financials

Going Deep to Understand Surgery Center Financials Helps Minimize Issues

Part 1 of a 2-part Q&A series with Leslie Favela

Getting a good handle on revenue cycle management can make a big difference for ambulatory surgery center (ASC) leaders when it comes to achieving profitability goals.

“What it comes down to is really understanding and knowing your center,” says Leslie Favela, manager of the business development team at Regent Revenue Cycle Management. “It’s all about being aware of all of your payer contracts and tracking your center’s trends. It’s important to be ahead of the game with the payers. If you know your center’s contracts, and the overall health of your revenue cycle, you know where you stand with the payers. And that helps you catch issues in the beginning so you’re able to minimize them as they come up in the future.”

Favela recently sat down to answer some of the most frequently asked questions she and her team receive from ASC professionals:

Question:

Our center would like to increase revenues this year and we have an aggressive goal of 8-10%. Is that doable?


Answer:

Yes, that level of improvement is doable. Whenever we bring on a new client, because of our best practices and our work quality, our statistics show that our team increases center revenues a minimum of 10% or more in that first year, and then we help our centers maintain that level or improve in the ensuing years. We start by reviewing the existing overall health of a center, and then help them improve by adopting the correct focus, making sure that we’re looking at the correct benchmarks, the correct business office processes and workflow, and making sure that we’re maintaining our expected net revenue of at least 97%. On a high level, it’s about having that mindset on how to improve revenue, that’s number one. And two, it’s efficiencies – making sure that you have the correct resources to ensure you’re auditing and managing your revenue cycle the right way.

Question:

Our surgery center is having issues with outstanding claims going well past 30 days. Do you know how we can improve on this metric?


Answer:

Yes, there are several steps centers can take to minimize past due claims. One way to start is to begin tracking all of the payers that are having that delay and look for trends. Then, start asking yourself some questions: What’s the source of the delay? Are you submitting the claims correctly, with all of the claim form values that need to be added for successful claim processing? Is there additional information that needs to go out with the claim, such as a medical record or a copy of the implant invoices? The goal is to identify how the payer likes to receive their claims and to be ahead of game. If you can identify payer trends, then you’ve got that data on your side and you can improve on-time reimbursement. 

For more information on efficiently managing your center’s revenue cycle, contact the Regent RCM team or contact Leslie Favela directly at lfavela@regentrcm.com.