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Contract Management: Updating Fee Schedules

Dec 19, 2019 | Posted by Hannah Hagan in ASC Billing & Coding

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It’s that time of year again! Medicare has finalized their highly anticipated 2021 Ambulatory Surgical Center (ASC) Payment System Final Rule. So, what’s next? Each ASC, and Physician who practices at an ASC, should review the ruling to see how it impacts their business and their bottom line.

Some things to consider:

  • Have any reimbursements decreased?
  • Are there any new carve outs?
  • Were any procedures dropped from coverage?
  • Were any new procedures added to coverage?

It’s also the ideal time to upload the new Medicare fee schedules into your billing system. Keep in mind, you may have several other contracts affected by the Medicare reimbursement rate so It’s a great time to review all fee schedules in your billing system.

If you haven’t been uploading your fee schedules into your billing system, don’t worry! Now is a great time to start.

What’s the benefit?

  • Knowing your contracted allowable and having it readily available will allow you to provide your patients with more accurate estimates.
  • You can estimate and collect some (or all!) patient responsibility prior to the procedure.
  • You can ensure you are receiving the maximum reimbursement for each procedure.
  • You can evaluate your cases to ensure they are profitable for your center.
  • You can enter contractual write offs on accounts at the time of billing in order to carry a more accurate reflection of your Net Outstanding A/R.

Now that we agree this practice is helpful, how do you get started? If you are already a full-service client of ours – sit back! We’ll take care of everything. If you’re not a client just yet, we recommend contacting one of our talented sales consultants. Drop us your information below, and we’ll contact you right away. If you’re determined to “DIY,” get in touch with your software’s support team to get started. Below is contact information for some of our common vendor partners.  

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Key Terms:
Outstanding A/R – a measure of how much money your center is owed by insurance carriers and patients.
Fee Schedule – a chart showing the maximum fee that can be charged for a given CPT code. A fee schedule is a common part of a contract between a healthcare provider and an insurance carrier.

Or use the form below to let us know you would like to discuss and we will reach out soon!

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