Caryl Serbin, president and founder of Serbin Surgery Center Billing, recommends ASCs focus on the following areas when auditing different components of their billing process.
When auditing coding:
- Accuracy of CPTs
- Need for additional CPTs
- Accuracy of diagnosis codes
- Need for additional/different diagnosis codes
- Accuracy of modifiers
- Need for additional/different modifiers
When auditing charge posting:
- Charges posted correctly
- Diagnosis codes posted correctly
- Modifiers posted correctly
- Up-front adjustments done correctly (automatic/manual)
- Number of days taken to generate claim after received from coder
When auditing payment posting:
- Payment posted correctly
- Adjustment made correctly
- Balance transferred correctly
- Notes posted as appropriate
- Credit balance processed correctly and timely
- Under/over payments handled correctly and timely
When auditing collections:
- First follow-up within 15-30 days
- Additional follow up every 30 days
- Detailed follow-up notes
- Appeal done properly
- Claim/patient statement generated as needed
- Appropriate pre-collection efforts made
Learn more about Serbin Surgery Center Billing.
Read more insight from Caryl Serbin:
- 5 Ways ASCs Can Improve Coding
- 8 Ways ASCs Can Improve Patient Collections
- Should Your ASC Outsource Coding And Billing?