The healthcare process involves different stages, with multiple people working in each stage. From the initial appointment to the payment collection stage, mistakes are bound to happen and can result in financial losses for the practice. Out of the many processes involved, medical coding tends to be prone to errors, specifically in ambulatory surgery center (ASC) settings.
Experts believe that 80 percent of medical bills have errors. Moreover, almost 50 percent of all Medicare claims contain billing mistakes, resulting in the double-billing of more than 411,000 seniors. Even the simplest ASC coding mistakes can cost hospitals $68 billion every year. ASCs are particularly prone to having billing errors that could get in the way of them getting paid correctly and promptly.
Why ASC coding is important
Through ASC billing services, freestanding ASCs can improve their coding capabilities, minimize errors, and stay compliant with federal and state regulations. Proper ASC billing and coding practices ensure the viable and timely delivery of outpatient services and pain management.
Common mistakes
Not all ASCs have sufficient labor and talent to handle ASC billing and know the appropriate codes for every patient. In most cases, it’s best to outsource revenue cycle management services to qualified companies that can address the challenges compromising the revenue performance of the facility, including denials and coding mistakes. Hiring the right ASC billing services can also prevent ASCs from further making these coding mistakes:
1. Not coding for multiple and bilateral procedures
2. Failure to code to the highest level of specificity
3. Coding from an operative note title instead of reading the operative note body, so they miss out on billable procedures conducted in surgery
4. Using non-specific or wrong diagnosis codes
5. Up-coding or unbundling
6. No or improper billing for implants
7. Wrong anatomical part
8. Lack of sufficient modifiers
9. Failure to use updated or current code sets
The consequences of these ASC coding mistakes include overtime, lengthy and tedious processes, and revenue loss. They may even encourage fraudulent practices, resulting in investigations and audits. That’s why it’s better to use ASC billing services to avoid problems down the line.
How Plutus Health can help
Leave ASC coding to Plutus Health, an experienced and technology-driven firm where you can find the revenue cycle management services your practice needs to increase efficiency, productivity, and savings. We offer medical coding, denial management, AR follow-up, and much more, with software and technologies to transform your practice digitally.
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