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What to Audit When You Audit Your ASC's Billing Process

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Caryl Serbin, president and founder of Serbin Surgery Center Billing, recommends ASCs focus on the following areas when auditing different components of their billing process.

 

When auditing coding:

  • Accuracy of CPTs
  • Need for additional CPTs
  • Accuracy of diagnosis codes
  • Need for additional/different diagnosis codes
  • Accuracy of modifiers
  • Need for additional/different modifiers


When auditing charge posting:

  • Charges posted correctly
  • Diagnosis codes posted correctly
  • Modifiers posted correctly
  • Up-front adjustments done correctly (automatic/manual)
  • Number of days taken to generate claim after received from coder


When auditing payment posting:

  • Payment posted correctly
  • Adjustment made correctly
  • Balance transferred correctly
  • Notes posted as appropriate
  • Credit balance processed correctly and timely
  • Under/over payments handled correctly and timely

 

When auditing collections:

  • First follow-up within 15-30 days
  • Additional follow up every 30 days
  • Detailed follow-up notes
  • Appeal done properly
  • Claim/patient statement generated as needed
  • Appropriate pre-collection efforts made

 

Learn more about Serbin Surgery Center Billing.


Read more insight from Caryl Serbin:


- 5 Ways ASCs Can Improve Coding 


- 8 Ways ASCs Can Improve Patient Collections 


- Should Your ASC Outsource Coding And Billing?


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