Jho Outlaw, senior vice president of revenue cycle services for Surgical Information Systems, shared three tips on how ASCs can tackle denials and appeals.
Here are the insights she shared on SIS' blog:
1. Ms. Outlaw said ASCs shouldn't take 'no' for an answer when a payer won't authorize multiple codes before a procedure is performed. ASCs can also check their data and submit codes that their surgeons use more often.
2. If verification of benefits falls through after eligibility is determined, ASCs can check if their state laws dictate insurers must pay according to the verification provided at the time of service. Documenting who your ASC representative spoke with as well as what was verified can streamline the process.
3. If an insurer asks for medical records and claims they were never sent, they can be sent through certified mail so ASCs can provide proof.