William Blake Beach of Comp Recovery, a firm specializing in the financial recovery of underpaid worker's compensation medical bills, identified three easily corrected errors that might prevent ASCs and hospitals from cashing in on a major revenue stream.
1. Inadequate billing review or poor communication
Hospitals and surgery centers might not have a billing department focused on workers' comp cases, and if they do, the department might be overworked or understaffed — causing errors and oversights. Poorly worded or enforced contracts, which go hand-in-hand with inadequate review, can also cost hospitals huge amounts of money.
2. Failing to keep abreast of fee schedule changes
Some states may regularly change the worker's comp fee schedule. If ASCs don't follow these changes, the provider might bill too little or the payer could refuse to pay the bill.
3. Not identifying areas for improvement
Benchmarking claims and successful reimbursements is crucial to understanding how operations can be improved. It can also help identify a reduction strategy if claim payments exceeding 90 days make up a large portion of claims.