ASC Nurse evaluating revenue cycle

Decreasing Days Outstanding by Managing Charge and Claims Lag

Building on our latest guide where Regent RCM updated is established Key Performance Indicators (KPIs) to highlight issues and determine how well an ASC is performing compared to other ASCs, the following post examines charge and claims lag.

Managing a financially successful ambulatory surgery center (ASC) hinges on efficient revenue cycle management (RCM), yet many center administrators struggle with charge lags leading to delayed claims submissions and ultimately delayed reimbursement. Lag days contribute to an uncertain revenue cycle. One of the most effective ways to decrease days outstanding is to manage lags and turnaround time.

Charge entry lag is calculated by the number of days from the date of service to the date charges are entered. Claim lag is defined as the date of service to the charge billing date. The best practice for ASCs for both lags together is less than three days. Charges should be entered as soon as they are coded and claims should be sent the same day, so there should be no difference between the claim lag and the charge lag.

“If centers are experiencing a difference between the two lags, this is an indication that the billing department may be holding claims or entering charges but not sending them out,” stated Erin Petrie, Director of Revenue Cycle Management. “Transcription should each be completed in 24 hours – that is the gold standard.”

Coding and physician dictation may also be contributing to slow turnaround times, and those are more complicated problems to solve. “At Regent RCM we get to the root of the lag problem by running daily reports on unbilled cases and from there, our staff will begin the research to understand the source of the problem,” explained Petrie. “Whether it is coding, transcription or dictation, we arm center staff with the necessary information to put processes in place to correct the problem.”

If your center is struggling with high charge and claims lag, click here to download our latest guide, and learn how to gain more control and efficiency.

ASC Revenue Cycle Management

Regent Revenue Cycle Management Spearheads Benchmarks to Assess Surgery Center Revenue Cycle Health

New white paper defines nine metrics centers can customize, deploy, and measure to improve performance.

Regent Revenue Cycle Management (Regent RCM), an independent division of Regent Surgical Health and a leading provider of innovative, cost-effective revenue cycle management services exclusively for ambulatory surgery centers (ASCs) in the United States, today released a white paper outlining nine ASC-specific benchmarks to accurately and consistently assess the health of a surgery center’s revenue cycle.

“One of the toughest challenges for surgery center leadership is determining if their revenue cycle is healthy,” said Regent RCM Vice President Michael Orseno. “Our new white paper gives ASC leadership more visibility into that performance, and to help them understand how numbers can be improved, why they might fluctuate, and how they can often be misleading. Using our benchmarks, ASCs can accurately measure revenue cycle health, and ultimately, locate every dollar they are entitled to.”

Lacking standardized revenue cycle measurement tools, specific to ASCs, leadership leaned on hospital or physician practice metrics. Given the differences in payer mix, case mix, and contracts, those metrics not only caused confusion, they failed to provide the assessment tools centers needed to be successful and to compete in an increasingly competitive healthcare market. Regent RCM’s white paper outlines nine critical metrics that centers can customize, deploy, and measure to gauge their financial health.

“Many of these metrics, such as Days Outstanding and Clean Claims Percent, are certainly familiar, but centers can’t currently use them as benchmarks because they don’t know what the gold standard should be for their case-mix and contracts,” said Orseno.

An important theme of this paper is how the nine benchmarks relate to each other. “Until now, center leadership might question how their center’s revenue cycle could be performing poorly when its Days in A/R are under 30. The numbers often lie, and these benchmarks can pinpoint the problem areas,” added Orseno.

Among the nine metrics is a benchmark for the optimal number of full-time business office employees per 1,000 cases. The exclusive metric was developed by Regent RCM after it mined data from ASCs for several years. “Surprisingly, we found that busier centers are often more efficient,” stated Orseno.

The white paper also features examples of ASCs where the application of the benchmarks is already improving revenue cycle management. An out-of-network center in the southeast, for example, learned first-hand the impact Regent RCM’s benchmarks have on improving financial health. Since working with Regent RCM, the center has become more efficient in A/R. The center in March 2016 shattered a trio of records, achieving 42 days in A/R, $895,590 in collections, and at 26.3%, its lowest percent of outstanding accounts in A/R over 90 days.

To download the free white paper, click here.

About Regent Revenue Cycle Management

Regent Revenue Cycle Management (Regent RCM), an independent division of Regent Surgical Health, is a leading provider of innovative, cost-effective revenue cycle management services exclusively for ambulatory surgery centers throughout the United States. Regent RCM harnesses Regent Surgical Health’s 15 years of ASC industry expertise, allowing Regent RCM to consistently outperform industry benchmarks. To learn more visit www.regentrcm.com or join the conversation via Twitter.

Michigan Ambulatory Surgery Association

Regent RCM to Host ASC Benchmarking Webinar Series for MASA

Regent Revenue Cycle Management (RCM) will present a three-part webinar series to the Michigan Ambulatory Surgery Association (MASA) in June. The webinars, led by Regent RCM Vice President Michael Orseno, examine ASC-specific benchmarks developed by Orseno and his team to better assess ASC revenue cycle health.

“At Regent RCM we weren’t able to find a definitive set of ASC-specific revenue cycle metrics, so we developed nine metrics that centers can customize, deploy, and measure to gauge their financial health. We’ve also provided a gold standard for each of the metrics,” said Orseno. “These metrics shape and define a center’s revenue cycle and help center administrators understand how numbers can be improved, why they might fluctuate and how they can often be misleading.”

The first webinar in the series focuses on optimal fulltime business office employees(FTE’s) per 1000 cases, defining the appropriate staffing levels at ASCs. The second webinar highlights five core ASC revenue cycle benchmarks and how to calculate, monitor and manage them. The webinar series will conclude with a third session highlighting net collection rate, an essential stand alone metric.

“I am pleased to be able to offer this valuable webinar series to MASA members,” said Executive Director Marcy Lay. “Regent RCM’s ASC-specific benchmarks are aligned with MASA’s mission to provide centers with information that will improve operations and foster cost efficiency without compromising on quality care.”

For more information call 312-882-7228 and join our conversation via Facebook and Twitter, @RegentRCM.

ASC Revenue Cycle Benchmarking Series Video

Regent RCM Focuses on Net Collection Rate in Webinar Series

In the final installment of Regent RCM’s three-part webinar series on ASC industry benchmarks to determine the health of a center’s revenue cycle, Vice President Michael Orseno and Director of Business Development Ed Tschan examine how to interpret these key performance indicators (KPIs) and what they are really communicating.

“Performance benchmarking continues to be an integral part of the Regent RCM team’s operations and its focus on continuous improvement,” said Tschan, who introduced the webinar and Orseno.

Orseno recapped the five ASC revenue cycle metrics mentioned in the second webinar but went into greater depth, discussing which ones could stand alone and which ones could be manipulated. He added a sixth ASC revenue cycle performance metric, net collection rate, which cannot be manipulated and explained its significance.

“It’s nearly impossible for office staff to manipulate the net collection rate,” said Orseno. “That’s why we sometimes refer to it as the great lie detector. All the other metrics we discussed previously can be manipulated. The only way this metric can be manipulated is by the person doing the calculation.”

Multiple attendees of the three-part webinar series commented that they plan to immediately incorporate ASC revenue cycle benchmarks to improve the health of their ASC.

“I think it was an awesome series with so much helpful information,” said one attendee. “I couldn’t believe all the insight our center can gain from utilizing these metrics. We’re running reports right now to see where we stand.”

Tschan stressed the importance of a revenue cycle audit that utilizes these recommended metrics to allow a center to confidentially capture existing performance metrics and get a solid sense of where they stand.

“What we’ve found historically is that most centers don’t have the luxury of having a strong financial contact that has performed revenue cycle audits before,” said Tschan. “We recommend that a center looks for an auditor specifically in the ASC community to provide relevant qualitative and quantitative insights.” He went on to explain how to find the right auditor, including four key areas that should be part of the audit and what to expect at the end of the audit process.

Orseno finished up the webinar by putting ASC revenue cycle benchmarks in perspective, noting that they are a valuable tool, but only part of the picture.

“We want to make sure that you have the tools in order to measure these metrics and to be able to identify how these metrics can be manipulated,” said Orseno, “but I think the most important message we want to put out is not to be blinded by these metrics, either one by one or altogether. Use them as a tool but ultimately, focus on the revenue due to the center.”

Click here to listen to the full webinar with detailed information on assessing the validity of these ASC revenue cycle benchmarks and how to be mindful of those that can be manipulated.

ASC Revenue Cycle Benchmarks Defined

Regent RCM Webinar Series Addresses Five ASC Revenue Cycle KPIs

In the second of Regent RCM’s three-part webinar series, Vice President Michael Orseno examined five ASC industry benchmarks or key performance indicators (KPIs) that measure the health of a center’s revenue cycle.

“Focusing on these industry benchmarks has been an integral driver of our team’s success and in the continuous improvement cycle of our partner centers,” said Director of Business Development, Ed Tschan, who introduced Orseno.

Tschan added that many revenue cycle conversations with ASCs frequently include questions regarding recommended metrics to drive the financial health of a center, whether metrics operate independently or in an integrated manner, what metric tracking capabilities exist and how to leverage the information to benefit the center.

Orseno addressed these questions while discussing five of the ASC industry benchmarks: Days Outstanding/Days in A/R, % of A/R greater than 90 Days, Denial% and Clean Claim, Charge, Claims Lag, and Statement Lag. He explained how to calculate the metrics, why the information is useful, the Regent gold standard for each of these metrics, and why keeping a center’s numbers within target parameters will maintain a healthy revenue cycle.

“Once your center is measuring these benchmarks, they should be monitored monthly, at minimum, possibly weekly,” said Orseno, in response to an attendee’s question. “For collections, a standard should be set as a goal each month and metrics should be looked at weekly. Other metrics, such as days in A/R should be monitored monthly.”

Click here to listen to the full webinar with detailed information on these benchmarks and answers to more questions on how to utilize them. To register for the final webinar in the series, held May 3, click here.

ASC Revenue Cycle Benchmarks Defined

Regent RCM Webinar Addresses Optimal ASC Office Staffing

Why Regent RCM’s standard of 1.5 fulltime business office employees (FTEs) per 1,000 cases is ideal.

In the first of a three-part webinar series, Vice President Michael Orseno explained Regent RCM’s exclusive benchmark on optimal business office staffing models.

In addition to a business office manager, office staff includes receptionist(s), biller(s), collector(s) and coder(s), as well as personnel dedicated to insurance verification, patient financial counseling and scheduling.

The Regent RCM gold standard, developed after several years of collecting data from ASCs, is 1.5 FTEs per 1000 cases. Data from 2010 to 2014 showed that busier centers operated more efficiently in terms of staffing, while staff at less busy centers were underutilized.

When center administrators are struggling to determine if staffing is contributing to or working against a healthy revenue cycle, Orseno addressed three critical questions:

  1. Are appropriate staff in place to perform needed tasks?
  2. Are policies and procedures being implemented to promote workflow productivity?
  3. Is the center utilizing advanced technology that will drive efficient operations?

“Addressing inefficiencies that arise from answering these three questions is a fundamental first step to optimizing staffing,” said Orseno, who concluded the webinar by answering several listener-generated questions.

The most popular questions came from attendees requesting information on how and when to justify outsourcing revenue cycle management. Orseno advised taking a close look at business office functions and performing a business office audit aimed at identifying inefficiencies. If it is not possible to do this in-house, Orseno advised hiring an outside firm.

Click here to listen to the full webinar. Click here to learn more about the next two webinars and register here.

RCM benchmark webinar

Regent Revenue Cycle Management Launches a Three-Part ASC Benchmarking Webinar

Participants learn how to customize, deploy, and measure nine metrics to gauge their center’s financial health

Regent Revenue Cycle Management (Regent RCM), an independent division of Regent Surgical Health and a leading provider of innovative, cost-effective revenue cycle management services exclusively for ambulatory surgery centers (ASCs) in the United States, announced today that it will host a three-part webinar featuring industry veteran and Regent RCM Vice President Michael Orseno. The webinar series expands on recently launched ASC RCM video series and demonstrates how benchmarking will accurately and consistently measure the health of an ASC’s revenue cycle.

“One of the toughest challenges for any surgery center is determining if your revenue cycle is performing well,” stated Orseno. “We developed this webinar series so center administrators can understand how numbers can be improved, why they might fluctuate and how they can often be misleading. We have developed nine metrics that centers can customize, deploy, and measure to gauge their financial health.”

PART ONE: Optimal Business Office FTEs per 1,000 Cases

WHEN: April 5, 2016 at 12 p.m. CST

WHY: Smart staffing is an integral part in gaining more control and efficiency over the revenue cycle. This webinar explains Regent RCM’s exclusive benchmark on optimal staffing models. Regent RCM will explain how it developed this benchmark and used it to reduce staffing to by over .3 FTEs per 1,000 cases in four years.

PART TWO: ASC RCM Benchmarks

WHEN: April 19, 2016 at 12 p.m. CST

WHY: Learn Regent RCM’s gold standard for the following benchmarks and understand how outside forces impact the numbers, how the benchmarks work together, and when the numbers lie.

  • Days Outstanding
  • % A/R over 90 Days
  • Denials and Clean Claims
  • Charge and Claims Lag
  • Statement Lag

PART THREE: Net Collections – the Great ASC RCM Lie Detector

WHEN: May 3, 2016 at 12 p.m. CST

WHY: Find out how to calculate your center’s net collections rate, how to set your gold standard based on your center’s payer and case mix, and why we call this benchmark “the great lie detector.”

To learn more or to register for the webinar series, click here.

 

revenue cycle analysis

Case Study: Regent RCM Nearly Doubles Monthly Revenue Collections for High-Volume ASC

When the Andrews Institute Ambulatory Surgery Center (AIASC) sought to address challenges impacting its monthly collections, the high-volume surgery center turned to Regent RCM for help. The specialized facility, based in Gulf Breeze, Fla., is a joint venture between Baptist Health Care and area physicians, offering orthopaedic and sports medicine services.

After identifying coding and A/R process & workflow challenges leading to lost revenue for the center, the AIASC signed with Regent RCM in May of 2015. By December 2015, just eight months later, AIASC nearly doubled its monthly collections without significant changes in volume or case mix.

Regent RCM worked with the center to achieve this success by leveraging coding expertise to code claims accurately. Regent RCM also brought the center up to a clean claim submission of 97 percent – the industry gold standard, and addressed the center’s A/R process & workflow issues. Regent RCM’s primary goal was tailoring effective solutions to AIASC’s specific needs.

For more information on how Regent RCM nearly doubled the monthly collections for AIASC, read the case study here or call 312-882-7228 to find out how Regent RCM can help your ASC.

zirmed logo revenue cycle management

Part Two: Regent Partner ZirMed Weighs in on Patient Responsibility

In the second installment of a two-part blog series, ZirMed® Partner Relationship Manager Emily Reder shares additional insights on the rise in patient responsibility and how this trend impacts the revenue cycle.

When asked to share a best practice for ensuring patient collections, Reder said that she advises providers to tell patients upfront what they’re going to owe before surgery.

“It’s almost like giving patients more of a say,” said Reder. “If it’s an elective procedure, knowing how much it’s going to cost can help them make an educated decision about whether to go through with it or not.”

Reder continued, “With the Affordable Healthcare Act, we see that Americans have more coverage now than ever before, but that doesn’t mean that healthcare providers are being paid faster or that they’re being paid in full.”

It all comes down to patient responsibility and creating a very solid customer experience for patients in order to collect on services rendered.

ZirMed’s partnership with Regent RCM gives ASCs the support and technology needed to effectively manage the revenue cycle, with each company staying abreast of current trends within both the healthcare and revenue cycle management industries.

“Regent RCM and ZirMed both want to be the best at what they do and the best at really helping ASCs manage their workflow processes,” said Reder. “It doesn’t hurt that Regent is a fun, wonderful group to work with, but I think that at the end of the day it’s really their hard work for their clients that matters, and that’s ZirMed’s approach as well. We both want the best for our clients, so working together is a natural fit.”

For more information about Regent RCM click here.

To contact ZirMed or request a demo, click here.

zirmed logo revenue cycle management

Part One: Regent Partner ZirMed Weighs in on High Deductible Plans

ZirMed®, which empowers healthcare organizations to optimize revenue and population health with the nation’s only comprehensive end-to-end platform of cloud-based financial and clinical performance management solutions, partners with Regent RCM to make sure ASCs have the shortest revenue cycle possible and get paid on time for services rendered. ZirMed Partner Relationship Manager Emily Reder has worked directly with Regent RCM for a year-and-a-half, but ZirMed’s association with Regent RCM goes back to June 2011.

In the first of a two-part blog series, Reder shares her perspective on the rise in patient responsibility and how this trend impacts the revenue cycle.

“We see that high deductible plans are becoming more and more popular because, from a premium perspective, that’s sometimes what’s affordable,” stated Reder.

She explained that ASCs and other providers once depended on getting all or most of their payment from the payer. But now ZirMed is finding that it’s double the amount of work for providers to get paid by the patient rather than the payer, due to higher deductibles and the time and expense required to collect from patients after they receive services.

“It’s expensive to send unpaid bills into collection,” said Reder. “So that game has really changed and we’re focusing more effort on collecting as much as possible from the payer, but also having a follow-up plan to make sure that once you get through the adjudication process with the payer, you’re on really solid footing to collect the rest from the patient.”

To accomplish that, Reder stressed the importance of establishing a foundation when the patient is first seen. “We call it the patient access phase of the revenue cycle, where you’re first seeing the patient, getting information from them, and collecting as much information as you can upfront,” said Reder. “Eligibility verification is very important, being able to create the start of a consumer-like process for the patient. Patients are really starting to behave more as consumers rather than traditional patients, because they’re having to pay for care out of their own pockets.” And Reder does not see that trend changing anytime soon.

In the second segment of this blog series, Reder will discuss how Regent and ZirMed are helping ASCs best address this trend while effectively managing the revenue cycle.

For more information about Regent RCM click here.

To contact ZirMed or request a demo, click here.

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