Billing companies that work ambulatory surgery claims every day. Describe your practice once and compare their proposals.
A few questions about the practice, then billing companies that fit send proposals. You are not committing to anything.
Hand off all of it or just the parts that are breaking. Say which in the form so the proposals match.
Charges entered, claims checked against payer edits, and sent daily so clean claims go out the first time.
Every denial worked, appealed, or corrected, with the root cause tracked so the same denial stops repeating.
Old balances called on and worked by payer and by age until they are paid, adjusted, or written off on purpose.
Certified coders assign CPT, ICD-10, and modifiers from your notes, or audit the codes your providers pick.
New providers enrolled with payers, CAQH kept current, and revalidations handled before they lapse.
Statements, online payment, payment plans, and the phone calls that come with them, handled in your name.
Eligibility checks, prior authorizations, and old AR cleanup go through the same request. If you only need one piece, say so.
There is no right answer for every practice. The usual tradeoffs:
An ambulatory surgery center does not bill like a physician office, and owners who came up through office-based billing tend to learn that the hard way. The facility claim pays for the room, the nursing, the supplies, the sterilization and, in many contracts, the implant. The surgeon and the anesthesia group bill separately for their own work. Because those are different streams, a denial on one can sit unnoticed for months. Nobody owns the connection between them.
Most ASC denials are born before the date of service. An authorization is written for one CPT code, the surgeon finds more in the shoulder than the MRI showed, and the claim goes out under a different code than the one approved. Then the contract gets its turn. Payers apply multiple procedure reductions the contract does not allow. Modifier 73 and 74 cases, where a patient is stopped before or after anesthesia starts, change the payment rules completely. An implant is paid separately under one contract and bundled under the next. Bilateral cases, add-on codes and anything the payer calls off-list for the setting make it worse, and workers' compensation and auto carriers bring paperwork of their own.
In-house staff miss the same things over and over. Implant invoices never reach the billing desk. Patient estimates are quoted from the scheduled code instead of the performed one. Underpayments get posted as paid because the check cleared, and nobody holds the contract up against the remittance. A good ASC biller reads your payer contracts, builds a payment grid from them and flags every claim that lands under it. Outsourcing makes sense when one person carries posting, follow-up and credentialing together, when a new center is waiting on payer enrollment, or when out-of-network aging has become a drawer nobody opens. On the form, give your case mix, your top payers, and whether the surgeons bill through you or on their own.
Three steps. Most practices hear from the first billing company within a business day.
Specialty, providers, claim volume, your software, and what you want handled.
Your request goes to billing companies that work your specialty and take on practices your size.
Compare fees, scope, reporting, and contract terms side by side. Pick one, or none.
What practice managers usually ask before they fill out the form.
Describe the practice once and compare proposals from billing companies that fit. No obligation.
Request proposals