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How ASCs can minimize wasted time & reduce claim denials — 5 strategies

The preauthorization process eats up an estimated 20 hours of staff time per week, including physician time, nursing time and clerical hours, HSTpathways COO Tara Vail said in an article on Inside Digital Health.

Ms. Vail shared five ways ASCs can cut down on both time spent and denials:

1. Verify the patient's insurance eligibility, benefits and coverage upfront, and consider using low-cost automation tools that give real-time confirmation.

2. Review each surgical case before the procedure to determine whether prior authorization is necessary. Call the insurance company to confirm.

3. Note exactly which procedure codes were included in the prior authorization and document the time frame of the preauthorization.

4. Immediately identify any discrepancies between the services preauthorized and the ones included in the physician's operative report. If necessary, request a retroactive authorization for additional services rendered as soon as possible.

5. Before submitting a claim, double-check that all codes detailing the billed treatment and procedures match the authorized codes.

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