Accurate coding is essential to the smooth running of an ASC, according to ASC software developer Surgical Information Systems. Jho Outlaw, SIS' senior vice president of revenue cycle services and Jessica Nelson, director of revenue cycle services shared insights on how to handle common ASC revenue cycle issues.
Three things to know:
1. How to handle upcoding. ASC staff can handle upcoding, or inaccurate coding to insurance companies to receive inflated reimbursement, by bringing in a third party to determine if there's wrongdoing, bringing up the issue to management or alerting CMS.
2. How to handle rejections. Rejections should be sent back to coders who are certified to make corrections. Billers may know why a claim was rejected, but they don't have the documentation to correct them.
3. How to handle undercoding. Most undercoding is accidental, but ASC staff should scrutinize their own billing practices to ensure accuracy.
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