Surgery centers that choose to keep billing and coding in-house instead of outsourcing should institute a policy of oversight and teamwork, ensuring that mistakes are caught before claims are submitted and physicians, administrators, coders and billers are all involved in the billing and coding process. Kimberly Tude Thuot, administrator of Yakima (Wash.) Ambulatory Surgical Center, discusses three tricks that helped her ASC when she decided to move coding and billing in-house.
1. Require your physicians to send over CPT codes when they schedule a case. Ms. Tude Thuot says managing your coding and billing in-house is easier if you involve your physicians by requiring them to provide CPT codes every time they schedule a case. By involving the physicians in your coding process, you can improve knowledge about appropriate CPT codes on the coder side as well as the provider side. This practice also reduces the coders' workload because they only have to double-check what the physician has sent over, rather than start from scratch to figure out which codes are appropriate. "We have great relationships with our physicians," she says. "While doing the research on the codes for each specialty can be a little challenging, it really helps that [the coder can go to the doctor] and ask, 'Is that what you needed?'" Likewise, opening the lines of communication means physicians will feel more comfortable asking how their procedures affect the center from a billing and coding standpoint.
2. Hire a certified coder. Don't just rely on your existing staff members to add billing and coding to their normal responsibilities. Ms. Tude Thuot says her center cleaned up its billing and coding processes by hiring a certified coder. If you want to assign someone to coding but they are not yet certified, see if a certification program exists at your local community college.
3. Invest in billing and coding software that will ease the process. Ms. Tude Thuot says her center's billing and coding software helps her staff by checking the eligibility of the patient as soon as it receives the patient's information. While reports should always be double-checked by a staff member, your center will reduce time spent on the billing process by investing in software that tells you whether a patient is eligible for surgery and will be able to pay. Similarly, the coding software at Yakima ASC automatically corrects mistakes it finds in the submitted CPT codes. Along with the several staff members assigned to billing and coding, the software acts as a system of a checks and balances, making sure that one person's oversight does not mean a denied claim for the center.
1. Require your physicians to send over CPT codes when they schedule a case. Ms. Tude Thuot says managing your coding and billing in-house is easier if you involve your physicians by requiring them to provide CPT codes every time they schedule a case. By involving the physicians in your coding process, you can improve knowledge about appropriate CPT codes on the coder side as well as the provider side. This practice also reduces the coders' workload because they only have to double-check what the physician has sent over, rather than start from scratch to figure out which codes are appropriate. "We have great relationships with our physicians," she says. "While doing the research on the codes for each specialty can be a little challenging, it really helps that [the coder can go to the doctor] and ask, 'Is that what you needed?'" Likewise, opening the lines of communication means physicians will feel more comfortable asking how their procedures affect the center from a billing and coding standpoint.
2. Hire a certified coder. Don't just rely on your existing staff members to add billing and coding to their normal responsibilities. Ms. Tude Thuot says her center cleaned up its billing and coding processes by hiring a certified coder. If you want to assign someone to coding but they are not yet certified, see if a certification program exists at your local community college.
3. Invest in billing and coding software that will ease the process. Ms. Tude Thuot says her center's billing and coding software helps her staff by checking the eligibility of the patient as soon as it receives the patient's information. While reports should always be double-checked by a staff member, your center will reduce time spent on the billing process by investing in software that tells you whether a patient is eligible for surgery and will be able to pay. Similarly, the coding software at Yakima ASC automatically corrects mistakes it finds in the submitted CPT codes. Along with the several staff members assigned to billing and coding, the software acts as a system of a checks and balances, making sure that one person's oversight does not mean a denied claim for the center.