What Global Period Documentation Gaps Are Really Costing Multi-Surgeon General Surgery Groups

-
Image
  For a multi-surgeon general surgery group, global period documentation can look like a small operational issue. A missing postoperative note, unclear transfer of care, incomplete procedure detail, or poorly supported modifier may not seem significant on a single claim. Across dozens or hundreds of surgical cases, however, those gaps can create a much larger revenue-cycle problem. The issue is not simply whether a claim gets denied. Poor global-period documentation can make it harder to determine what work was actually performed, which surgeon was responsible for that work, whether a service was included in the surgical package, and whether a separately reported service was properly supported. Medicare generally includes postoperative services within the payment for procedures assigned a 10-day or 90-day global period. For major surgery, the 90-day global period includes the day of surgery and the 90 days following it, along with the applicable preoperative period. For a multi-sur...
Post a Comment

4 Common Misconceptions about Ambulatory Surgical Centers (ASC)

-

 

4commonmisconceptionsaboutambulatorysurgicalcentersasc.jpg

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

Comments

Post a Comment

Popular posts from this blog

Is Your Neurology Billing Outsourcing Helping or Hurting You at Year-End?

-
Image
  As year-end approaches, neurology practices face a crucial decision: Is your billing outsourcing truly improving your financial performance, or silently affecting your revenue? Neurology billing is complex due to time-based coding, modifier usage, high documentation requirements, frequent audits, and prior authorization challenges. If your billing partner lacks neurology-specific expertise, it may lead to claim denials, revenue loss, and compliance risks. Signs Your Neurology Billing Outsourcing Is Helping If your billing partner is performing well, you will see: • Reduced denial rates for neurology codes (EEG, EMG, Botox, Nerve Conduction Studies) • Faster reimbursements and fewer delays from payers • Active recovery of old AR beyond 60, 90, or 120+ days • Accurate CPT, ICD-10, and modifier usage for neurology procedures • Clear billing reports, denial analysis, and revenue insights • Compliance with Medicare, commercial payers, and documentation standards Warning ...
Read more

How Hidden OB-GYN Billing Errors Are Quietly Costing You Millions Each Year

-
Image
  The Silent Revenue Leak in OB-GYN Practices Most OB-GYN practices don’t realize they’re bleeding money. Not in dramatic, headline-grabbing ways, but quietly, steadily, month after month. The phones are ringing, appointment slots are full, deliveries are happening, and yet the numbers never seem to match the effort. Sound familiar? This is often the first sign of hidden OB-GYN billing errors working behind the scenes. These errors don’t announce themselves. They don’t crash your systems or send angry alerts. Instead, they slip through claims, hide in coding nuances, and quietly shave thousands—or millions—off your annual revenue. OB-GYN billing is uniquely complex compared to other specialties. Between global maternity packages, split billing scenarios, high-risk pregnancy coding, and ever-changing payer rules, the margin for error is enormous. A single missed modifier or incorrectly bundled service might seem insignificant on its own. But when repeated across hundreds or thousand...
Read more

The #1 Reason ASCs Lose Revenue from Medicare Claims (And How to Fix It)

-
Image
Ambulatory Surgical Centers don’t lose Medicare revenue because of low case volume. They lose it because of one recurring, preventable failure: Incorrect coding and documentation for Medicare’s ASC-specific payment rules. This single issue triggers denials, underpayments, delayed reimbursement, and permanent write-offs — especially at year-end. If your ASC’s Medicare revenue feels unpredictable, this is why. The #1 Revenue Killer: Not Billing Medicare the “ASC Way” Medicare does not treat ASCs like hospitals or physician offices. Yet many ASCs still: Use hospital-style assumptions Miss ASC-only payment rules Underestimate Medicare’s bundling logic The result? Claims get paid less than expected — or not at all. Where Medicare ASC Claims Go Wrong 1. Incorrect CPT eligibility for ASC payment Not every CPT code is payable in an ASC setting under Medicare. Common mistakes: Billing procedures not on Medicare’s ASC approved list Assuming “covered in hospital” = “covered in ASC” Missing annual...
Read more