As your ambulatory surgery center (ASC) navigates ongoing challenges, such as rising healthcare costs and complex insurance environments, it is critical that you take a more proactive approach to managing your center’s profitability and cash flow. When you improve your billing and collections processes, you get paid quickly and accurately, strengthening the overall financial health of your center.
Follow these five strategies to optimize your ASC’s revenue cycle management.
- Triple-check insurance eligibility
Collect patients’ current insurance information to prevent billing errors and denials. Have front desk staff update pertinent data in your records, including:
- Insurance company, phone number, and claims address
- Patient’s name and date of birth
- If different, the name and date of birth of the primary plan holder (and their relationship to the patient)
- Policy and group ID numbers
- Dates covered by the policy
It’s a good practice to ask patients for a copy of their insurance card at each visit, even if they say they have the same plan. Triple-check the information you have on file against the card before sending a claim.
- Communicate with your billing and coding team
Whether you have an in-house team or you outsource to a partner, it’s important to have full transparency into your center’s billing and coding workflow. How quickly are claims billed out and followed up on? When claims are denied, how fast are appeals sent? Look for inefficiencies or communications gaps in the billing process that you can address.
- Monitor your AR
Monitoring the % over 90 days is key for a healthy revenue cycle and will identify trends and issues. Are you experiencing payment delays or denials because of missing documentation or incorrect insurance information? Do you have an up-front collections process in place? Set A/R benchmarks for your ASC; for Regent RCM clients, our gold standard is below 25% for A/R over 90 days.
- Capture all charges
Record all charges for every patient encounter. Centers sometimes under-code patient services because staff don’t receive all of the necessary information or are worried about potential audits. But faulty capture processes are problematic and can lead to significant revenue losses for your ASC. Outline a comprehensive checklist for documenting charges so your team can bill accurately.
- Measure key numbers
Identifying shortcomings in your billing and collections systems is an important first step. But to optimize your revenue cycle, you need to implement new processes that measure key numbers and set ongoing goals. What statistics will help you evaluate progress and keep you on track toward your objectives? Look at metrics such as the number of claims that are denied each month, the percentage of patients who pay their balance, and AR % over 90 days. Make small, incremental changes to try to improve each of these key metrics.
Click here for access to two case studies where two partner centers followed best practices and improved collections compared year-over-year.