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What to Audit When You Audit Your ASC's Billing Process

Caryl Serbin, president and founder of Serbin Surgery Center Billing, recommends ASCs focus on the following areas when auditing different components of their billing process.

 

When auditing coding:

  • Accuracy of CPTs
  • Need for additional CPTs
  • Accuracy of diagnosis codes
  • Need for additional/different diagnosis codes
  • Accuracy of modifiers
  • Need for additional/different modifiers


When auditing charge posting:

  • Charges posted correctly
  • Diagnosis codes posted correctly
  • Modifiers posted correctly
  • Up-front adjustments done correctly (automatic/manual)
  • Number of days taken to generate claim after received from coder


When auditing payment posting:

  • Payment posted correctly
  • Adjustment made correctly
  • Balance transferred correctly
  • Notes posted as appropriate
  • Credit balance processed correctly and timely
  • Under/over payments handled correctly and timely

 

When auditing collections:

  • First follow-up within 15-30 days
  • Additional follow up every 30 days
  • Detailed follow-up notes
  • Appeal done properly
  • Claim/patient statement generated as needed
  • Appropriate pre-collection efforts made

 

Learn more about Serbin Surgery Center Billing.


Read more insight from Caryl Serbin:


- 5 Ways ASCs Can Improve Coding 


- 8 Ways ASCs Can Improve Patient Collections 


- Should Your ASC Outsource Coding And Billing?


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