How Do You Measure ASC Revenue Cycle Health? HINT: Use ASC-Specific Benchmarks

Prior to Regent RCM’s development of revenue cycle management benchmarks specifically for ambulatory surgery centers (ASCs) in 2017, leadership leaned on hospital or physician practice metrics. But those “borrowed” metrics caused confusion and failed to provide the assessment tools ASCs needed to compete successfully in the healthcare marketplace.

A new white paper updates the nine ASC-specific benchmarks based on two years of learning, adding an essential new metric to help surgery centers accurately measure their revenue cycle health. The new benchmark tracks Net Collections Rate: the percentage of eligible money that was actually collected. The Regent RCM gold standard is to collect greater than 97% from contracted payers.

According to Erin Petrie, Regent RCM’s Director of Revenue Cycle Management, while striving for an efficient revenue cycle if a center’s net collections percentage is low, it may be a sign that the business office is accepting whatever the third-party pays and not fighting for what is contractually owed.

With reimbursement dollars continuing to be stretched, Regent RCM’s gold standard benchmarks assist ASCs around the country in receiving the most revenue possible for the care they provide. In addition to Net Collections Rate, the white paper provides insights on the advantages of tracking:

  • Claim and Charge Lag: The Regent RCM gold standard for both the number of days from date of service until the billing date, and from the date of service until charge entry, is 48 hours.
  • Statement Lag: According to the Regent RCM benchmarks, the lag between the date a balance becomes a patient’s responsibility to the time the statement is sent should be less than 5 days.
  • Clean Claims %: Proper coding, a knowledgeable billing staff, and the use of a robust clearinghouse to scrub claims prior to submission are paramount for achieving the Regent RCM gold standard of a 98% clean claims rate.
  • Denials: The Regent RCM gold standard for denied claims is less than 10% denials.

Click here to download the full white paper on using Regent RCM’s benchmarks to assess the health of your revenue cycle.

ASC Revenue Cycle Benchmarks Defined

Regent RCM Defined ASC Revenue Cycle Benchmarks

One of the toughest challenges for any ambulatory surgery center (ASC) leader is determining if your center’s revenue cycle is healthy and performing well.

Industry metrics can be clouded by complications such as payer mix, case mix and whether or not the center is in-network. Many centers have resorted to using hospital or physician metrics to try to gauge success, but they are not always equivalent and can cause confusion.

Regent RCM Vice President Mike Orseno recognized the need for standardized measurement native to the ASC community. Alongside the Regent RCM team, he developed a series of nine core ASC revenue cycle benchmarks aimed at dispelling myths and outlining which benchmarks stand on their own and which ones are affected by outside forces. Importantly, the series includes instruction on how to calculate or measure what Orseno refers to as the great lie detector, the net collection rate.

Click here to watch the first video in the ASC Benchmark series and learn more about the metrics that gauge the health and success of an ASC’s revenue cycle.