Ambulatory Surgery Center (ASC) Credentialing FAQ

Navigating Credentialing So Your ASC Can Focus on Patient Care

TriumpHealth Helps ASCs, Labs, and Other Facilities Achieve Seamless Credentialing and Payer Participation

1. Why is credentialing important for Ambulatory Surgery Centers (ASCs)?

Credentialing is essential for ASCs to obtain reimbursement from Medicare, Medicaid, and commercial insurance carriers. Without proper credentialing, your ASC cannot legally or compliantly bill for facility fees, which are a primary revenue stream.

TriumpHealth ensures your ASC meets all regulatory, payer, and compliance requirements to operate and bill successfully.

2. What does TriumpHealth’s ASC credentialing service include?

We offer comprehensive, end-to-end credentialing and enrollment support for ASCs:

TriumpHealth also works with MSOs, private equity groups, and multisite operators to manage credentialing at scale.

3. When should credentialing begin for a new ASC or expansion project?

Credentialing should begin at least ~90–180 days before your ASC’s go-live date.
Payers like Medicare and major commercial insurers require time for enrollment, site verification, and approval.

TriumpHealth works in parallel with your licensing, accreditation, and contracting processes to ensure credentialing doesn’t delay your revenue cycle.

4. What payers should an ASC be credentialed with?

We typically credential ASCs with:

  • Medicare (CMS)
  • State Medicaid and Medicaid MCOs
  • Commercial payers, including BCBS, Aetna, United Healthcare, Cigna, Humana, Anthem
  • TPAs and Workers’ Comp networks
  • Out-of-network payers (when strategic for cash pay or carve-outs)

We help you assess payer mix, negotiate favorable terms, and align credentialing with your ASC’s surgical specialties and volume goals.

5. How long does ASC credentialing take?

Credentialing timelines vary by payer and state but generally range from:

  • Medicare/Medicaid ~90–120+ days
  • Commercial payers ~60–150 days
  • Recredentialing/updates ~30–90 days

TriumpHealth proactively monitors and follows up on all applications to minimize delays and denials. We also help escalate and resolve stalled applications.

Please note: These timelines are general estimates and may vary based on payer-specific processes, state regulations, application completeness, and responsiveness to follow-up requests. Delays may also occur due to payer backlogs or additional documentation requirements.

6. What’s the difference between credentialing the ASC vs. credentialing individual providers?

ASC credentialing focuses on the facility itself i.e. its tax ID, NPI, licensure, ownership, and operating structure.

Provider credentialing, by contrast, is specific to surgeons, anesthesiologists, and other clinicians working at your ASC.

TriumpHealth handles both facility and individual provider credentialing to streamline your entire enrollment and compliance process.

7. Does TriumpHealth help with payer contracts and rate negotiations?

Yes. In addition to credentialing, we offer payer contract negotiations and rate analysis to ensure your ASC is paid fairly and consistently.

TriumpHealth payer contract experts benchmark reimbursement rates and identify carve-out opportunities for high-volume or high-value procedures.

8. Can TriumpHealth credential multi-specialty ASCs or those owned by physicians or private equity?

Absolutely. We work with a wide variety of ASC ownership models, including:

  • Physician-owned single and multi-specialty ASCs
  • Private equity-backed ASCs and surgery center networks
  • Hospital-affiliated ASCs (joint ventures)
  • New de novo ASC developments and acquisitions

We tailor credentialing to your ownership structure, state compliance rules, and specialty mix (e.g., ortho, ENT, GI, pain management, ophthalmology, plastics, podiatry, etc.).

9. What other compliance or enrollment services does TriumpHealth provide to ASCs?

In addition to credentialing, TriumpHealth supports ASCs with:

  • CMS and state licensure enrollment support
  • Accreditation readiness (CHAPAAAASFAAAHCTJC)
  • Ongoing revalidation management
  • CAQH and PECOS support
  • Taxonomy code guidance
  • Credentialing SOP development
  • HIPAA compliance and risk assessments

We are your long-term credentialing and regulatory partner, not just a one-time vendor.

10. What happens if our ASC changes ownership, moves locations, or adds a new service line?

Any of these changes will trigger updates with Medicare, Medicaid, and commercial payers. Delays or failure to notify payers can disrupt your reimbursement.

TriumpHealth provides change-of-ownership (CHOW) support, location updates, service line additions, and rapid enrollment updates to keep your billing uninterrupted.

11. How do we get started with TriumpHealth’s ASC Credentialing Services?

You can schedule a free consultation to understand your ASC’s timeline, specialties, state requirements, and payer goals. You can always contact us via email: [email protected] or call us at (888) 747-3836

Learn more:  TriumpHealth ASC Credentialing Services

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