Pain management after surgery can be, well, a “pain.” Everyone in a surgery center environment has to work in sync to help keep patients comfortable, and the whole process is subject to extra scrutiny as regulations continue to crack down on opioid abuse.
Pain management billing for ASCs is an important part of this puzzle.
Correct medical billing can provide timely relief and offer patients safer alternatives to traditional pain medications. Billing problems, on the other hand, don’t just affect patient care. They can result in costly delays, audits, or other financial hiccups for the surgery center.
Pain management billing for ASCs is not just about submitting claims to the insurance company. It is about keeping surgery centers running smoothly and patients on the road to recovery.
These tips can help you avoid common issues and manage your billing for pain management procedures more efficiently.
What is Pain Management Billing for ASCs?
Pain management billing for ASCs allows patients to receive medications or pain management devices to patients with help from insurance.
Key Steps in the Medical Billing Process
To start the billing process, facilities must collect detailed information and complete a variety of forms. All this paperwork helps the insurer determine what is covered and how much to reimburse the facility. Here are the four typical key steps when it comes to medical billing:
- Verification of Benefits
- Medical Coding for the Diagnosis for the Procedures
- Charge Entry & Claims Submission
- Payment Posting & Follow-up
After the claim is submitted, facilities must wait weeks for a response. Sometimes the billing company will require history and physical or other documents to complete billing paperwork. If any information is missing, the claim must be updated, and the clock resets.
Following a successful claim, the insurer will reimburse the facility. If the device is not fully covered or the claim is denied, they will bill the patient for any remaining costs.
Further Reading: Learn more about optimizing the medical billing process.
Types of Pain Management Procedures in ASCs
When it comes to pain management, there are a variety of methods that ambulatory surgery centers utilize to help their patients be comfortable. Some of those include:
- Nerve block procedures- in an ASC setting, this is used to treat acute pain or aid in pain control during surgery.
- Cryotherapy– cold therapy can help freeze nerve endings aiding in pain relief.
- Spinal injection procedures- often referred to as a nerve block, can aid in pain management by blocking specific nerves.
- Freeze nerve therapy- a more aggressive approach to cryotherapy, nerve therapy is minimally invasive and uses freezing temperatures to treat pain.
- Pain pump– this device is inserted directly after surgery and delivers the prescribed amount of pain medication
Further Reading: Learn more about opioid-sparing approaches to post-operative pain.
How to Avoid Common ASC Pain Management Billing Pitfalls
Healthcare technology and guidelines continue to change rapidly. it’s important to stay on top of up-to-date regulations to avoid common pitfalls and maintain an edge in pain management billing.
Tip #1: Keep Up with the Latest CPT Codes
Relevant, “current procedural terminology,” or CPT codes, are vital to medical billing. These codes are dictated by the physician and help the insurer understand the procedure performed. Better coding creates more opportunities for higher reimbursements.
While there are no changes to these codes, new codes can be added each year.
Here are a few resources to reference when researching the latest updates and changes to CPT codes:
- CPT Code Lookup by AAPC
- CPT Changes: Insiders View
- AAPC or AHIMA for continuous learning options and certification programs
Tip #2: Keep Up with the Latest HCPC Codes
HCPC codes are codes used to describe the equipment dispensed to the patient. These codes (and any necessary modifiers) are used by the billing company to determine if the device will be covered by insurance.
Specific billing coders take classes on how to properly code bill sheets to obtain the highest reimbursement. Like CPT codes, these do not change. However, new codes are added each year, and some can become obsolete.
Tip #3: For Quicker Reimbursements, Reduce Patient Data Errors Upfront
The biggest delay when it comes to billing is WIPs, or “work in progress” bill sheets. The key to faster reimbursements is to reduce patient data errors and obtain all needed documentation before releasing the claim to the insurance company.
When a biller can pull information electronically, it can help reduce the WIPs, allow for fewer errors, and expedite reimbursements.
Further Reading: Learn more about error-free billing data.
Tip #4: Utilize an Expert Billing Partner
When prescribing pain management devices, ASCs often have the opportunity to partner with a medical billing company.
Because medical billing can be so cumbersome, it is imperative to have a reliable partner and team that is skilled to correctly code and bill for DME. Having a supportive billing manager truly takes the “pain” out of the pain management process!
Compression Solutions Provides Hassle-Free Pain Management Billing for ASCs
At Compression Solutions, we both supply ambIT pain pumps and manage the entire billing process associated with these devices. We verify patients’ benefits, track, code, and handle the reimbursement process from start to finish.
With more than 30 years as a durable medical equipment (DME) supplier and medical billing, our team of billing experts is deeply knowledgeable and facilitates communications with Medicare, Medicaid, and private insurance — saving time, headaches, and administrative burdens.
As a Medicare-accredited company, we can partner with the facilities to securely access billing paperwork and patient information from their EMR system. This direct integration allows for less back-and-forth and faster reimbursements.
Along the way, our customer service team provides 24/7 billing support to patients and providers, addressing billing questions so facilities can better focus on patient care.
Get ambIT for Your Facility
Equip your hospital or surgery center with ambIT pain pump devices, including convenient medical billing and customer support when you order through Compression Solutions.
