Medicus provides specialized billing management for ambulatory surgery centers, with attention to coding accuracy, ASC-specific payer rules, modifier use, implants, and high-value surgical reimbursement. The focus is improving claim accuracy, reducing denials, and strengthening the financial performance of ASC clients.

The dollar amounts per case are large enough that a small error rate becomes a serious number very quickly. A single missed implant charge can exceed a week of office visit revenue.

ASC Charge Capture & Case Review

Every case is reviewed against the operative report to confirm the charge actually reflects what was performed. Surgery centers lose more revenue to missed charges than to denials, and it rarely shows up in a report because the charge was never entered.

ASC Coding & Modifier Optimization

ASC coding carries its own rules for bilateral procedures, multiple procedure reductions, and discontinued cases. Modifiers drive reimbursement here more than in almost any other setting, and applying them correctly is the difference between full payment and a fraction of it.

Implant & Device Billing Support

High-cost implants and devices are frequently billable separately depending on the payer contract and the code involved. When invoice documentation and carve-out terms are not tracked together, centers absorb the cost of hardware they should have been reimbursed for.

ASC Payer Contract Alignment

Contracts are reviewed against actual remittance to confirm the center is being paid what the agreement says. Grouper rates, carve-outs, and implant terms are checked case by case, because underpayment against contract is common and almost never flagged by the payer.

ASC Denial Tracking & Recovery

Denials are classified by reason, payer, and procedure type so patterns become visible rather than anecdotal. Recovery work goes after the current dollars, and the pattern analysis stops the same denial from recurring next month.

Usually because collections do not match case volume and nobody can explain the gap. Sometimes because a payer audit is underway. Occasionally because the center is being acquired and the buyer is examining billing integrity.

We also work with groups that own both a practice and a center, where the professional and facility claims have to reconcile and currently do not.

• Case-level reconciliation between the operative report and the submitted claim
• Implant and device documentation tracked against contract carve-outs
• Contract-versus-remittance auditing to surface systematic underpayment
• Denial classification with feedback to your clinical and scheduling staff

We will review a sample of recent cases and tell you what is not being captured.