ASC revenue cycle benchmarking

How to tell if your ASC needs better revenue cycle management: Part 2

In part one of this series, we discussed the foundational changes in key performance indicators (KPIs) that might signal that your ambulatory surgery center is in need of a better revenue cycle management. Today, we’re going to take a closer look at the less obvious changes that could negatively affect the financial health of your center.

Changes in AR, revenue and clean claims percentage should be fairly visible to the center, but many other essential performance indicators may not be as apparent.

The need for a real-time dashboard
Access to a real-time management console that aggregates all KPIs can provide a competitive edge. Even if the employees have a suspicion that there’s an issue, having the time and resources interally to perform an evaluation and substantiate a concern may be challenging at best.

Patient dissatisfaction
Perhaps most poignantly, billing issues can also lead directly to patient dissatisfaction. Lengthy delays in billing can create situations where a past due notice is received even before the original bill.

The need for a full business office audit
When a center is experiencing a rise in AR days, a drop in revenue, and struggling clean claims percentage, a business office audit may be the best course of action. While some centers may request just a coding audit, especially with the impending ICD-10 changes, it is more beneficial to perform a full business office audit including all components of the revenue cycle process. Importantly, finding an RCM firm that offers a no-cost business office audit is the first key step in benchmarking center performance and building a strong foundation for growth.

A lack of regular measurement and reporting
Internally, billing employees can and should be running reports to determine the root cause of financial problems. It’s important to note that an ASC needs to have the right staff, time and tools in place in order to identify and take the appropriate steps to find and resolve financial challenges.

ASCs that can’t dedicate the time and resources or don’t have the expertise may be better off outsourcing billing and coding to a firm with highly skilled employees whose sole focus is on revenue cycle management. The right provider has the necessary reporting and analytical capabilities to pinpoint AR, revenue and clean claim percentage challenges to ensure not only revenue consistency but revenue growth.

Revenue Cycle Dashboard

The Benefits of Outsourcing RCM: Transparent Measurement and Reporting

 Over the course of March, we are diving deep into four key benefits of outsourcing revenue cycle management (RCM) for ambulatory surgery centers.  Last week, we examined how outsourcing RCM provides ASCs with smart staffing solutions and helps them avoid the need for succession planning. This week, we take a closer look at the importance of transparent measurement and reporting, which provides a greater insight into accounts receivable and collection trends.

With the ever-changing landscape of healthcare, including the fast approaching implementation of ICD-10, it’s imperative that ASCs have solid and transparent means of measurement and reporting to understand how the center is performing, where changes need to made and how to improve the bottom line.

Internally, ASCs may not have the necessary expertise, technology and resources – not to mention time – needed to devote to measurement and reporting. To truly track and trend change, these processes can be outsourced to a firm whose employees possess the training and knowledge needed to analyze the data and make a real difference in the center’s financial performance. Outsourcing RCM makes this entire process more efficient with better end results.

Spending time reviewing reports and analytics provides critical insight. Not only does the data offer valuable feedback for the ASC, but having this information can drive change by reducing AR days and tracking collection rate trends. However, internal employees may only have access to canned reports from which they can pull only generalized data. One of the key benefits of outsourcing revenue cycle management is that the RCM provider can develop customized reports and slice-and-dice the most pertinent information for more specified results.

Expertise with third party reporting software allows the RCM provider to pull these specific reports in order to find the root cause of a problem. For example, outsourcing RCM can allow an ASC to determine exactly when and why AR days began increasing so that the center can take steps to reverse this trend.

A management console is a useful tool for seeing various metrics change in real time. The RCM provider can customize each dashboard to display certain key performances indicators (KPIs) that alert the ASC to how well the center is meeting its bottom line.

Some of the top KPIs that can be included in the management console include:

  • Monitoring AR days
  • Collection rate trends
  • Statement lags
  • Charge lags

For each ASC, the RCM provider can set a range that falls between red, yellow and green stages in order to create a visual representation of when issues arise in real time. In some circumstances, it can be useful to compare specific KPIs to industry benchmarks, but success can also depend on the specific center. An RCM provider can determine when it’s best to judge information against these benchmarks and when it is not.