The Top 7 Billing Mistakes Costing ASCs—
Solved by MMS
Running an Ambulatory Surgery Center (ASC) is tough, especially when it comes to getting paid for all your hard work. Most of the time, it’s not big mistakes that cost you money—it’s the little things that add up.
Here are the top 7 ways we see ASCs lose money, and what MMS does to fix them:
Here we will outline five actionable revenue cycle management (RCM) fixes to help your organization reduce denials, maintain compliance, and maximize reimbursement-ensuring a more resilient and profitable practice.
Multiple Procedure Coding Errors: The Silent Revenue Killer
If your ASC does a lot of surgeries—like in orthopedics or GI—you probably bill for more than one procedure at a time. But if your coders use the wrong modifiers, or forget them, you could get paid less or not at all.
Example: Using CPT modifiers 51 and 59 in the wrong order, or missing them, means you lose money.
How MMS Fixes It:
Our expert coders know the right rules for every specialty and payer. We make sure your codes and modifiers are always correct, so you get paid what you deserve.
Implant Reimbursement Gaps
Implants (like screws or plates) are expensive. If you don’t bill them right, you might not get paid for them—especially with private insurance companies, who all have their own rules.
Problem: Some payers want special paperwork or contracts, and they don’t always follow Medicare’s rules.
How MMS Fixes It:
We check every implant charge, use the right codes, and send in all the paperwork up front, so you don’t miss out on money for implants.
Prior Authorization Problems
Some procedures need a “yes” from the insurance company before you do them. If you skip this step, your claim can get denied—even if the procedure is covered!
Impact: This means delayed care, more denials, and rescheduled surgeries.
How MMS Fixes It:
We keep a database of each payer’s rules and make sure you get the right approvals before the surgery, cutting down on denials by up to 40%.
Out-of-Network Billing Confusion
If your ASC isn’t “in-network” with every insurance company, getting paid is even harder. Without a plan, you might end up with lots of unpaid bills and frustrated patients.
How MMS Fixes It:
We help you set the right prices, handle balance billing (when allowed), and talk to patients, so you collect more and have fewer problems.
Not Tracking Revenue by Specialty
If you treat lots of different specialties—like ENT, ortho, GI, or pain—you need to know which ones make money and which ones don’t. Most billing systems don’t show this clearly.
Problem: You can’t make smart choices about your business if you don’t know where your money is coming from.
How MMS Fixes It:
We give you easy-to-read dashboards that show how each specialty is doing, so you can make better decisions.
Not Tracking Revenue by Specialty
If you treat lots of different specialties—like ENT, ortho, GI, or pain—you need to know which ones make money and which ones don’t. Most billing systems don’t show this clearly.
Problem: You can’t make smart choices about your business if you don’t know where your money is coming from.
How MMS Fixes It:
We give you easy-to-read dashboards that show how each specialty is doing, so you can make better decisions.
Billing for Procedures Not on the Approved List
Medicare and other payers only pay for certain procedures in ASCs. If you bill for something not on their list, you’ll get denied.
How MMS Fixes It:
We check every case before you bill, making sure it’s on the approved list, so you don’t waste time or lose money.
Front-End Staff Training Gaps
Sometimes, mistakes happen before the patient even gets to the operating room. If your front desk staff doesn’t know the latest coding rules, they can make errors that lead to denials.
How MMS Fixes It:
We train your front desk and schedulers on the newest rules, so your claims are clean from the start.
The Bottom Line
Most money lost in ASCs comes from small, everyday mistakes—not big disasters. At MMS, we help you:
- Cut down on denials from coding errors
- Get paid for every implant and out-of-network case
- See which specialties make the most money
- Fix problems before they start
Ready to stop losing money? Contact MMS and let’s make your ASC more profitable—together!
MMS’s experience in medical billing and coding, along with our specialized approach to pre-authorization, enables healthcare providers to minimize administrative burdens, prevent revenue losses, and enhance patient experience.
By choosing MMS, you’re simplifying your prior authorization process and aligning your practice with a trusted partner who understands the intricacies of medical billing.
Let MBC handle the complexities so you can focus on what matters most: providing excellent patient care.
📞 Schedule a call today 706.315.4660 and let’s talk about how our coding experts can make a real difference in your practice.
Disclaimer: This information is for education purposes only, and is not intended to be a substitute for specific individualized tax, legal, or investment advice. Where specific advice is necessary or appropriate, you should consult with a qualifies tax advisor, Financial Planner or CPA.
For assistance managing and improving your Revenue Cycle, contact Mark Manning of Medical Management Services at 706.315.4660.
