ASC Biller

[painisfear]

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I am looking for recommendations for pain ASC billers.

I have gotten good recommendations from Bob Barker about pain billers but they lack ASC billing experience. I will be opening a pain ASC this summer and am trying to find a good group who can help me navigate based on experience.

Initially the ASC will be single specialty but looking to add Ortho and Podiatry down the line. Pain specific experience would be ideal starting out.

If you have any good recs please let me know!

 

[mille125]

I sent you PM

 

[BobBarker]

Contracting and knowing if you will get paid enough to cover the case costs is critical also.

We can’t do on bcbs/united commercial or bcbs federal 27279 SI fusions or SCS or Interstim implant for United commercial as they don’t pay enough to cover the cost of the implants.

 

[painisfear]

Thanks Bob. You have been very helpful for me over the last two years. Finally threw in the towel at the hospital after 10 years of building for them.


I’ve been told for ASC commercial contracts to do what’s called device carve out so it’s invoice of device plus 10% and then a non device portion of the facility fee. This is all new to me so I’m trying to learn as much as I can.

 

[PinchandBurn]

Thanks Bob. You have been very helpful for me over the last two years. Finally threw in the towel at the hospital after 10 years of building for them.


I’ve been told for ASC commercial contracts to do what’s called device carve out so it’s invoice of device plus 10% and then a non device portion of the facility fee. This is all new to me so I’m trying to learn as much as I can.

If u can. Try to stay out of network with a few insurances

 

[painisfear]

If u can. Try to stay out of network with a few insurances

Is there a reliable way to guarantee payment amount if you’re out of network?

 

[mille125]

Contracting and knowing if you will get paid enough to cover the case costs is critical also.

We can’t do on bcbs/united commercial or bcbs federal 27279 SI fusions or SCS or Interstim implant for United commercial as they don’t pay enough to cover the cost of the implants.

They dont even pay the cost of your SCS implant?

 

[PinchandBurn]

Is there a reliable way to guarantee payment amount if you’re out of network?

No

That's the problem..

 

[BobBarker]

Usually they will pay like $12000 total. Implant costs way more than that.