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What is an Ambulatory Surgery Center?
The Outpatient Surgery Center of Hilton Head is an Ambulatory Surgery Center (ASC), which is a facility providing same-day surgery procedures for treatment of conditions not requiring hospitalization. Procedures performed in ASC’s are typically less-complex and can involve the administration of anesthetics ranging from minimal sedation to general anesthesia. Routinely, ASC procedures involve short preparation and recovery timeframes. By law, an ASC can keep a patient up to 23 hours, but this is a rarity. Also, importantly, an ASC is NOT an emergency facility.
Only surgical and scopic and other outpatient treatment procedures are performed at OSCHH. This enables us to focus solely on providing you or your loved one the most comfortable and comforting surgical experience available.
How Medicare Defines an ASC
There are more than 1,600 Medicare-certified ASC’s in the United States today. To be eligible to be classified as an ASC, a facility must be:
- A distinct entity that operates exclusively to furnish outpatient surgical services;
- Either an independent, freestanding facility, a freestanding, joint-venture with a hospital, or a freestanding facility wholly under the control, licensure and ownership of a hospital; and,
- A facility surveyed, approved by and certified by Medicare.
How are ASC services covered by insurance providers other than Medicare?
Coverage of surgery and services in an ASC is dependent on your health insurance plan, but most plans cover surgery and treatment in ASC’s.
The Outpatient Surgery Center of Hilton Head plans to be an in-network provider of services with most of the major insurers including Aetna, Blue Cross/Blue Shield, Cigna, United Healthcare, PHCS, Fortis, Medicare, Federal Blue Cross, and Medicaid, as well as lesser known healthcare insurers like Guardian and John Alden.
How does Billing work in an ASC?
ASC’s charge the patient’s insurance (or the patient) a “facility fee” for each procedure completed in an ASC. The insurance pays the portion of the charge which it is obligated to pay under the patient’s health insurance plan contract. The remainder of the facility fee, if any, is the responsibility of the patient.
The ASC’s billing personnel work with patients prior to the scheduled surgery to make sure that patients know exactly what their direct financial responsibility will be for each procedure. All or a major portion of this amount is usually collected by the ASC on the day of surgery or before. ASC’s will typically work with patients to set up payment terms for patient-paid facility fees if they are unable to pay the entire amount prior to surgery.
In addition to the facility fee bill from the ASC, patients will also receive bills directly from their attending surgeon/physician and the anesthetist on their case, as well as any laboratory bills for pathology services involved.
What types of surgery are done at an ASC?
ASC’s can be single-specialty, such as a surgery center performing only gastroenterology or orthopaedic procedures; or they can be multi-specialty, performing procedures in more than one specialty.
Medical staff at the Outpatient Surgery Center of Hilton Head will be performing procedures in the following specialties: ENT, gastroenterology, ophthalmology, orthopaedics, pain management, urology and general surgery, as well as gynecology, plastic surgery, and podiatry.
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