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.
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.