Outpatient Billing Expert eBook

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.

• 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.
• Quarterly CD updates. Stay current with regulatory changes specific to your facility.

Exclusive to the eBook! Includes a compilation of PPS edits and edit resolution strategies for daily clean claims submission and denial management:

• Hospital CCI edits
• MCE edits
• OCE logic tables
• OCE edit explanation tables
• OCE edit resolution tables

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