Costly ASC Mistake: Poor Upfront Collections Process

Bill Gilbert, vice president of marketing for AdvantEdge Healthcare Solutions, discusses the costly ASC mistake of denied claims caused by a poor upfront collections process.

Bill Gilbert: We did an estimate and determined that a single denial costs at least $50 and some a lot more than that. Many denials are preventable by better upfront procedures, such as capturing more accurate and complete insurance information. That kind of attention to detail in the scheduling and registration process can certainly lead to cost reductions.

Some surgery centers don't have solid, formal procedures or checklists — whether it's on paper or on a computer — that they train and require their staff to follow on a consistent basis. It's really about asking all of the right questions. One example: Asking patients if their case is related to normal health insurance, motor vehicle insurance or workers' compensation. Some patients don't know for sure which insurance is primary, so it is best to ask where the "accident" occurred, and at what time of day. For ASCs that deal with issues related to motor vehicle insurance and/or workers' compensation, if you submit  patient's regular health insurance but the case is really motor vehicle or employment related,  the claim is going to be denied. The denial means wasted time, extra costs and in the end, a negative impact on cash.

Learn more about AdvantEdge Healthcare Solutions.

Read more guidance from the leadership team of AdvantEdge Healthcare Solutions:

- 5 Tips for Proper Documentation and Billing of Post-Op Pain Blocks

- 3 Common Surgery Center Billing, Coding and Collection Mistakes

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