ASCs should closely and continually examine processes for preauthorization of the patient's procedure, a crucial step in the revenue cycle process, according to Surgical Information Systems Revenue Cycle Services Director Jessica Nelson.
Here are five ways ASCs can improve their preauthorization process:
1. Collect background information from the patient, including their name, contact information, birthday, social security number, insurance, diagnosis and procedure type.
2. Reach out to payers between 48 hours and two weeks before the scheduled procedure to verify patient benefits for primary and secondary insurance.
3. Become familiar with the physician's procedures and common changes in approach that may occur during the surgery. Preauthorize CPT codes for those common changes in addition to CPT codes for the planned/documented procedures.
4. Closely monitor correspondence with payers to identify any changes to authorization requirements.
5. Give preauthorization specialists adequate time and resources for training when they join the staff. Closely supervise preauthorization specialists when they're first getting started.
For three additional tips, visit Surgical Information Systems' blog post.