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Asc out of network

  1. Default Asc out of network
    Clearnace Sale
    Does anyone out there code for a ASC facility that is out of network for all policies? except medicare...

  2. #2
    Yes, I do.. two of them
    Walker Bachman, CPC, CPPM

  3. #3
    walker22, how do you like coding for the out of network- which one do you prefer, in network or out of network ?

  4. Default
    I have some questions can i send you a PM or an email???


  5. #5
    There is no difference in the coding for in or out of network. You can PM me with questions if you like. I don't think my employer would appreciate me answering personal emails on company time. You should know that my coding experience for ASC's is limited to Pain Management.
    Walker Bachman, CPC, CPPM

  6. Default
    We are out of network for all but 3 insurances. You can email me at with any questions, etc. Cyndy

  7. #7
    I also bill for ASC and out of network for everyone except Medicare.

  8. #8
    I bill for both in network and out of network facilties. In California, the reimbursements and billing is quite different for in network vs out of network. Of course, out of network are much higher. But in network reimbursements good but due to good contracting and carve outs.

  9. Default
    Can you explain what you mean by the billing is different for out of network vs. in network? I understand that payments are different for the two but I guess I need some explanation as far as how you bill differently?


  10. #10
    I do billing and coding for oon and inn....for the inn we have carve out codes with some of the insurances so when we are billing and there is a carve out code we bill it only because we get reimbursed with the oon we will bill everything that is done but of coarse we will pend modifiers that are needed or if they are bundled codes then it wont get billed....

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