Outpatient Billing That Drives Faster Reimbursement

U.S.-based outpatient billing for ASCs, clinics & specialty centers—97% clean claim rate, 60% fewer denials, and full compliance with payer rules.

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Why ASCs & Clinics Trust Our Outpatient Billing

35% Higher Net Collections

We identify undercoded procedures, missed modifiers, and payer-specific edits to boost revenue capture per visit.

60% Fewer Claim Denials

Pre-submission scrubbing catches eligibility, coding, and documentation errors before claims go out.

100% U.S.-Based Coders

CPC-certified experts with outpatient specialty experience—no offshore delays or language barriers.

Seamless EHR Integration

Works with Epic, Cerner, eClinicalWorks, Athena—no double data entry or workflow disruption.

Specialty-Specific Coding

Expertise in gastroenterology, orthopedics, cardiology, pain management, and more—coded right the first time.

Dedicated Billing Manager

Your personal U.S. contact for strategy, support, and real-time performance insights.

Common Outpatient Billing Challenges

Small coding errors or missing documentation can lead to denials, recoupments, and 30–50% revenue leakage.

Missed Modifiers & Bundling Errors

Failure to apply -25, -59, or other modifiers leads to automatic denials or underpayment.

High Denial Rates (15–30%)

Eligibility lapses, missing referrals, or insufficient documentation trigger payer rejections.

Payer-Specific Rule Changes

Commercial payers frequently update policies—non-compliance results in delayed or denied payments.

Slow Follow-Up on AR

Unmonitored aging claims turn into bad debt—especially beyond 90 days.

Our Outpatient Billing Workflow

A streamlined 5-step process built for ASCs, surgery centers, and specialty clinics.

1. Pre-Visit Eligibility & Auth

Verify insurance, benefits, and prior authorization 48h before service.

2. Accurate Coding & Charge Capture

Assign CPT/HCPCS with correct modifiers; validate against documentation.

3. Clean Claim Submission

Submit within 24h with real-time scrubbing for 97% first-pass approval.

4. Denial & Appeal Management

Appeal within 5 days; recover 87% of denied revenue.

5. Monthly Reporting & Optimization

KPIs: net collection %, denial root causes, payer performance.

Proven Impact for Outpatient Providers

0%

Clean Claim Rate

0%

Fewer Denials

0%

Higher Net Collections

Based on 150+ outpatient clients in 2024. Results may vary.

Outpatient Billing: Frequently Asked Questions

Yes—we specialize in ASC billing, including facility + professional fee claims, CPT bundling rules, and payer-specific ASC rate schedules.

Payments are posted within 24–48 hours of receipt. Denials are reviewed daily and appealed within 5 business days.

Yes—our team manages end-to-end prior auths for high-risk procedures (e.g., pain management, imaging, surgeries) to prevent claim denials upfront.

Absolutely. We have dedicated teams for GI, pain management, cardiology, orthopedics, and other high-volume outpatient specialties.

Stop Leaving Money on the Table

Outpatient providers lose $80K–$250K/year to missed codes, modifier errors, and slow denial follow-up.

97%
Clean Claim Rate
60%
Fewer Denials

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