3 ways ASCs can overcome denials & appeals challenges

Jho Outlaw, senior vice president of revenue cycle services for Surgical Information Systems, shared three tips on how ASCs can tackle denials and appeals.

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Here are the insights she shared on SIS’ blog:

1. Ms. Outlaw said ASCs shouldn’t take ‘no’ for an answer when a payer won’t authorize multiple codes before a procedure is performed. ASCs can also check their data and submit codes that their surgeons use more often.

2. If verification of benefits falls through after eligibility is determined, ASCs can check if their state laws dictate insurers must pay according to the verification provided at the time of service. Documenting who your ASC representative spoke with as well as what was verified can streamline the process.

3. If an insurer asks for medical records and claims they were never sent, they can be sent through certified mail so ASCs can provide proof.

More articles on coding, billing and collections:
3 ways ASCs can increase profits through managed care contracts
What CMS’ decision to pay separately for Exparel use means for ASCs — 5 insights
Envision & UnitedHealthcare agree to extend contract after intense, lengthy battle — 5 insights

At the Becker’s 32nd Annual Meeting: The Business and Operations of ASCs, taking place October 29-31 in Chicago, ASC leaders, surgeons and healthcare executives will explore strategies to drive growth, enhance operational performance, navigate reimbursement challenges and prepare for the future of ambulatory surgery. Apply for complimentary registration now.

Register to Attend Webinar

Is ambulatory care healthcare’s big margin engine? 4 leaders weigh in

Wednesday, July 29
1:00 PM - 2:00 PM CDT

Presenters: Joe Ganley, athenahealthJeffrey Flynn, CASC, Gramercy Surgery CenterBryan Tsao, Access Center, Loma Linda University HealthJason Zepeda, Northridge Hospital Medical Center, CommonSpirit HealthGreg DeConciliis, PA-C, CASC, Boston Out­Patient Surgical Suites

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