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ASCs: Case Build, Auth & Day-of-Surgery Risk

Centralized case build & auth with payer criteria, benefits & estimates, coding QA, and rejections SWAT to protect surgical schedules.

Talk to ASC LeadLanes We Run

Why Carenox for ASCs

We reduce DOS cancellations via clear criteria, timers, and escalation macros.

  • Payer criteria prompts & document checklists
  • Benefits and patient responsibility estimates
  • Procedure/implant coding QA & edits
  • Rejection & appeal templates with evidence

Lanes We Run

  • Case Build & Prior Auth
  • Eligibility/Benefits & Estimates
  • Scheduling & DOS risk checks
  • Charge Entry & Claim Scrub
  • Rejections SWAT (≤48h)
  • Payment Posting & Refunds
  • Coding QA (modifiers/implants)
  • AR Follow-up & Denials/Appeals
  • Dashboards & definitions

KPIs

  • Auth TAT & DOS cancel rate
  • Clean-claim & FPY
  • AR aging & denial win-rate
  • Coding QA pass & rework

Outcomes

Auth TAT −30% • DOS cancels −40% • Clean-claim +9 pts.

Protect your surgical schedule

We’ll tune case build & auth flows, then run them with SLAs.

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