ASC Revenue Cycle Benchmarks Claim Lag and Charge Lag

ASC Revenue Cycle Benchmark Video #6 – Claim Lag/Charge Lag

Gauging the health of a surgery center’s revenue cycle is challenging. Regent Revenue Cycle Management (Regent RCM) Vice President Michael Orseno and his team recognized the struggle and responded by identifying, defining, and interpreting ASC-specific revenue cycle benchmarks and developing a series of videos series that can be used to evaluate the health of any ASC’s revenue cycle.

The sixth video examines claim lag and charge lag. Charge lag is measured from the date of service until the charge entry date, while the claim lag is the number of days from the date of service until the billing date. Claims should be sent out the same day as charges are entered and coded.

“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 in a timely manner,” said Orseno. “Transcription and coding for each should be completed in 24 hours or less – that is the gold standard – which still leaves 24 hours to get the claims out the door.”

Click here to watch the video and learn more about this valuable metric, and why there should be no difference between the two lags.

Are you ready to use this key performance indicator to improve your revenue cycle? Gain information on this and the other ASC benchmarks by watching the three-part webinar that goes into further detail on the topic, or have your questions answered by contacting one of Regent RCM’s revenue cycle specialists.

ASC Nurse evaluating revenue cycle

Decreasing Days Outstanding by Managing Charge and Claims Lag

Building on a recent post where Regent RCM 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 Michael Orseno, Vice President of Regent RCM. “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 Orseno. “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 register for an upcoming webinar, and learn how to gain more control and efficiency.