MediGain's Senior Vice President of Business Development spoke with Becker's ASC Review about strategies surgery centers can do today to improve their revenue per case.
Question: What are some pitfalls ASCs make that made impede their ability to receive the appropriate reimbursement?
Karl Johnson: [Some challenges include] incomplete clinical documentation and coding errors, ICD-10 mismatch or missed modifiers. [ASCs also may] fail to pre-collect estimated patient responsibility
Q: What can ASCs do every case to receive the maximum reimbursement?
KJ: Obtain authorizations and predetermination of benefits (out of network) when required/available. [They can also] communication with patients about their financial responsibility and verify insurance eligibility.
Q: How do you see payment faring for surgery centers moving forward? Are more payers engaging in contract negotiations with ASCs?
KJ: I see reimbursement being stable. Negotiations will be dependent on centers being able to demonstrate quality and value.
Learn more from Mr. Johnson at the 24th Annual Meeting: The Business and Operations of ASCs in October 2017. Click here for more information.