7 Common Errors while Billing for Ambulatory Surgical Centers (ASC)

One of the modern healthcare facilities known as Ambulatory Surgical Centers (ASC) focus on providing surgical care on the same day that is required. With passage of time, there has been a complete transformation in the way the services are being provided, including preventive and diagnostic procedures. In fact, the outpatient experience has transformed the life of millions of patients. Now, they get more convenient and fast alternative medical care. Though the patient outcomes are positive and hold a strong track record, the medical practitioners often find it hard to manage the common errors in ambulatory surgical centers medical billing and coding.  

This blog is inclined to help you focus more on their patients while avoiding the following common errors in ASC medical billing and coding:

1. Inappropriate Discounts

The matter of the fact is that ASCs are not only focusing on reducing the financial burden of the patients, but also aiming at providing the convenient medical care. But at times when the hardship discounts or waiving is done routinely to achieve the process, it adversely impact the ASC medical billing and coding. Moreover, your practices often violate the insurance contracts as payers expect you to collect the ASC medical billing amount directly from the insurance providers after fulfilling the complicated procedures.  

To collect the amount, you can communicate the patient’s financial responsibility before the service date. Also, you can offer various payment options and retain the agreement copies.

2. Improper Tracking of Denials

Being the ASC practitioner, you can also experience a slow cash flow in case of arising of denials and further improper tracking of the same. Fortunately, 90% of the denials are preventable and 2/3rd of them are successfully appealed with proper and timely tracking of the same. Therefore, this demands the implementation of a proper system to make the tracking easy. It should include the reason, who denied it, initial coding, and the final result. This way you will find it feasible to review the latest trends. Moreover, you’ll be able to identify the billing errors in one go.

3. Using old forms

If in case you haven’t made the updates in your patient encounters forms, you might miss out on revenue opportunities as regular changes are required to the DSM and coding system. The use of old forms will directly hit the revenue cycle of your practice. That’s why it is advisable to use updated forms with the latest codes. Even if you might update the codes a year ago, prioritize updating the codes to increase your revenues.

4. Unclear Reporting

In case of multiple elements or procedures in a single surgery, it is essential to bill every procedure in detail. Otherwise, you will face downfall in your revenues, leading to the shutting down of your practice forever. Don’t assume your ASC medical billing staff to record all the elements automatically. Instead, it is better to be attentive and make clear records to ensure 99.99% accuracy.

5. Misused or missed modifiers

When using modifiers, you might miss or misuse any modifier. This results in unclear reporting or oversight of the codes, leading to enhancement in the denials. Higher the mistakes in the usage of the modifier, greater will be the chances of claim denials. Therefore, try making your documentation clear to clarify why you used that specific modifier.

For instance, if you provide various distinctive services (like surgery or counseling) to a patient during the surgical appointment, you should clearly define the codes. Try using modifier 25 to flag it. Use code 59 to show multiple procedures (like surgical repair and nerve pain) performed in one surgical session to distinguish the codes in the ASC medical billing.

6. Inadequate payer contracts

Your practice financial performance further gets damaged when agreeing to poor payer contracts. That’s why it is highly recommendable to agree on skillful negotiation of the agreement to ensure fair ASC medical billing. The best way out is to compare the third parties and the proposed contract. Further, consider new ASC medical billing procedures such as increasing supply costs and other improper reimbursements while renegotiating. Avoid using expensive implants and if the payer avoids covering implants, ask for carve-outs, especially for the higher costs.

7. Negligence towards payment posting

Payment posting should be performed time-to-time. Maintaining reconciliation and posting daily payments is the need of an hour for any ASC medical practice. The concerned person should understand the benefits for easy indication of any processing errors. You should further prioritize to stay on top of credit balances to write off bad debt. Also, drop the balance to the secondary insurance when the claim is adjusted accurately.

Prioritize your Patient’s Financial Health!

From providing ASC medical care to raising the ASC medical bills, try making your ASC medical billing and coding free from any error or adverse impact. Choose adequate revenue cycle assessment for identification of any workflow weakness to get rid of common errors in ASC medical billing and coding. If you are still facing issues related to medical billing for ASC, outsource ASC medical billing to an experienced medical billing partner such as 24/7 Medical Billing Services to see the improvements with significant efficiencies.  

Read more: 5 Common Errors With ASC Billing

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