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CODING & BILLING
many facilities arrange payment plans with patients who can't afford
the full amount, only offer this as a last resort. First, detail your traditional methods of payment: "We accept all major credit cards, checks,
cash, and financing through XYZ Credit Services."
o Developing online pre-registration and pre-surgical instruction
forms for computer-savvy patients can minimize the amount of time
they spend filling out forms and reduce the possibility of anxious
errors on the morning of surgery, which can prevent delays in the
reimbursement process.
Reimbursement
o When negotiating managed care contracts, include your coding,
denials and materials management experts in the discussion. They
can provide insights into the implants, supplies and procedures that
may require strategic approaches for capturing reimbursement.
o Always calculate supply and implant costs, not just clinical performance requirements, before introducing new procedures to your
case mix. Services added without an aggressive comparison of case
costs against actual reimbursements can spell disaster. Begin negotiating contracts for new procedures as early as possible. The process
can be time-consuming.
o Don't rely solely on vendor-supplied reimbursement information or
coding directives when deciding whether to add new procedures.
Work with your coders to verify the information through a reliable
source and research the appropriate coding and billing details according to carrier directives.
Follow-up
o Adopt a standardized method of measuring coding quality. Periodic
audits can provide a baseline indicator of accuracy by identifying root
causes of error, as well as the strengths and weaknesses of the
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O U T PAT I E N T S U R G E R Y M A G A Z I N E O N L I N E | J U N E 2013
