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How to secure reimbursement authorizations, according to one administrator

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Handling claims and denials with payers can be an obstacle for ASCs to maximize revenue. 

Robert Lerma, administrator of Blue Springs Surgery Center in Orange City, Fla., spoke with Becker's ASC Review on how his center tackles claims issues and secures authorizations. 

This interview was edited lightly for clarity.

Question: What is the biggest reimbursement issue affecting your ASC's revenue?

Robert Lerma: The reimbursement issue that most affects revenue at our ASC is claim denials. We found that routinely educating and reminding the physicians offices to request timely securing of authorizations two or three days prior for outpatient surgery will allow us the time to confirm benefits and sometimes negotiate carve-out for implants. 

Another reimbursement issue is the annual review of contracts for appropriate reimbursement and ensuring that the contracts are accurately loaded into our billing system, as well as volume on cases with profitable reimbursement.

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