Transparency in the ASC billing process is crucial to ensure proper processing and reimbursement. ASC billing includes several complexities thus increasing probability of errors leading to delay in processing. The ASC billing process involves intricate data accuracy. A slight error can result in an incorrect billing and spiral a multitude of other issues. The billing begins with the doctor’s report. The omission of any detail can result in under billing thus reduced revenue for the healthcare facility.
The US federal law states that there should be billing transparency in healthcare. The transparency process begins with a detailed breakup of the pricing of procedures and medical equipment used for a treatment. The medical procedures and equipment are then categorized and coded. Some procedures are not covered under the claim and need to be billed directly to the patient.
Transparency requires healthcare centers to be upfront regarding the details of the treatment cost with a patient. The patient needs to be given a breakup of the charges. It allows the patient to understand which costs can be reimbursed and which are chargeable to the patient. It also helps them to make informed decisions regarding their treatment and choose procedures which can be most beneficial for them.
There are several reasons why ASC requires billing transparency. Claiming reimbursements from insurance carriers becomes a smoother process when the details are clearly listed out. This can avert confusion and ambiguity regarding items under the insurance cover and the claim amount.
How to improve billing transparency
Providing the patient with the treatment cost estimate is one of the best ways to incorporate transparency. The healthcare facility needs to inform patients that the actual cost of the treatment may vary depending on compilations and sudden requirement of equipment or medical expertise during the surgery.
Patients also need to be educated about their medical claim benefits. AllianceMed has a Patient Choice program which focuses on explaining to patients what treatments they are eligible for under their insurance cover. Numerous healthcare insurance policies charge people huge sums to cover Out of Network benefits. While policy holders pay the additional amount they do not completely comprehend what they are paying for or how to avail of these benefits.
AllianceMed takes on the responsibility of educating patients about their insurance policies and the benefits that they have purchased, which they can now freely use. The AllianceMed advocates counsel patients and explicitly lay out the treatment choices that they can have.
AllianceMed provides a complete end to end support for patients starting from the point where they need treatment to post surgery. The Patient Choice program can also be incorporated with the costs related for the different procedures and the liability of the patient.
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