Becker's ASC Review

19 ASC TURNAROUNDS CPT 31276 together. However, CPT code 31255 and CPT code 31276 are still valid codes and appropriate to be billed when performed separately. In this example, reimbursement decreased by 50% as there was no increase in reimbursement for the new combo code. #7: Physician documentation turnaround. What is the average turnaround time for physician documentation? Are physicians quickly dictating notes with your current process? Are there opportunities to leverage new technology? Analyzing the physician turnaround time and discussing any delays with your group is a quick way to improve days to bill and consistent cash flow. #8: Unbilled claims reconciliation. Does your ASC have a process in place to identify claims that have not been billed? Does your current soware system allow for your team to track claims that have not been billed? #9:Charge posting accuracy. Are your charges being posted correctly for all services performed in each case? Pay close attention to cases with implants as most implant charges are manually calculated allow- ing plenty of room for error. Implants can be the most expensive part of the surgery, so it is important to get these charges right. #10: Claims turnaround. Evaluate the time it takes to move from receipt of source documentation, to code the claim, post the charges, and submit the claim. By monitoring these steps, you can understand and improve upon the days to bill for your ASC. #11: Claims rejections. Rejections should be worked the same day. Login to your clearinghouse and pull a report on outstanding rejections. How long is it taking your team to work them? What are your top claims rejections reasons? Is there anything that can be done on the front end to prevent your claims from rejecting? Does your clearinghouse have edits turned on to ensure that you are sending out clean claims? #12: Communication practices. What are your current methods of communication? Meetings, emails, phone calls, reports, etc.? Does your ASC have a standardized way of communicating issues identified, financial performance, and any other important information to the appropriate stakeholders? #13: Staffing optimization. By looking at various performance metrics, you can determine if your revenue cycle team is appropriately staffed with the necessary experience. For example, if you have frequent coding errors, you might be working with an inexperienced coding staff who don't understand all of the ins-and-outs of ASC coding. As such, you would want to consider hiring certified ASC coders who have experience in the specialty that you are serving. #14: Denial trends. What are your ASC's top denial trends? How much money is tied up in denials and what are you doing about it? Are you getting reimbursed correctly for the services your ASC provides? Track- ing and trending denials seems like such an easy task but it's one of the first areas problems start to literally pile up. Denials should be discussed oen and staff should always be looking to find solutions to prevent your claims from denying in the first place. You can't fix the problem if you don't know what the problem is. If you take the time to review your ASC operational strategy, your ASC will likely be in a position to succeed. e ASC revenue cycle is incredibly nuanced, however, all ASCs have the ability to make improvements before this financial year comes to an end. As Arthur W. Jones, an Australian born sociologist and former editor of Fortune Magazine once said, "All organiza- tions are perfectly aligned to get the results they get." 1 n References 1 SQT Training. https://www.sqt-training.com/2016/03/all-organisations-are- perfectly-aligned-to-get-the-results-they-get/ 1,100+ ATTENDEES FROM ACROSS THE NATION REGISTER BY MAY 1, 2018 AND SAVE! KEYNOTES BY 16TH ANNUAL FUTURE OF SPINE + THE SPINE, ORTHOPEDIC AND PAIN MANAGEMENT-DRIVEN ASC CONFERENCE JUNE 14-16, 2018 SWISSÔTEL | CHICAGO, ILLINOIS 140 PHYSICIANS SPEAKING, PRIMARILY SPINE & ORTHOPEDIC SURGEONS – 222+ SPEAKERS TOTAL REGISTER HERE beckersasc.com/june-conference registration@beckershealthcare.com jcole@beckershealthcare.com sbecker@beckershealthcare.com or 800.417.2035. BECKER'S ASC REVIEW JOE MONTANA Former American Football Quarterback, San Francisco 49ers, Kansas City Chiefs FRANK PHILLIPS MD, Director, Division of Spine Surger y, Professor, Orthopaedic Surgery, Rush University Medical Center ANDREW HAYEK Chief Executive Officer, OptumHealth and Chief Executive Officer, Surgical Care Affiliates RICHARD WOHNS MD, JD, MBA, Founder, President and Board Certified Neurosurgeon, NeoSpine TUCKER CARLSON Host, Tucker Carlson Tonight and Founder, The Daily Caller JAMES LYNCH MD, FRCSI, FA ANS, Spinal Neurosurgeon and Founder/ Chairman, SpineNevada I. NAYA KEHAYES Principal, ECG Management Consultants HOLLY BUCKLEY JD, Partner, McGuireWoods LLP

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