4 lessons from an analysis of general surgery billing denials

It’s important to understand why general surgery practices face denials, according to MedicalBillersandCoders.com, a consortium of medical billers and coders in the U.S.

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MedicalBillersandCoders.com analyzed 40 centers’ billing for general surgery procedures in the first half of 2018.

Here are four findings:

1. Thirty percent of the centers faced denials or had reimbursement adjusted as a result of errors.

2. After centers appealed again, revenue loss generally decreased to about 5 percent.

3. Denials are often caused by two factors: verification and information mistakes or coding errors.

4. Verification and information mistakes include having incorrectly spelled names, mistaken sexes or wrong insurance numbers. Coding errors may occur if physicians leave out important information.

More articles on coding, billing and collections:
Eye Centers of Florida pays $525K to settle Medicare billing fraud allegations: 5 things to know
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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.

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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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