How to Avoid Add-On Code Denials
There’s nothing fun about dealing with insurance companies. Even when things are going well, it can be stressful. When complications arise and claims are denied, it’s easy to get caught in a never-ending cycle of wasted time, frustration and rising blood pressure.
Glitches in the billing system mean the surgeon is not fully reimbursed for every code performed, which means the practice takes an unnecessary and avoidable financial hit.
How add-on codes can lead to billing battles
If surgery goes as planned, the billing process is a routine matter of dotting the “i’s and crossing the “t’s. When the unexpected happens and surgeons perform extra procedures, the insurance claim process can turn from an everyday task into a sprint and marathon rolled into one.
|As long as you receive the add-on codes for these extra procedures and submit them within the limited time-frame, there’s little to worry about. It’s when the add-ons go missing or get separated from their primary (parent) codes that the race against time begins. Missing the filing deadline leaves you no option but to gird yourself for a battle royale with the insurance company.|
Why “old school” is not cool!
While surgeons must stay ahead of the technology curve to keep up with medical advances and progress in their field, many cling to outdated methods of record keeping. Inevitably, this makes your job harder than it needs to be.
You may think we are joking, but we’ve heard about surgeons who have a hard time letting go of their index cards. We aren’t psychologists, but we believe it’s a way to keep their med school past (and youth) alive!
No matter the reason, once surgery is over, these surgeons write everything – add-on codes, care instructions, post-op medications – on a 3 x 5 inch index card. And that’s that. They spend little time considering how the cards will get back to the office.
With such a system, the surgeon is spending money on an index card delivery service or in paying a staff member to tote index cards to and fro. Additionally, there’s no back-up system in case a card goes AWOL, which can impact patient care and makes it hard to track revenue or other financials.
Such a scenario doesn’t even take into account the old joke about doctors’ handwriting being illegible (it’s true), which leads to unnecessary questions and confusion.
|So, while you’re busy hunting down missing index cards (excuse me doctor, can you check your pockets again, please?) or deciphering handwriting that’s less legible than Ancient Egyptian, the insurance clock is ticking louder and louder as the submission window narrows…|
Use basic technology to save time and effort with add-on codes
If a surgeon insists on manually tracking add-on codes, suggest they send the information as an email or text or using a dictation app. It’s not ideal, but it eliminates the need to physically transfer the index cards and provides a backup system.
We know, it means double the work for whoever deals with insurance claims, but at least there is a record in the event that the originals go missing. Despite the added steps, it’s relatively foolproof and this more expedited system can potentially save the surgeons in the long run.
Cranking it up a notch and using an EHR system to keep track of procedures is a great advance over index cards and cuts down on the busy work of texts and emails. We realize this may not be an option in all EHR systems. But some EHRs offer apps or other functions for surgeons to record information when the surgery is completed, and immediately share this data with their back office.
Custom tools for ultimate ease
|For ultimate ease of use, and to minimize potential problems and delays, encourage your surgeons to use tools like SurgiApp. This custom application enables the surgeon to indicate when add-on codes have been performed, as soon as they have scrubbed out. They can also include notes or an explanation to send the schedulers or billing department. The information is then instantaneously updated with the system in the back office (all HIPAA compliant of course), and allows the billing process to be initiated without unnecessary delay or the information being inputted in triplicate. |
The app also allows surgeons to view all the surgery details right on their smartphone – including all patient details, insurance info, MRI/Xrays, equipment ordered – without lugging around files or CDs.
For the surgeon, the only thing that should matter is performing the best surgery for the patient, no matter what surprises crop up in the operating room. But what happens when surgery is over is also a vital part of any procedure. Encouraging surgeons to move away from manual record keeping will help the practice run more smoothly and efficiently. It also has the added benefit of keeping your interaction with the insurance companies to the minimum and reducing costly denials.