Can the Right Primary Care Billing Company Increase Collections for California Practices?

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California primary care practices face growing financial pressure in 2026. Rising operational costs, increasing payer complexity, Medicare Advantage expansion, prior authorization requirements, and staffing shortages are making it harder to maintain healthy cash flow. While many practices focus on increasing patient volume, they often overlook one of the most effective ways to improve profitability—working with the right Primary Care Billing Company . A billing company does much more than submit insurance claims. An experienced partner helps practices improve coding accuracy, reduce claim denials, recover underpayments, accelerate reimbursements, and strengthen revenue cycle performance. Even small improvements in billing efficiency can significantly increase monthly collections and reduce accounts receivable (AR). This is why many California providers are partnering with specialized Primary Care Billing Services , comprehensive medical billing services , advanced RCM services , and pr...
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Understand Payment Rates and Basics of ASC Billing

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Basics of ASC Billing

An Ambulatory Surgical Center (ASC) is defined by CMS as a facility with the sole purpose of providing outpatient surgical services to patients. ASC is a facility that, very simply, specializes in outpatient procedures. Procedures done at an ASC are more extensive than those done at the typical provider’s office but are not so involved that they require a hospital stay. The basics of ASC billing (Ambulatory Surgery Center) are completely different than any other type of billing. For ASC services to be paid, the service must be determined to be medically necessary. Generally, there are two primary elements in the total cost of performing a surgical procedure:

  • The cost of the physician’s professional services for performing the procedure
  • The cost of services furnished by the facility where the procedure is performed (for example, surgical supplies and equipment, and nursing services).

In general, the Medicare program pays ASCs 80 percent of the lesser of the actual charge or the ASC facility payment rate for the covered services performed. The beneficiary pays 20 percent of the lesser of the submitted charge or the ASC facility payment rate for the covered services performed. Payment rates for most services are geographically adjusted using the pre-reclassification wage index values that CMS uses to pay non-acute providers. The adjustment for geographic wage variation will be made based on a 50 percent labor-related share.

Ambulatory surgical center claims are filed to Medicare, Medicare Advantage Plans, and Medicaid on an HCFA 1500 or the 837P. This is different from hospital outpatient surgery claims to the payers, which are filed on the UB-04 or the 837I. The CMS-1500 is the red-ink on white paper standard claim form used by physicians and suppliers for claim billing.

To know more about the Payment Rates and Basics of ASC Billing click here: http://bit.ly/3y8auny Contact us at info@medicalbillersandcoders.com/ 888-357-3226.

Location: United States

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