Why Surgeon Coding and Facility Claims Must Match — The ASC Synchronization Problem Payers Are Now Auditing

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Ambulatory surgery centers (ASCs) are facing increasing pressure to keep professional and facility claims consistent. A surgeon may submit a professional claim for a procedure while the ASC submits a separate facility claim for the same encounter. Although these claims serve different billing purposes, the clinical details behind them should tell the same story. When surgeon coding and facility claims do not match, payers may see inconsistencies that can trigger claim reviews, payment delays, downcoding, or denials. The problem is not always an incorrect CPT code. Sometimes the issue is that two correctly prepared claims do not appear synchronized. The ASC Synchronization Problem ASC billing involves multiple parties. The surgeon or physician group submits the professional claim, while the facility submits the institutional claim for the services and resources provided by the ASC. Both claims can contain different codes because they represent different components of the same encounter....
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Everything You Need To Know About Podiatry Billing Services Guidelines

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Podiatry is one of the medical specialties, which concentrates on the diagnosis and treatment of the human feet and ankles. Podiatrists care about different conditions related to the foot such as heel spurs, toenails, fallen arches, foot/ankle injuries, and plantar fasciitis. Services offered by podiatrists should be paid for by either insurance companies or the patients or by both. Podiatry billing services are a very critical part of many practices.

As far as podiatry billing services are concerned, it is able to collect money efficiently from payers that are accountable for covering the services offered by podiatrists and patients. There are some services, which are not covered by payers, especially those which are not considered medically needed for appropriate foot care as per the Medicare Benefit Policy Manual (MBPM).

Below we Mentioned the Services which are Covered by Payers:

An exception to podiatry services covered

There are specific foot care services that are not covered by Medicare, and there are chances to be covered under general third-party insurance. If you avail of some sort of foot care services that fall into this category then it is a waste of time to hassle with your insurance company for reimbursement. Which are those services?

To know more about Podiatry Billing Services Guidelines click here: http://bit.ly/3Z5eHnU Contact us at info@medicalbillersandcoders.com/ 888-357-3226.

Location: United States

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