Ambulatory Surgery Center Billing Services For The Facility Claim.
ASC billing is facility billing: covered procedure lists, payment indicators, multiple-procedure discounts, implants and contract carve-outs. We connect each completed case to a checked facility claim and keep the surgeon and anesthesia lanes clearly separate.
- Facility claims only
- Implants and carve-outs per contract
- Prompt charge entry from case records
Each lane has its own billing entity, tax ID and payer rules. An agreement for the ASC covers the facility lane only, unless others are confirmed in writing.
Your Surgical TeamCompletes the case record
What Decides An ASC Payment.
An ASC claim is not a physician claim with a different place of service. It follows its own payment system and contract terms.
Covered Procedures List
Medicare pays ASCs only for procedures on its ASC covered procedures list. Commercial plans set their own lists by contract. With Full RCM, we check before scheduling, not after denial.
Multiple-Procedure Discounting
When several eligible procedures are done in one case, the highest-paying is paid in full and others at a reduced rate. Line order and codes need to reflect that.
Packaged Or Separate
Medicare payment indicators decide whether a service, drug or supply is paid separately or packaged into the procedure. Contracts may differ.
When A Case Stops Partway Through.
Stopped Before Anesthesia
The patient was prepared and taken to the room, but the case was stopped before anesthesia was given. Medicare typically pays a reduced facility amount.
Stopped After Anesthesia
Anesthesia was given or the procedure started, then stopped. The note must explain when and why.
A case canceled before the patient is taken back is not billed. The operative or nursing note needs the exact point the case stopped.
Where Margin Is Won Or Lost.
Implants and high-cost supplies are often the difference between a profitable case and a loss. How they are paid depends entirely on the payer and the contract.
Commercial Carve-Outs
Many contracts pay implants separately, often based on invoice cost. The invoice and implant log need to reach billing with the case.
Device-Intensive Procedures
Medicare builds device cost into payment for procedures it designates as device-intensive, with specific reporting of the device.
Contract Terms On File
We bill to your payer contracts. Sharing fee schedules lets us flag payments that do not match what the contract says.
What Reaches Billing With Every Case.
Clean ASC claims come from complete case packets. When something is missing, we name the case and the document, and your team supplies it through the approved route.
Charges are entered from the case record, ideally the same or next business day.
- Signed operative report
- Implant log and invoices
- Supply and drug usage where separately billable
- Authorization matching the procedure and site
- Notes for any procedure that changed or stopped
Facility Billing Or Broader RCM?
Medical Billing
Your facility keeps registration, eligibility and authorizations. We bill facility claims from case records, apply payment rules and contract terms, and follow every response.
About Medical Billing Services →Full RCM
We also verify benefits, manage procedure and site-of-service authorizations, and code each case, with facility credentialing support included.
About Full RCM →Surgeon and anesthesia claims are separate billing entities. We confirm each one in writing before including it.
Questions ASC Leaders Ask.
Please keep patient records out of the website form.
Can You Bill Our Surgeons And Anesthesia Too?
Possibly, as separate entities with their own claims. We review each one and confirm in writing before work starts.
How Do You Handle Implants?
By payer and contract. Where implants are carved out, we bill them with the invoice and implant log; where they are packaged, we report them as the payer requires.
What About Procedures Not On Medicare's ASC List?
Medicare will not pay the facility for them. With Full RCM, we flag those cases before scheduling so your team can choose the right site.
Do You Check Payments Against Our Contracts?
When you share your fee schedules, we compare payments to contract terms and follow up on short payments.
Talk Through Your Facility Billing.
Tell us your case mix, payer contracts, implant volume and how case records reach billing. Please keep patient records out of the form.
- Facility claims built from case records
- BAA signed before any patient-data access
- Surgeon and anesthesia lanes kept separate