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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Choosing the Right Internal Medicine Billing Solution

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According to a Physician Compensation survey conducted by Sullivan, Cotter, and Associates, specialty physicians across the US saw a 1.9% increase in their compensation in 2014. Internal medicine physicians also experienced a two percent change in their compensation between 2013 and 2014. The median total cash compensation for them recorded in 2014 is $213,428.  Our internal medicine billing process is streamlined so that you can have a healthy revenue cycle management. In this blog, Here we shared more reasons why you choose the MedicalBillersandCoders for the Right Internal Medicine Billing Solution.

Even though the internal medicine specialty witnessed a slight increase in compensation this year, many internists continue to grapple with a shrinking bottom line. This is because treatment by an internal medicine physician depends on or collaborates with different diagnostic laboratories and care to justify. Due to such varied aspects of the treatment episode, the medical billing and coding become complicated. The medical claims for internists require joint coding of services. They also have to deal with a variety of separate codes as they have to treat various health disorders.

Did you know that internists have the fifth-highest burnout rate among physicians? On average, they see 20 – 30 patients a day, working for long hours every week. The pressure caused by healthcare reforms has heightened their workload. It has been observed that internists spend around 10 or more hours on paperwork and other miscellaneous tasks every week. Some of the most commonly faced challenges are:

  • Failing to keep track of the changes to ICD-9-CM and CPT codes for various treatment procedures included in internal medicine. Regular changes in the ICD-9-CM, HCPCS, and CPT codes have complicated the billing procedure for internal medicine physicians
  • Not coding peripheral tests and processes such as removal of skin tags and injections in an accurate manner

To learn more about Choosing the Right Internal Medicine Billing Solution, click here: https://bit.ly/3qx5u86 Contact us at info@medicalbillersandcoders.com/ 888-357-3226.

Location: United States

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