Coding Check: Are You Vulnerable to Payor Audits?

The payor landscape is constantly changing as rates and other coding and claim review practices evolve. Meanwhile, reimbursement delays can negatively impact profit margins in any surgical care setting. Given tighter operating margins in ASCs, these settings are especially vulnerable to the negative impacts of coding scrutiny impacting reimbursement. This is one reason ASC leaders and their managed care teams have developed a keen eye for smart coding practices.

Surgery Partners Senior Vice President & Chief Clinical Officer Tamala Norris-McJunkins, DHA, BSN, RN, CPHQ, HACP, LSSGBC, offers these insights from her ASC vantage point on staying ahead of payor practice changes, navigating a payor audit and being proactive in coding practices to avoid one.