Outpatient Surgery Magazine - Subscribers

The Economics of Prefilled Syringes - August 2017 - Outpatient Surgery Magazine

Outpatient Surgery Magazine, providing current information on Surgical Services, Surgical Facility Administration, Outpatient Surgery News and Trends, OR Excellence and more.

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10 Revenue-Cycle Mistakes to Avoid These blunders could endanger more than just your reimbursements. R eimbursements are the lifeblood of your surgical facility, which is why you fight so hard for every dollar. At the same time, you need to evaluate your entire revenue cycle so your processes are efficient, accurate and profitable. Avoid these 10 com- mon mistakes that could put your reimbursements — and your facili- ty — at risk. Submitting fraudulent claims. Under the False Claims Act, it is illegal to submit claims for payment that you know or should know are fraudulent. When you bill a claim, your facility is certifying that it has earned the payment requested and complied with the billing requirements. Always let the physician's written clinical documentation determine your code selection. Your center is subject to a take-back of all overpayments when discov- ered, and it might also incur additional monetary penal- ties per violation above and beyond the overpayment. If you bill it, federal investigators will take notice. Reporting the wrong place-of-service code. Although no one should ever misrepresent place of service, there's an uptick in the reporting of the place of service "11: physician office" by the physician office staff for procedures performed in the ASC simply to get claims out the door. The correct place-of-service code reported by the physician office when a procedure is performed in an ASC should be "24: ambulatory surgery center." 1 2 2 4 • O U T PA T I E N T S U R G E R Y M A G A Z I N E • A U G U S T Coding & Billing Cristina Bentin, CMA, CCS-P, COC, CPPM

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