Guidance for ambulatory surgery centers (ASCs) from Caryl Serbin of Serbin Medical Billing on improving reimbursement through strengthening the auditing process, monitoring of accounts receivable (A/R) and following an efficient reimbursement cycle.

1. 1

2. 2

3. • Perform quarterly internal audits for accuracy and
timeliness for the following processes:
- Coding
- Claims Processing (charge posting/submission)
- Payment Posting – additionally check for error
follow-up, denials and appeals
- Collections – in addition, check for effectiveness
(condition of A/R)
• Recommend annual independent coding audits
3

4. • Industry benchmarks are helpful but are
not always the best indicator of the health
of your A/R
• Center-specific benchmarks should be
established that include a combination of:
- Total A/R
- A/R by Payer
- Aging of A/R
- Days in A/R
- Patient Portion of A/R
4

5. 5
The Right Staff
Hiring &
Training
Scheduling
Registration
IT Systems
Ins. Verification
Financial
Counseling
Up-front
Collections
Coding
Charge Posting
Claim
Submission
Clearinghouse
Claim Follow-Up
3rd Party Payer
Collections
Patient
Collections
Denials
Appeals
Internal
Auditing
A/R

6. 6