New York Family Practice Billing: Capture Transitional Care Management Revenue in the 30-Day Window

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Family practices in New York are missing significant Transitional Care Management (TCM) revenue because services are not properly documented, tracked, or billed within the required 30-day window. When workflows are not aligned with TCM guidelines, eligible services go unbilled or are denied, resulting in preventable revenue loss. Transitional Care Management is designed to reimburse providers for coordinating care after a patient is discharged from a hospital or facility. While the opportunity is substantial, execution is where most practices fail. This is why many providers rely on specialized primary care billing services and medical billing services in New York to ensure compliance and maximize reimbursement. Why the 30-Day TCM Window Matters TCM billing is strictly tied to 30 days following patient discharge. To qualify for reimbursement, providers must meet specific requirements, including timely patient contact and follow-up visits. The first interaction must occur within...
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4 Common Misconceptions about Ambulatory Surgical Centers (ASC)

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Ambulatory Surgical Centers or ASCs as it is commonly called were first established in Phoenix, Arizona in 1970 by two physicians who wanted to provide comfortable care to the people in their community so that they could avoid more impersonal venues like hospitals. Slowly over the years with Medicare approving payments to ASCs they have gained prominence and in some cases are scoring over the normal hospitals for certain procedures.

The fact that ASCs provide a high-quality yet cost-effective alternative to the inpatient care provided at hospitals has seen a surge in outpatient centers. Hospitals grappling with scheduling delays, slow operating room turnover, and budget cuts which have impacted the purchase of new medical equipment, coupled with other operational issues that have prompted patients to visit ASCs to receive care.

Industry Snippet

The revenue of the ASC is slated at $28 billion with an expected growth rate of over 5 percent between the years 2010– 015. ASCs are said to have a low level of market share concentration. A case in point being the four largest market players will generate less than 12 percent of the total revenue. However, over the next few years, it is expected that the industry will consolidate with many large ASCs taking over the smaller ones and forging associations with other healthcare providers.

Demystifying 4 Common Misconceptions about Ambulatory Surgical Centers

Ambulatory Surgical Centers and hospitals are not different entities

People should realize that ASCs and hospitals are two different entities. It is not necessary that the kind of facilities that hospitals have ASCs might have them too. Of course, patient care should not be compromised but it would be incorrect to expect the same treatment at an ASC as a hospital.

ASCs can help in getting surgery done cheaply

This is one of the sad misconceptions where people feel that if one needs to get a procedure done cheaply they can avoid a hospital and go to an ASC. However, one needs to remember that ASCs get the same Medicare certification and other accreditations that a hospital needs to get and the motive for ASC is to provide high-quality care at a lower cost compared to a hospital but it is by no means cheap as they have standards to uphold.

ASCs suit everyone

To learn more about The 4 Common Misconceptions about Ambulatory Surgical Centers (ASC), click here: https://bit.ly/3qJ0zBM  Contact us at info@medicalbillersandcoders.com/ 888-357-3226.

Location: United States

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