Five key billing insights from ASC experts:
1. Surgery centers can improve claims denial management by adopting proactive strategies, including identifying the root causes of denials, according to Mnet Health, a financial technology firm specializing in healthcare. Root causes may include flawed internal processes or technology errors.
2. ASC management software developer Surgical Information Systems shared insights on improving financial performance. According to SIS, if physicians say they prefer that payments not be collected upfront due to patients canceling, ASCs should ensure patients receive financial counseling so they understand the procedure cost.
3. Undetected revenue leaks can hurt an ASC's profitability and cash flow, according to Serbin Medical Billing. To avoid them, ASCs should ensure the total dollar amount of the bill isn't increasing and that days bills are in accounts receivable are decreasing.
4. Gina Tolbert, a Regent RCM specialist serving the Center for Specialized Surgery in Fort Myers, Fla., recommended gathering information on claim status online and using electronic tools, such as calendar alerts, to prompt follow-up on accounts receivable.
5. ASC staff can handle upcoding — inaccurate coding to insurance companies to receive inflated reimbursement — by bringing in a third party to determine if there's wrongdoing, bringing up the issue to management or alerting CMS, according to Jessica Nelson, director of revenue cycle services for Surgical Information Systems