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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Maximizing Family Practice Revenue by Implementing These Strategies

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Since family practices are facing a lot of factors that make it more difficult to get paid, it’s more important than ever to get proactive about billing procedures. Being proactive and preventing problems before they occur can help your family practice maximize revenue, ensuring you’re properly reimbursed so your practice can continue providing quality care to patients. Every year, medical providers in the United States leave more than $100 billion dollars of uncollected revenue on the table due to billing errors, coding mistakes, and failure to stay current on medical billing rules. Here’s a closer look at the top 5 medical billing strategies you can use proactively to begin maximizing your family practice revenue.

Contact us today to speak with one of our specialists about the benefits of outsourced Family Practice Billing management.

Top 5 Medical Billing Strategies to Maximize Family Practice Revenue

1. Review your scheduling practices

You may need to fine-tune the way your appointments are scheduled. If appointments are booked in standard 15-minute increments, you might be spending more time waiting for patients than you should. Or if appointments are all booked at the top of the hour (i.e., wave scheduling), your patients might be spending more time waiting for you than they should.

A modified-wave template schedules two 15-minute appointments on the hour, one appointment 15 minutes later, and another appointment 30 minutes after the hour. Typically there is no appointment 45 minutes after the hour, which allows time for a 30-minute appointment, an extra work-in patient, or time to return phone calls or catch up on documentation. A modified-wave template also helps to ensure that you’re not behind schedule even before you begin. If you start seeing patients at 9 a.m. and one doesn’t arrive on time, chances are the other patient with a 9 a.m. appointment will.

You should also consider whether your scheduler is getting the right visit type – or the right patient – in the right appointment slot. For example, diabetes checks may not require 30 minutes, especially if you have systems in place to ensure that lab results are available in the chart at the time of the visit. And certain patients will invariably consume the time of two appointments; book them accordingly. You can optimize your scheduling procedures by enabling easy communication between your scheduler and your clinical staff, for example, by putting their desks close to one another.

To know more about the Top 5 Medical Billing Strategies to Maximize Family Practice Revenue click here: http://bit.ly/3L29WY3 Contact us at info@medicalbillersandcoders.com/ 888-357-3226.

Location: United States

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