How to Improve KPIs in Your ASC

How healthy is your ambulatory surgery center’s (ASC’s) revenue cycle? Do you have a general sense of your center’s profits and cash flow – or can you point to real data and analytics?

To develop a clear picture of your revenue cycle performance, you need to gather the right information. Tracking and analyzing key performance indicators (KPIs) gives your ASC powerful tools to pinpoint positive and negative trends, address problems, and make data-driven improvements. Implement benchmarks to set a baseline, marking where you are starting from, where you are heading, and what process changes you need to make to reach your goals.

Here are three important KPIs to focus on to make significant improvements in your revenue cycle.

Accounts Receivable (A/R)

Investigate how many outstanding accounts you have and how many are more than 90 days old. If the percentage is too high, your center may not have an efficient process for following up on claims. If it’s too low, you may be writing off balances before receiving the full amount due. Establish systems for tracking A/R on a certain schedule, setting up alerts to remind staff to follow up on claims after a set number of days. Pay attention to patterns that show up across denials, and educate your staff about common errors to avoid in new claims.

Charge Lag

Measure how long it takes, on average, to enter new charges for billing. Set a benchmark for this action, ideally within 24 to 48 hours of the date of service. If you notice a longer charge lag, look for factors that may have contributed to the delay. Are there problems with dictation, coding, or invoicing? What can you do to remove these obstacles?

Clean Claims

Calculate the percentage of clean claims your ASC sends out each month. How many contain errors or missing documentation that lead to denials? Have you noticed trends with certain payers? A high clean claims rate is correlated with a low denial rate and timely payment. Identify and document the reasons claims are being denied, and make adjustments to your processes so you can send complete and correct information to payers the first time.

Interested in improving your revenue cycle management? Contact Regent RCM’s expert team.

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.