Ambulatory Surgery & EMS Billing Services
One outsourced team for ASC RCM and EMS revenue cycle. AAPC-credentialed ASC coders, ambulance billers, and prior auth specialists working inside Waystar, Trizetto, ZOLL, ESO, eClinicalWorks, NextGen, and Athena. 800+ providers trust us. Pilot in 2 weeks.
Trained ambulatory & EMS billers, inside your software
Coding and RCM specialists under HIPAA-compliant workflows.
Ambulatory Surgery & EMS Billing outsourcing from Staffingly covers ambulatory surgery center billing services, ASC and EMS revenue cycle management, and surgical billing: a HIPAA-compliant healthcare BPO model with dedicated, remote specialists (named to your account, never a shared offshore pool) who run this part of your back office as a fully outsourced team, billed at a flat weekly fee per specialist, not a percentage of collections.
ASCs and EMS providers are losing revenue to three forces at once .
Three pressures quietly drain ambulatory surgery centers and EMS providers every week. Coders see it. Billers feel it. Owners and CFOs see it in the days-in-AR and net-collection numbers. The 2026 rule environment makes each one heavier.
ASC reimbursement squeeze
CMS finalized a +2.6% ASC payment update for CY 2026, with a 2.0 percentage point reduction if quality reporting requirements are not met. Anthem started penalizing facilities for OON ancillary provider use on January 1, 2026. Margins move on case mix, modifier accuracy, and claim cleanliness.
EMS reimbursement shortfall
The RAND Corporation Ground Ambulance Data Collection System report (December 2024) put average EMS transport cost at $2,673 versus average reimbursement of $1,147. That is a $1,526 shortfall every transport. The CY 2026 Ambulance Inflation Factor is 2.0%, down from 2.4% in 2025.
Prior auth volume crushing both
MGMA's 2025 Annual Regulatory Burden Report found 92% of medical group practices hire or reassign staff solely to handle prior authorization. ASCs and EMS providers feel both ends, cataract and colonoscopy PAs on one side, MA and Medicaid non-emergency ALS PAs on the other.
Tell us about your ASC or agency.
Send us your busiest billing queue and our team will scope the right setup, usually within one business day. No obligation.
What is an ambulatory & EMS billing service ?
Inside a Staffingly ambulatory & EMS billing pod
An ambulatory and EMS billing service is a remote revenue cycle team that works inside your software platform, follows your facility-specific or trip-sheet documentation, and treats your patients, surgeons, and crews the way an in-office biller does. Not a generic VA. Not a one-off coder. A trained ASC or ambulance billing specialist who logs into the same Waystar, Trizetto, ZOLL, ESO, or eClinicalWorks instance your in-office team uses.
Explore our Ambulatory & EMS billing services
What your outsourced ASC and EMS team actually handles, day to day
Pick the revenue cycle queues that hurt most. Your outsourced billers absorb them. Your in-house team focuses on patient experience, surgeon and crew relationships, and case mix optimization.
ASC surgical coding
AAPC-credentialed coding for cataract (66984), colonoscopy (45378-45385), arthroscopy (29881), EGD (43239), TKA (27447), and pain procedures.
EMS / ambulance billing
HCPCS A0425-A0434 base and mileage coding, origin and destination modifiers, PCR documentation review.
Prior authorization
ASC procedure-specific PA and non-emergency ALS ambulance PA aligned with CMS-0057-F 72-hour and 7-day decision timelines.
Modifier discipline
Correct SG, 73, 74, 59, XE/XS/XP/XU usage. No modifier 50 on ASC claims. Origin and destination modifier pairs on every ambulance line.
Claim submission & scrubbing
Clean submission through Waystar, Trizetto, and payer portals. NCCI edits run before submission, not after denial.
Denial management
Root-cause coding on every denial bucket. Appeals built around CMS LCDs, ASC CPL changes, and ambulance medical necessity rules.
Payment posting & AR follow-up
ERA posting in Waystar and Trizetto, secondary billing, patient statement support, AR follow-up across MA, Medicaid, and commercial.
Reporting & KPIs
Days in AR, clean claim rate, denial rate, net collection rate, modifier accuracy, run-to-bill cycle for EMS providers.
ASC- and EMS-trained billers, not generic VAs
Most outsourcing companies offer call-center agents and call them "billers." We do not. Our ASC coders are AAPC-credentialed, our ambulance billers are tested on origin/destination logic, and every specialist is software-certified before they touch a live claim.
ASC and EMS trained, not generic
Every ASC coder passes an AAPC-aligned assessment on CPT 66984, 45378-45385, 29881, 27447, 43239, and modifier 73/74/SG rules. Every EMS biller passes a test on A0425-A0434 and origin/destination modifier logic before placement.
Stacked compliance posture
HIPAA-compliant workflows, signed BAA, role-based access, and audit logging. Plus alignment with CMS-0057-F decision-time rules (72 hours urgent, 7 calendar days standard) that are now in effect for MA, Medicaid managed care, CHIP MC, and FFE QHPs.
2-Week Free Pilot, BAA Signed
Industry offers no trial. We give you 14 days of live ASC coding or EMS billing work at the same rate. Cancel before day 14, owe nothing. No annual contracts after.
Staffingly vs DIY in-house vs generic VA or onshore BPO
The real cost math for a single full-time ASC coder or EMS biller role at a mid-size facility.
From "let's talk" to live in 1 to 2 weeks
Six steps. Each one is documented. Nothing is mysterious.
Discovery call (15 min)
Tell us which revenue cycle pain is loudest. ASC coding accuracy? Ambulance run-to-bill lag? PA volume? We map it on a shared call.
BAA + platform access
Business associate agreement signed. Role-based access provisioned in Waystar, Trizetto, ZOLL Billing, ESO RescueNet, eClinicalWorks, NextGen, or Athena.
Workflow shadow (2 to 3 days)
Your specialist shadows your in-house coders or billers. Op-note conventions, PCR habits, payer-specific tweaks captured. Escalation rules locked.
Parallel pilot starts
Week 2 to 3. Your outsourced FTE runs alongside your team. Daily 15-minute sync. You see every claim coded, every PA submitted, every run billed.
Decision point (end of week 2)
Pilot results reviewed. Go or no-go. No penalty if you cancel. Most facilities keep going.
Full handoff, cadence locked
Days-in-AR, clean claim rate, modifier accuracy, denial rate in your inbox. Weekly review with your account lead. Monthly QA audit.
How your ASC or EMS billing day actually looks
A real shift, hour by hour. Times shown in your local time. We rotate coverage so your facility billing queues are never stale during business hours.
“Staffingly is far and away the best.”
“I have tried a few outsourced solutions but Staffingly is far and away the best . Dan and Sameeksha have personally made sure my implementation and onboarding were smooth and they never overpromised and underdelivered. That is very rare in my experience. You hear all the right things in the sales process, but when it comes time to actually go live, too many solution providers fail miserably. Not Staffingly. I am a big fan. ”
Trained on every ASC and EMS platform your facility actually uses
Onboarding time per platform shown. Standard systems go live in 5 to 7 business days. ASC-specific and ambulance-specific setups add 3 to 5 days for facility-specific configuration.
Authoritative Sources & Standards (Ambulatory Surgery & EMS)
How Staffingly works, in practice
Inside the work A trained Staffingly specialist runs the workflow inside your existing ambulance and ASC billing software, with clear escalation back to your team.
One Flat Weekly Rate. No Surprises.
Dedicated ambulatory & EMS specialists at a fixed weekly cost. Per specialist FTE, per week. No contracts, no minimums, no hidden fees.
Want to compare against an in-house hire? Use the savings calculator.
Frequently asked questions
How fast can a Staffingly ASC coder or EMS biller start working in our software?
Onboarding for Waystar, Trizetto, ZOLL Billing, eClinicalWorks, NextGen, Athena, and AdvancedMD typically takes 5 to 7 business days from BAA execution to first live claim. ESO RescueNet, Traumasoft, EMRStar, and Centricity ASC take 7 to 10 business days. Facility-specific PA workflows add 3 to 5 days for payer-portal access.
How is PHI and HIPAA handled across remote ASC and EMS staff?
HIPAA-compliant workflows with signed BAA, role-based platform access, and audit logging. PHI never leaves the controlled environment. Specialists work from biometric-secured facilities.
What does the CY 2026 +2.6% ASC payment update mean for our facility?
CMS finalized a 2.6% ASC payment update for CY 2026 as part of the OPPS/ASC final rule. Facilities that fail to meet quality reporting program requirements take a 2.0 percentage point reduction. CMS also added 560 new surgical procedures and 35 ancillary services to the ASC Covered Procedures List for CY 2026.
How do you handle CMS-0057-F prior authorization timelines?
CMS-0057-F binds Medicare Advantage, Medicaid FFS, Medicaid Managed Care, CHIP FFS, CHIP Managed Care, and FFE QHPs. Decision time is 72 hours for urgent requests and 7 calendar days for standard requests, and those rules are now in effect. API requirements move to enforced compliance by January 1, 2027.
What about the EMS reimbursement shortfall and the CY 2026 Ambulance Inflation Factor?
The RAND Ground Ambulance Data Collection System report (December 2024) put average EMS transport cost at $2,673 versus average reimbursement of $1,147, a $1,526 gap per transport. The CY 2026 Ambulance Inflation Factor is 2.0%, down from 2.4% in 2025.
What is included in the 2-Week Free Pilot, BAA Signed?
Two weeks of live ASC coding, EMS billing, or PA work running in parallel with your in-house team. Full reporting on clean claim rate, modifier accuracy, days in AR, denial rate, and PA approval rate. No setup fee. No penalty if you cancel before day 14.
How does pricing work across multiple facilities or ambulance bases?
Per FTE, per week. Per-skill pricing. No setup fees. $399 Standard, $349 Volume (3 or more), $299 Enterprise (10 or more). Add or remove FTEs by the week. No annual contracts.
How are your ASC coders and EMS billers trained?
Our ASC coders are AAPC-credentialed and tested on facility-fee CPT 66984, 45378-45385, 29881, 27447, 43239, 62323, and modifier 73, 74, SG rules. Our ambulance billers are tested on HCPCS A0425-A0434, A0998, and origin/destination modifier pairs.
Is outsourcing medical billing worth it?
For most ASCs and ambulance services, yes: a dedicated, trained team raises clean-claim rates and works denials and AR consistently, usually for less than the loaded cost of in-house staff. Staffingly bills a flat weekly fee per specialist rather than a percentage of your collections.
What is a healthcare BPO?
A healthcare BPO (business process outsourcing) runs back-office work such as billing, coding, prior authorization, and AR follow-up for providers. Staffingly is a HIPAA-compliant healthcare BPO that places named, remote specialists inside your existing software.
How much does outsourced medical billing cost?
Pricing models vary: a percentage of collections (commonly 4 to 9 percent) or a flat fee. Staffingly uses a flat weekly rate per dedicated specialist, so your cost is predictable and not tied to a cut of every dollar collected.
President and CEO, Staffingly, Inc. 25+ years in IT consulting and healthcare BPO operations. One of the earliest US operators to set up an RPO/BPO delivery network in India. Leads AI-driven ambulatory and EMS billing workflows that help ASCs, ambulance services, and surgery centers cut admin cost without compromising compliance.
