Even before COVID-19, many ASCs were working to overcome revenue cycle management challenges, like slow reimbursement, charge lag, and high claim denial rates. The pandemic has made it a more urgent priority for centers to collect the revenue they are entitled to as quickly as possible.
In our work with ASCs across the country, we have found that optimizing front-end processes — the direct touchpoints that centers have with patients — increases revenue and improves the overall patient experience. When your front office has the right systems and structures in place, your revenue cycle operates seamlessly, and the rest of your organization benefits as a result.
Here are three steps you can take to start improving your center’s front-end processes and work toward achieving revenue cycle benchmarks.
- Train Front Desk Staff
The employees who work at your front desk play a crucial role in your patients’ comfort and satisfaction and your center’s financial health. Set clear expectations for communicating with patients and how staff can treat each person with professionalism and respect. Create thorough training practices for front desk staff on every aspect of billing and collections. Some processes might include:
- Contacting patients to schedule surgeries, confirm appointments, and outline expectations
- Provide patients with procedure information and go over pre-op requirements
- Gathering patients’ personal and payer information before an appointment
- Verifying insurance and obtaining pre-authorization before a procedure, either over the phone or online
- Provide Financial Counseling
Before surgery, patients are often unclear on how much their insurance will cover and how much they will have to pay — which could be as much as 30% out-of-pocket. Any confusion about financial responsibility will result in delayed payments and have a negative impact on your center’s days in AR.
Provide patients with financial counseling before their scheduled surgery. Make sure patients understand how much of the total amount their insurance provider will pay and how much they will be responsible for. Discuss different payment options and plans, answer their questions, and help them come up with a financial strategy in advance.
We have seen significant improvement in ASCs that offer financial counseling. At East Hills Surgery Center in New York, financial counseling accounted for only 36% of upfront collections in 2019 but 99% in 2020, when it implemented new counseling practices. The center achieved 149% of its cash goal in 2020.
- Focus on Upfront Collections
Financial counseling and upfront collections go hand in hand. When patients know what they will owe when they check in for surgery, they are far more likely to have a payment plan in place — which helps give them confidence and peace of mind as well. Incorporate discussions of upfront collections into your center’s financial counseling program. Try to identify any gaps in patient knowledge so you can address them before a procedure.
At Glasgow Surgery Center, upfront collections increased from 11% in 2019 to 40% in 2020 as a result of dedicated financial counseling and upfront collections efforts.
Contact Regent RCM for an evaluation of your ASC’s front office to identify areas where you can improve your revenue cycle management and increase your revenue.