A mistake made at any point throughout the revenue cycle process can negatively impact a facility's bottom line. To help keep billing errors at a minimum, review the most common billing mistakes made by ASCs and tips to avoid them.
1. Unreconciled billing:
Simply put, unbilled procedures directly result in lost revenue or revenue leakage. The monotony of tracking billing procedures and following up on claims allows for many errors and missed reconciled bills (especially when conducted manually). It is as important to understand the reasons for unbilled cases to ensure that all performed procedures are billed. RPA (robotic process automation) can offer excellent enhancements to your current standard operating practices when processing billing and tracking denials, along with many other backend functions.
2. Coding errors:
Common coding errors can significantly affect financial output and performance. There are several coding errors that can take place from using outdated forms, missed coding to incorrect modifiers, upcoding, unbundling and so on. A common error is coding scheduled reports instead of waiting for the actual report compiled by a surgeon as the services can vary in the final report. According to Medicare Guidelines, the codes transferred between the surgeon and the ASC should not vary else the payer delays caused are severe. Regular communication between offices can help solve this problem and avoid discrepancies. At any time it is recommended to adopt verified and experienced ASC coders (inhouse or outsourced).
3. Unmeasured performance metrics:
Workflow models that predict and identify the root cause of RCM tribulations, minimize cash leakage, and provide cyclical improvements can only be revolutionized with the help of measured data analytics that monitor and categorize key performance metrics. Software that tracks specific benchmarks to scale any ASC’s performance health and set goals forward is no longer a luxury, it is a necessity. Denials percentages, charge lags, claim rejection rates, unadjusted accounts – these are a few examples of figures that can be forecast and benchmarked, and analyzed against real time results to take immediate corrective action.
For all of the above actions including coding, billing, collections, payment posting, staying up to date on technology and newly released information from relevant organizations (such as Medicare and Medicaid) is crucial as is a detailed monitoring of federal and state regulations and financial requirements. To schedule a call with one of our ASC revenue cycle consultants call 331-330-4808.