Ask Caryl: Top ASC Billing Compliance Problems

Q: What do see as the biggest billing compliance problems in most ASCs?

Caryl Serbin: The two most common problems we see are:

1. Inequity in fees. This typically occurs when an ASC lacks good financial policies and fails to adhere to their policies. These are policies that address issues such as out-of-network versus in-network patient responsibility; billing patients for deductibles, co-pays or co-insurance; and professional or courtesy discounts.   

2. Refunds. Failure to process refunds for overpayments to government and private payors in a timely manner can land an ASC in hot water. ASCs must follow 30-day guidelines for refunds to Medicare. While not all third-party payers have the same 30-day guidelines (check contract language), we recommend following these guidelines for all payors to help ensure refund deadlines are not missed.

Have an ASC revenue cycle question? Ask Caryl by emailing caryl@serbinmedicalbilling.com or fill out the form at the top of this page.

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