Experts in Surgery Center Management
We pride ourselves in building close relationships with your staff to help you achieve your financial goals.
ePHI Software Consulting and Implementation
SCMS continuously reviews the latest software. The ASC’s preferences are bumped up against vendor features. After pre-screening, demonstrations are scheduled.
Once selected the center may choose to retain us in support of the implementation process as a project manager. In this phase, we become the communication conduit between the vendor and ASC staff.
Insurance Contracting and Credentialing
Second only to the construction process, this component has the biggest impact on cash flow. The best results are realized when this process is started 6-8 weeks prior to completion of construction.
We guide the ASC through the State and Federal application and submittal process. We compile and prepare all insurance applications waiting for Medicare’s final acceptance and issuance of the CMS Certification Number (CCN) and Medicare PTAN ID. Once issued by CMS, all preferred insurance plan applications are submitted to the respective carriers.
We monitor the progress of all applications and coordinate the contract negotiations with the ASC administrator. All finalized contracts will be signed by an authorized official from the facility, and copies of all executed contracts will be stored for the center’s records.
Billing and Coding
1. Our team of certified coders and billers work with the software vendor and the ASC staff to setup and load support data such as clinical staff credentials, CPTs, ICDs, Referring Doctors, Insurance Carriers and fee schedules.
We review the charges along with OP Notes to insure the notes support the codes selected. Clean claims are submitted for payment within 48 hours of the submitted encounter’s charges.
2. Our team works with the software vendor, electronic clearing house, and banks to integrate electronic claims submission, electronic fund transfers (EFTs) and remittance. Our staff reviews each and every denial, corrects, and appeals all qualified encounters.
3. We send out patient statements, answer patient phone calls, accept patient payments, and make special payment arrangements when applicable.
- Required of the ASC to obtain payment from third party payors, we assist the ASC in obtaining and
maintaining all licenses, certifications and accreditation from state and federal agencies for staff providing services in the ASC.
- We assist with the operational financial and informational systems, including all journals and ledgers, check register and payroll records in order to conduct the physical and administrative operations of the ASC.
- We maintain the books of account and conducts quarterly financial and operation review meetings with ASC management.
- We assist with strategic planning and marketing plans for the ASC.
Our team provides operations oversight and management of the ASC which includes interviewing, hiring and train of all ASC staff.
- Management Services
- RCM / Billing Services
- Insurance Contracting
- Software usage