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
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.