9 min read
What an implant claim needs behind it
What an ASC needs behind an implant line, from the federal record rule, Medicare, two commercial payer policies and three workers’ comp fee schedules.
Blog
Implant reimbursement, in practice
Notes on charge capture, vendor invoices and revenue cycle operations for ambulatory surgery centers.
10 min read
What an ASC implant carve-out has to define
Regulators and payers disagree on what an implant is and what invoice cost includes. A carve-out that leaves either undefined defaults to the payer’s policy.
8 min read
What the CMS manual actually says about ASC implant billing
Medicare packages almost every ASC implant into the procedure rate. The exceptions are narrow, and two turn on the vendor’s paperwork, not the operative note.
10 min read
Six questions about ASC implant billing, answered
Six questions ASC teams ask about implant billing. Some have a firm regulatory answer the industry widely gets wrong. Others have no single answer at all.
7 min read
The Gap Between Two Systems: How Bill-Back Came to Be
I spent years reconciling accounts in finance. Then I found the same gap between two systems costing ASCs their implant revenue, so I’m building Bill-Back to close it.
5 min read
Where implant charges fall out of the billing workflow
An invoiced implant and a submitted claim sit in different systems on different timelines. Where ASC implant charge capture breaks, and why neither flags it.
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