This reference tool is a one-source guide for both hospital outpatient departments (HOPD) and free-standing ambulatory surgical centers (ASC) billing outpatient claims. Outpatient Billing Expert provides detailed references with payment information and guidance to improve reimbursement and reduce claim denials. This all-in-one resource also provides APC and ASC groups, reimbursement amounts, coverage issues, and information on what is not covered.
- New — Now includes OPPS Manager CD-ROM. Provides narrative explanations for OPPS regulatory requirements, direct links to the original CMS source documents, and operational strategy for management, auditing, and consulting. Now you can access the entire history, original source documents, and the intent of OPPS in a single place.
- Comprehensive coverage of both ASC and APC payment systems. Establish the right payment and audit reimbursement processes for your facility.
- Includes the most recent code sets and information from CMS and other industry sources. Keep all billing current and accurate using up-to-date rates and groups for the APC and ASC payment systems.
- Contains information used on a daily basis by HOPD and ASC facilities. Resolve billing and denial issues and establish payment and audit reimbursement processes.
- Easily determine fee and payments prior to submitting your claim. Includes fees, formulas, and tables to determine appropriate APC or ASC reimbursement.
- Non-OPPS payment fee schedule. Provides the name of the fee schedule that applies to non-OPPS payments.
- Web updates and quarterly CD updates. Stay current with regulatory changes specific to your facility.
- Outpatient Billing Expert website. Contains downloadable Excel interactive calculators that determine facility-specific reimbursement and detailed drug information.
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