Can Enterprise BI Dashboards Reduce Payer Variance and Protect Revenue?

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Payer variance is one of the most persistent threats to healthcare profitability. Differences in contracted rates, payment timing, denial behavior, and underpayment patterns often go unnoticed until revenue loss becomes significant. As healthcare organizations scale, manual reporting and disconnected systems can no longer keep pace with this complexity. Enterprise-level business intelligence (BI) dashboards are emerging as a critical tool for identifying payer variance early and protecting the financial bottom line. When used correctly, they turn fragmented data into actionable insights that drive smarter revenue cycle decisions. Understanding Payer Variance in Enterprise Healthcare Payer variance occurs when reimbursement differs from expected contract rates or historical performance. These differences may result from: Contractual adjustments Coding or billing errors Payer-specific payment policies Delayed or partial reimbursements Denial trends by payer In larg...
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ASC Coding And Billing: Knowing What’s Important

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The basics of ASC Coding And Billing aren’t hard to master, but they do differ from physician and facility requirements. The following overview will help you know what’s most important in the ASC setting. ASCs use a combination of hospital and physician billing. Although ASCs use CPT and HCPCS Level II codes to bill most of their services (as do physicians), some payers will allow an ASC to bill ICD-10-CM procedure codes (like a hospital). Some payers even base implant reimbursement on revenue code classification.

One of the most fundamental differences between billing for professional services and billing for ambulatory surgery center services is the concept of the global surgical package. The global package applies to the professional component of a surgical service that is performed when using a surgical CPT code. On the professional side, this typically encompasses a 90-day follow-up. In the ASC billing methodology, no such surgical package exists.

Therefore, each time a patient enters the operating room represents a unique and separate encounter and has no historical economic relationship to previous encounters. This is a very important difference and very often leads to the need for qualifying modifiers. Those modifiers tend to clarify a situation such as returning to the operating room on the same day or returning to the operating room by another doctor on a different date.

To know more about ASC Coding And Billing: Knowing What’s Important click here: bit.ly/3EFQc8y Contact us at info@medicalbillersandcoders.com/ 888-357-3226.

Location: United States

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