Internal Auditing for ASCs: Are You Receiving Maximum Revenue?

How would you rate the overall financial health of your ambulatory surgery center?

Are you producing maximum revenue – or are you running into obstacles that interfere with your profitability?

As an ASC administrator, you have an extensive to-do list on any given day. However, it’s important to make time to step back and look at your big-picture financial goals and processes.

Conducting an internal revenue cycle audit is an effective way to evaluate your ASC’s operations, identifying financial stress points, strengths, and opportunities. An internal audit examines, quantitatively and qualitatively, all components of the revenue cycle process. It helps you ask the right questions to reveal what is working and what can be improved, helping your center get on track and stay on track.

If you’ve noticed negative changes in important benchmarks, such as accounts receivable days, net collection rates, or statement and charge lags, a revenue cycle audit may be the best course of action.

According to Regent RCM’s Director of Revenue Cycle Management Erin Petrie, a successful self-audit focuses on four main financial areas of an ASC:

Reimbursement

Do a thorough examination of your center’s billing and reimbursement procedures, paying close attention to payer contracts and total revenue collected.

Coding and Billing

Evaluate coding procedures, whether your ASC has a certified coder on staff or outsources services. Determine if cases are coded and billed correctly, identifying inaccuracies that could delay, reduce, or invalidate claims.

Staffing

Assess how administrative employees spend their time and what causes their pain points. What

facilitates smooth operations? What requires excessive time or effort to accomplish?

Observation

Scrutinize business office functions over time, noting recurring inconsistencies or inefficiencies. Look for solutions, through technology or processes, that could address these problems.

To help you get started, the experts at Regent Revenue Cycle Management have developed a free guide, “How to Self-Audit and Improve Your ASC’s Financial Health.” It takes an in-depth look at key revenue cycle functions, giving you the information you need to keep your ASC within compliance while producing maximum revenue. Download the full guide here.