Revenue Cycle Analysis

4 Key Areas Analyzed During a Business Office Audit

Ambulatory surgery center (ASC) administrators are charged with improving their ASC’s financial health and periodic business office audits are key to identifying, both quantitatively and qualitatively, a center’s strengths and opportunities.

On the surface, an audit sounds intimidating. But according to Michael Orseno, VP of Revenue Cycle at Regent RCM, it doesn’t have to be that way.

“We want our centers to maximize revenue and a routine audit is the fastest way to get on track and stay on track,” said Orseno. “The audit identifies issues – then working with our partner centers, we implement strategies and processes to correct them; it’s that simple.”

A Regent RCM audit goes beyond a traditional reimbursement assessment by examining four areas vital to the function of an ASC: reimbursement, coding, staffing and observation (workflow and process).

  1. Reimbursement. Regent RCM conducts a thorough review of a center’s billing and reimbursement procedures, including reviewing payor contracts. “Ensuring that an ASC is being reimbursed the full and correct amount per each procedure code for every case is one of the most important billing practices to maximize revenue for the center,” said Orseno. “Due diligence is crucial and for our partner centers, our team of revenue cycle specialists are intimately familiar with every payor contract.”
  2. Coding and Billing. Whether a center outsources its coding services or employs a certified coder, Regent RCM’s audit evaluates coding, determining if cases are coded correctly and billed properly. “We watch for inaccurate modifiers, which can negate or reduce payment on an otherwise clean claim,” noted Orseno, “and when applicable, we pay particularly close attention to implant coding errors.”
  3. Staffing. More business office staff does not always equal more efficiency, and striking a balance is difficult. Regent RCM’s audit diligently tracks business office FTEs in all of its facilities and compares facilities against the gold standard.
  4. Observation. Regent RCM’s expertise comes from exclusively developing, executing and refining revenue cycle management strategies. “Leveraging our collective experience, our team observes business office functions and processes and looks for inconsistencies and efficiencies,” said Orseno. “For example, a front office employee may be spending vast amounts of time verifying insurance benefits when this can be accomplished more efficiently with the use of technology.”

To learn more, read a case study revealing how an audit uncovered coding errors which led to recouping more than $590,000 in additional funds.

A recent blog highlighted what to expect from a business office audit, including Regent RCM’s methodology. Ready to schedule an audit for your center? Call (312) 882-7228 today.

Reasons to Outsource

Top 6 Reasons to Outsource RCM – Part One

Revenue cycle management (RCM) is one of the functions healthcare providers outsource the most. In fact, the RCM market is projected to experience a 12 percent uptick in growth through 2021, according to a MicroMarket Monitor report.

Outsourcing is projected to expand due to two primary market forces: Value-based care’s emphasis on improving quality while reducing costs, and the increased complexity that comes with a more accountable organization. Ambulatory surgery center (ASC) leaders are recognizing the need to make RCM more transparent and predictable, and outsourcing RCM is the optimal way to increase cash flow, cut costs and stabilize their centers’ revenue cycle.

In a two-part series, Regent RCM’s VP of Revenue Cycle Michael Orseno identifies the top six reasons for outsourcing RCM. The first installment focuses on expertise, technology and staffing.

  1. Expertise. With the Affordable Care Act, Medicare and Medicaid payment bundling, and updated ICD-10 guidelines looming, the RCM landscape is changing at a rapid pace. Ensuring optimal results while keeping up with the latest opportunities related to RCM requires specialized expertise. The team at Regent RCM specializes in developing, executing and refining billing and collection strategies, and invests in the most up-to-date tools and technologies. “Revenue cycle management can no longer be an afterthought,” said Orseno. “With the vast overhaul that the healthcare industry continues to undergo, business office managers at surgery centers must employ RCM experts that have seen it all, and can not only roll with the changes, but anticipate what’s around the bend.”
  2. Best-in-class technology. With tighter margins, and priorities favoring patient care over improved billing resources, ASCs are often not equipped to excel at managing the revenue cycle in-house. By outsourcing RCM, centers can take advantage of economies of scale and gain access to best-in-class technology. At Regent RCM, staff use a trio of technologies: ASC Management Information Systems (MIS platform), clearinghouse software, and next generation dashboard and real-time monitoring and management. “RCM providers have a deep knowledge of which tools work well together and which work in silos,” said Orseno. “We have enterprise dictionaries already built for one MIS platform, so that only facility-specific information needs to be inputted. This makes implementing new technology easier, too. At an ASC, implementation typically takes more than three months, but for our partner centers, we can cut that time in half.”
  3. Smart staffing/no succession planning. For ASCs, an experienced billing and coding staff with built in redundancies is now a necessity. Cutting corners by hiring inexperienced staff can cost an ASC hundreds of thousands of dollars per year, not to mention direct impact on workflow and efficiencies. Outsourced RCM providers have the resources to attract experienced staff because they can pay well, provide good benefits, and situate themselves in desirable locations. In addition, because outsourcing RCM is what they do, these specialists know how to find and hire the best of the best, and often have a pipeline of qualified applicants waiting for a spot to open up.

Are you considering outsourcing to optimize your center’s revenue cycle? Ed Tschan and the experienced team at Regent RCM are available to your answer questions and discuss if a revenue cycle evaluation makes sense for you. Please call 312-882-7228.

Click here to continue to Part Two.

Revenue Cycle

Regent RCM and ZirMed Partner to Improve Revenue Performance

Authored by Vice President of Revenue Cycle Michael Orseno, Regent Revenue Cycle Management (RCM) this week released an article that outlines five ways in which Regent RCM and ZirMed combine to improve revenue performance.

“The ASC revenue cycle is complex and we both know that. Through our partnership, we leverage our expertise and provide ASCs with the support and technology needed to effectively manage the revenue cycle,” said Orseno. “With this article we drill down on five keys to getting paid quickly and efficiently.” Strategies include:

  1. Verify insurance coverage.
  2. Code claims correctly the first time.
  3. Minimize claim denials.
  4. Act quickly against denials.
  5. Arrange for/Collect patient out-of-pocket expense up front.

“Surgery centers need revenue cycle strategies that work and together with ZirMed, we deliver breakthrough revenue cycle management solutions that enable partner centers to collect every dollar they are entitled to,” added Orseno.

The article, Regent RCM, ZirMed Work Together to Solve ASC Revenue Issues, appears exclusively online at Becker’s ASC Review. Click here to read the full article.

Regent RCM’s Michael Orseno to Speak at Becker’s Second Annual CIO/HIT + Revenue Cycle Conference

Regent Revenue Cycle Management (Regent RCM) has been selected to participate in this year’s CIO/HIT + Revenue Cycle Conference hosted by Becker’s.

Michael Orseno, Vice President of Revenue Cycle at Regent RCM, will contribute to a timely panel discussion, Addressing High Deductible Patient Plans and the Evolving Role of Patients Becoming Payers, from 1:00 p.m. – 1:45 p.m. on Thursday, July 28.

“More and more, patients are responsible for handling most of the financial responsibility for their medical care,” said Orseno. “Moving forward, it is critical for revenue cycle leaders to focus on high deductible patient plans, and understand how these plans impact the revenue cycle.”

The conference takes place July 27-28 at the Fairmont Hotel in Chicago. Attendees can sit in on a variety of sessions, featuring 175 experts and revenue cycle leaders. Overall, there will be nearly 100 sessions over the two-day conference, with three full CIO/Health IT tracks, as well as three full revenue cycle tracks. Topics include:

  • The Transformation from Volume to Value and the Constant Movement and Impact on the Revenue Cycle—Wednesday, July 27, 8:05 a.m. to 8:45 a.m.
  • Adapting Best Practices for the Revenue Cycle– Wednesday, July 27, 8:50 a.m.-9:30 a.m.
  • Key Thoughts on Improving Revenue Cycle– Wednesday July 27, 9:50 a.m.-10:30 a.m.
  • The Biggest RCM Pitfalls– Thursday, July 28, 9:45 a.m.-10:25 a.m.
  • Post ICD-10—How is the Revenue Cycle Performing? – Thursday, July 28, 1:00 p.m.-1:45 p.m.

For more information on the conference and registration, download the brochure here.

The Center for Specialized Surgery

Regent RCM Awards 2016 ASC Business Office Manager of the Year

Rachel Caksackkar from The Center for Specialized Surgery (TCSS) in Ft. Meyers, Florida, received the 2016 Regent RCM Business Office Manager of the Year award at the Regent RCM-hosted Business Office Manager Conference, held recently in Lafayette, California.

Ambulatory Surgery Center (ASC) business office managers throughout the country attended the conference, which highlighted insights and information from leading speakers in the industry.

“Rachel exemplifies the best qualities in an ASC business office manager,” said Regent RCM Vice President Michael Orseno. “Her positive attitude, tenacity, attention to detail, and dedication play a major role in the success of her facility. We’re thrilled to recognize her as this year’s winner.”

Orseno added that of the candidates in consideration for this award, Caksackkar was chosen because her work, in conjunction with the Regent RCM team, contributed to markedly improving revenue cycle metrics for TCSS in the past year.

Among her duties, Caksackkar handles patient financial counseling to estimate out-of-pocket costs in advance of procedures. She reviews scheduled cases against anticipated reimbursement to protect the facility against revenue loss, and she works diligently with the Regent RCM team on turning around unbilled cases, such as instances where physicians did not dictate in a timely manner or additional information was needed for coding or billing.

“It’s an honor to receive this award from Regent RCM in acknowledgment of the work I do on behalf of The Center for Specialized Surgery,” said Caksackkar. “Partnering with the specialists at Regent RCM has been a great experience and our collaborative approach makes all the difference in our success.”

Are you a business office manager or center administrator actively researching RCM solutions? Click here to access a free ROI calculator to estimate your annual financial improvement through outsourcing RCM or click here to speak with a member of our team.

Regent RCM Employees

Regent RCM Hosts Business Office Manager Conference

Regent RCM recently hosted a Business Office Manager Conference April 12-13 in Lafayette, California. Ambulatory Surgery Center (ASC) business office managers from Alaska to Florida were in attendance.

“It was great to have so many managers in one room all sharing ideas and best practices, while learning from industry leaders and innovators,” stated Regent RCM Vice President Michael Orseno. “Our partners from Regent Surgical Health, including Founder and CEO Tom Mallon and Vice President of Risk Management and Clinical Operations Kathy Bernicky, were also on hand and weighed in with their industry insights and expertise and addressed a variety of ASC specific questions from the attendees.”

Regent RCM slated an information-packed conference with speakers from ZirMed, Surgical Notes, MedTek, HSTpathways and MedHQ, as well as CEO Mallon.

The keynote address was delivered by Delise Crimmins, partner with Redline Leadership Associates. She shared her deep experience and highlighted the importance of leadership for business office managers in the ASC setting.

“I’m so glad I got to attend the conference this year,” said Diane Ethan, business office manager at Plaza Surgery Center in Portland, Oregon. “From leveraging technology, to understanding new ASC revenue cycle benchmarks, and measuring the health of our ASC, this conference was time well spent and I’m thrilled to have had the opportunity to connect with and learn from my peers in the industry.”

In addition to sharing industry insights and information, Regent RCM also honored employees at this year’s conference. Sue Campbell, business office manager at Knightsbridge Surgery Center in Columbus, Ohio, received recognition and a special retirement gift in honor of her service. Rachel Caksackkar from The Center for Specialized Surgery in Ft. Myers, Florida was awarded the 2016 Business Office Manager of the Year award for her outstanding performance and her dedication to improving all pertinent ASC revenue cycle metrics during the past year.

The Business Office Manager Conference was held in conjunction with the HSTpathways user’s conference where Regent RCM Director of Business Development Ed Tschan and Revenue Cycle Supervisor Leslie Favela shared their extensive ASC revenue cycle knowledge with specific attention to staffing, standardized workflow processes, automation and technology. They also discussed nine ASC revenue cycle benchmarks aimed at dispelling myths, and outlined which benchmarks stand on their own and which ones are affected by outside forces.

Pictured:

(Front Row)

Nick George – Knightsbridge

Sherrie Wiseman – High Plaines

Amanda Mellott – High Plaines

Kari Sroka – ISMOSC

Rachel Caksackkar – TCSS Ft. Myers (2016 BOM of the Year)

Sandy Lagunas – Regent

Tanya Ramirez – Lodi

Vicki Webb – Reno

Sue Campbell – Knightsbridge

Mary McGill – Palos

Linda Reid – RWJ Endo

Vianca Bautista – Regent

Leslie Favela – Regent

(Back Row)

Mary Kearns – Glasgow Medical Center

Michael Orseno – Regent

Diane Ethan – Plaza

Kathleen Fischer – Andrews Institute

Joan Vassilogambros – Midland

Susan Bryson – Wasilla

RCM benchmark webinar

Regent Revenue Cycle Management Launches a Three-Part ASC Benchmarking Webinar

Participants learn how to customize, deploy, and measure nine metrics to gauge their center’s financial health

Regent Revenue Cycle Management (Regent RCM), an independent division of Regent Surgical Health and a leading provider of innovative, cost-effective revenue cycle management services exclusively for ambulatory surgery centers (ASCs) in the United States, announced today that it will host a three-part webinar featuring industry veteran and Regent RCM Vice President Michael Orseno. The webinar series expands on recently launched ASC RCM video series and demonstrates how benchmarking will accurately and consistently measure the health of an ASC’s revenue cycle.

“One of the toughest challenges for any surgery center is determining if your revenue cycle is performing well,” stated Orseno. “We developed this webinar series so center administrators can understand how numbers can be improved, why they might fluctuate and how they can often be misleading. We have developed nine metrics that centers can customize, deploy, and measure to gauge their financial health.”

PART ONE: Optimal Business Office FTEs per 1,000 Cases

WHEN: April 5, 2016 at 12 p.m. CST

WHY: Smart staffing is an integral part in gaining more control and efficiency over the revenue cycle. This webinar explains Regent RCM’s exclusive benchmark on optimal staffing models. Regent RCM will explain how it developed this benchmark and used it to reduce staffing to by over .3 FTEs per 1,000 cases in four years.

PART TWO: ASC RCM Benchmarks

WHEN: April 19, 2016 at 12 p.m. CST

WHY: Learn Regent RCM’s gold standard for the following benchmarks and understand how outside forces impact the numbers, how the benchmarks work together, and when the numbers lie.

  • Days Outstanding
  • % A/R over 90 Days
  • Denials and Clean Claims
  • Charge and Claims Lag
  • Statement Lag

PART THREE: Net Collections – the Great ASC RCM Lie Detector

WHEN: May 3, 2016 at 12 p.m. CST

WHY: Find out how to calculate your center’s net collections rate, how to set your gold standard based on your center’s payer and case mix, and why we call this benchmark “the great lie detector.”

To learn more or to register for the webinar series, click here.

 

asc billing and collections vp regent rcm

Regent RCM Pitches Revenue Cycle Management

On March 4, 2016, Regent RCM Vice President Mike Orseno will give a presentation on revenue cycle management to the Association of Wisconsin Surgery Centers, Inc., at their 2016 Clinical Forum. The baseball-themed presentation will focus on defining an optimum ASC revenue cycle, determining the health of an ASC’s revenue cycle through key performance indicators, and exploring the benefits of outsourcing.

Orseno will discuss industry specific metrics, what they are and their significance, all from the perspective of a baseball team manager. Just as the Brewers embody the spirit of performance at Miller Park, so does Regent RCM embody that same spirit of performance across the ASC community. With these best practices, ASCs can take their revenue cycle to the Big League.

For more information on how Regent RCM can give your ASC a competitive edge call 312-882-7228.

ASC revenue cycle management best practice

Becker’s ASC Review Highlights Best RCM Practice Recommendations

There is more to the revenue cycle than money – equally important are operational efficiency and patient relations.

A recent article in Becker’s ASC expanded on that notion and shared insights and best practices gleaned from a presentation led by Michael Orseno, revenue cycle director for Regent Revenue Cycle Management during Becker’s 22nd annual meeting.

During the presentation, Orseno described how the linear process between front office and back office has evolved. And today, explained Orseno, the feedback mechanism between the two is what defines a revenue cycle.

“In the past, the back office would struggle with issues from the front office, so for example, if they would transpose payer identification numbers or not verify the right demographic or insurance information, it would cause headaches for the back end. So this whole revenue cycle piece was invented and defined,” stated Orseno.

Revenue cycle management has come a long way.

From automating insurance verification prior to a patient visit to researching denials to determine if they can be re-billed after a visit, click here to read pre-visit and post-visit best practice recommendations.

If you’re ready to learn more about outsourcing RCM, register for an upcoming webinar, “Gaining More Control and Efficiency by Outsourcing RCM.”

asc billing and collections vp regent rcm

Regent Revenue Cycle Management Announces Executive Promotion

 Strengthening Leadership Team to Drive Next Phase of Growth and Success

Chicago, Ill. – Oct. 21, 2015 – Regent Revenue Cycle Management (Regent RCM), an independent division of Regent Surgical Health and a leading provider of innovative, cost-effective revenue cycle management services exclusively for Ambulatory Surgery Centers (ASC) in the U.S., announced today that Michael Orseno has been promoted to Vice President.

“We are fortunate to have a leader like Michael Orseno and believe he is uniquely qualified to position Regent RCM for future growth and success,” stated Tom Mallon, co-founder and Chief Executive Officer of Regent Surgical Health. “Michael shares our vision for excellence and he is credited with protecting Regent RCM’s dedicated service delivery model while proactively shaping Regent RCM to meet the needs of our growing customer base.”

“I’m proud to be in the company of such talented and experienced health care innovators and leaders,” stated Mr. Orseno. “With the recent announcement of our infrastructure expansion, there’s no doubt that this is an exciting time for Regent RCM. I am thrilled to be leading this dynamic team as we deliver transformational service and define protocols and best practices for the industry.”

Prior to joining Regent, Orseno served as Revenue Cycle Administrator for the Chicago Institute of Neurosurgery and Neuroresearch. He received a Master of Science Degree in Health Systems Management from Rush University Medical Center and a Bachelor of Arts Degree in Public Administration from Augustana College.

Regent RCM’s services optimize ASC workflow and processes, and generate analytics and real-time dashboards that are critical to assessing an ASC’s financial health. Regent RCM consistently outperforms industry benchmarks allowing ASC managers to focus on high-value activities.

About Regent Revenue Cycle Management

Regent Revenue Cycle Management (Regent RCM), an independent division of Regent Surgical Health, is a leading provider of quality, cost-effective revenue cycle management services exclusively for ambulatory surgery centers throughout the United States. Regent RCM harnesses Regent Surgical Health’s 15 years of ASC industry expertise, allowing Regent RCM to consistently outperform industry benchmarks. To learn more visit www.regentrcm.com or join the conversation via Twitter.

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