costly hardware and software upgrades, mail processing, staffing, training and continuing education. You will see an increase in revenue, a reduction in administrative overhead costs and an improvement in patient and customer service.

Our Value

• Our biller’s conjunction with EMS and Ambulance services staff will help in claiming appropriate reimbursement
• Proficient in correct use of modifiers, evaluate underpayments and manage all aspects of your billing
• Our core team of medical billing specialists have many years of experience with ICD-9, CPT and HCPCS coding systems
• We will work hand in hand with your teams to provide education on best-in-class billing practices and procedures
• Our medical coders are certified by the American Association of Professional Coders

Laboratory Billing Services

Let our staff of professional lab managers and billing experts at Laboratory Billing Solutions provide you with a detailed assessment of your laboratory’s billing functions. We are highly experienced at analyzing and identifying revenue cycle problems. Our assessments are customized to the needs of the client and their particular situation at the time, but can include:

• Review of in-house compliance programs and CPT coding for laboratory procedures.
• Detailed analysis of the laboratory’s billing and collection history to pinpoint areas of opportunities for performance improvement.
• Operational reviews of billing functions to determine appropriateness of systems and resources to perform activities.
• Analysis of revenue loss from medical necessity with recommended changes to follow-up procedures to insure greater compliance.
• Examination of fee schedules, provider arrangements and CPT coding, and recommended changes to address situations where claims are denied or inadequately paid.
• Review of internal processes with recommendations for streamlining patient registration, the pursuit of missing information, and the collection effort.

The cost of our operational assessment is estimated based on the time required by the scope of work agreed to in advance. The assessment fee may be reduced or pro-rated if your lab decides to contract with LBS for additional billing services. We are confident that our detailed assessment and follow-up recommendations will translate into major cost savings and revenue recovery opportunities for your laboratory.

Our Value

• We have a highly-trained and experienced billing and claims processing staff
• Our expertise in compliance and coding as well as negotiating and analyzing payments from providers.
• While billing and claims processing is a major focus, we understand that deciphering the billing information is tantamount to optimizing performance.
• Our team is dedicated to turning our clients’ financial data into actionable business intelligence.