Regent Revenue Cycle Management Names Luz Renteria to Revenue Cycle Supervisor

After a year as Revenue Cycle Specialist, Renteria to assume Revenue Cycle Supervisor Position

Regent Revenue Cycle Management (Regent RCM), a leading provider of cost-effective billing and collection services for ambulatory surgery centers in the United States, today announced Luz Renteria has been promoted to Revenue Cycle Supervisor.

Luz is a 15-year veteran of the healthcare industry, she brings a wealth of experience to her role and she continues to move the needle and add value to our surgery center partners.

Renteria joined Regent RCM in 2015 as a Revenue Cycle Specialist, and was responsible for the charge entry, billing, and collections for a surgery center in the Southeast.  While she served in this role, the center’s days in accounts receivable dropped to the lowest in its history. In addition, she collected over $1 million during August 2016, which is the highest amount ever collected during the ASC’s history. As a supervisor, Renteria will lead a team of specialists who are each responsible for a center of their own.  Additionally, she will be conducting business office audits for current and prospective clients.

“I am pleased to serve in this new role alongside my fantastic team, and look forward to contributing to the growth of Regent RCM,” said Renteria. “My goals for this position are to exceed the metrics for our team, and to maintain the high standard of excellence that our company is known for.”

Renteria began her career on the payer side as a data entry specialist for a Blue Cross and Blue Shield of Illinois fund office. She then transitioned to the provider side a decade ago, and most recently managed a patient accounts office for University of Illinois Hospital & Health Sciences System in Chicago.

revenue cycle management

3 Secrets to Successful ASC Revenue Cycle Management

Effective ambulatory surgery center (ASC) revenue cycle management can be hard to achieve, particularly as internal and external forces exercise their influence. According to Regent RCM’s Director of Revenue Cycle Management Erin Petrie, ASCs that pay attention to three key success factors are well-suited for the challenge.

“The first key success factor is driven by the healthcare industry’s shift toward value-based care,” Petrie says. “While assuming reimbursement risk from payers along with the responsibility to provide quality care has created some uncertainty and challenges for ASCs, managed care is in better hands. ASCs are equipped to both deliver quality care and manage costs more effectively than insurance companies ever were. But to be successful in revenue cycle management (RCM), ASCs need to become more adept at both managing costs and collecting additional revenue directly from patients, many of whom have selected healthcare insurance plans with lower premiums but higher deductibles.”

Another factor is also closely related to the evolution of value-based care. While many ASCs are succeeding at streamlining procedures and costs for procedures new to out-patient treatment, such as total joint replacement, payment bundling and reimbursement declines introduce new pressures. For example, payers are beginning to scrutinize payment of high-cost implant procedures and are driving a hard bargain when it comes to bundled payment agreements. As ASCs assume leadership of these bundles, a second key success factor is careful negotiation along the way. “You need to be diligent – check your costs, factor in economies of scale but also account for patient-driven variation, and renegotiate contracts annually,” Petrie suggests.

A third way to ensure successful RCM is to optimize business office staffing. “The best-run ASCs make sure their RCM staff is motivated and incentivized to aggressively pursue revenue, rather than just remaining content with the status quo,” Petrie says. “If an ASC’s staff is accepting only what the insurer pays and not fighting for what the center is contractually entitled to or higher than ‘usual and customary,’ that particular facility may be leaving a lot of money on the table.”

asc revenue cycle management solution

ASC Revenue Cycle August Industry News Wrap-Up

Each month Regent Revenue Cycle Management (Regent RCM) explores the top news and headlines affecting the health care industry. This month in the news: An editorial discusses the importance of effective infection and outcome metrics for ASCs; North Carolina attempts to repeal its certificate of need legislation; and a Regent Surgical Health Vice President of Managed Care reveals fundamentals for day-to-day payer negotiations.

Editorial: The need for effective infection & outcome metrics to propel the ASC industry forward

As healthcare continues to move to the outpatient setting, the ASC industry needs to have systems in place to measure quality outcomes in order to thrive, writes Dr. Donald Fry, executive vice president for clinic outcomes management for MPA Healthcare Solutions and an adjunct surgery professor at Chicago-based Northwestern University Feinberg School of Medicine. Click here to read more.

North Carolina moves to repeal CON legislation

A North Carolina state senator has added a CON repeal proposal to House Bill 161, which would repeal North Carolina’s controversial certificate-of-need legislation. Experts say the state’s CON law for ambulatory surgery centers has costly repercussions for patients and insurers, and that repealing the CON laws would give patients more treatment options, thereby improving quality of care. Click here to read more.

Managed Care ABCs for Day-to-Day Payer Negotiations

As new payment models continue to emerge, one of the critical mistakes that ambulatory surgery centers (ASCs) make is not paying attention to the day-to-day management of payer contracts. Andrea Woodell, Vice President of Managed Care at Regent Surgical Health, says that even as MACRA (Medicare Access & CHIP Reauthorization Act) drives healthcare to performance targets, it will take some time for those changes to take full effect. Click here to read more.

revenue cycle dashboard

Managed Care ABCs for Day-to-Day Payer Negotiations

While Medicare’s recent changes and emerging alternate payment models are top-of-mind for many in the healthcare industry today, it is equally important to pay attention to the day-to-day management of payer contracts.

According to Andrea Woodell, Vice President of Managed Care at Regent Surgical Health, even as MACRA (Medicare Access & CHIP Reauthorization Act) drives healthcare to performance targets it will take some time for those changes to take full effect. Meanwhile, healthcare facilities can’t lose sight of their routine negotiations. “It’s not magic, it just takes constant attention,” Woodell says. “One of the biggest mistakes that many centers make is not renegotiating contracts annually, or entering into multi-year contracts without factoring in incremental increases each year.”

Many ambulatory surgery centers in the industry do not revisit and renegotiate their managed care contracts annually to maximize their payments. Keeping reimbursement contracts current is critical for ongoing financial health of most centers. “If you’re not getting at least a 3% increase each year, you’re probably falling behind,” Woodell explains. “We advise centers to look at contracts annually. Identify the facility team member with the correct skill set and align their incentive plan to reward annual payer negotiations and go get those increases!”

Even for standalone surgery centers in saturated markets with no hospital partners, Woodell says, it is possible – and important – to negotiate minimum annual increases of 3%. SWB, new technologies and medical instrumentation, and implants drive up the cost of surgery every year. “I am working on a new project with development reviewing a center’s agreements for the lift I can bring; one of the contracts was last negotiated in 2002 and pays well below Medicare. If the agreement had been touched annually their payments could be 40% higher for that payer.”

Woodell outlines two key steps for centers looking to do a better job in this important area:

“One strategy we’ve found to be effective, is to involve a surgeon in the negotiations. Elevating the negotiation beyond your financial counterpart at the payer organization changes the dynamic. If you have your surgeon contact the VP over ancillaries on the payer side, it can completely change the conversation and may have the power to take you from a 3% increase in a contract year to 10 or 15%.”

Another of Woodell’s recommendations is to pay attention to your facility’s relationships with payers. “These relationships are more important than ever,” she says. “If they don’t like you, not only will they not help you, they will hurt you. – A good relationship with a payer means you understand their challenges as much as you want them to understand yours, and you help them help you by giving them good, objective data that they can take on to their interior team to help you achieve what you’re asking for.”

The bottom line in these contract negotiations, according to Woodell, is to demonstrate the value and cost savings that you’re providing to payer organization. Focused attention, surgeon involvement and strong relationships within the infrastructure of payer organizations can improve results beyond the standard response of “No, all I can do is 2%.”

To learn more about payer negotiations and how Regent RCM can help, contact 312-882-7228.

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.

ASC Revenue Cycle Management

Regent Revenue Cycle Management Spearheads Benchmarks to Assess Surgery Center Revenue Cycle Health

New white paper defines nine metrics centers can customize, deploy, and measure to improve performance.

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, today released a white paper outlining nine ASC-specific benchmarks to accurately and consistently assess the health of a surgery center’s revenue cycle.

“One of the toughest challenges for surgery center leadership is determining if their revenue cycle is healthy,” said Regent RCM Vice President Michael Orseno. “Our new white paper gives ASC leadership more visibility into that performance, and to help them understand how numbers can be improved, why they might fluctuate, and how they can often be misleading. Using our benchmarks, ASCs can accurately measure revenue cycle health, and ultimately, locate every dollar they are entitled to.”

Lacking standardized revenue cycle measurement tools, specific to ASCs, leadership leaned on hospital or physician practice metrics. Given the differences in payer mix, case mix, and contracts, those metrics not only caused confusion, they failed to provide the assessment tools centers needed to be successful and to compete in an increasingly competitive healthcare market. Regent RCM’s white paper outlines nine critical metrics that centers can customize, deploy, and measure to gauge their financial health.

“Many of these metrics, such as Days Outstanding and Clean Claims Percent, are certainly familiar, but centers can’t currently use them as benchmarks because they don’t know what the gold standard should be for their case-mix and contracts,” said Orseno.

An important theme of this paper is how the nine benchmarks relate to each other. “Until now, center leadership might question how their center’s revenue cycle could be performing poorly when its Days in A/R are under 30. The numbers often lie, and these benchmarks can pinpoint the problem areas,” added Orseno.

Among the nine metrics is a benchmark for the optimal number of full-time business office employees per 1,000 cases. The exclusive metric was developed by Regent RCM after it mined data from ASCs for several years. “Surprisingly, we found that busier centers are often more efficient,” stated Orseno.

The white paper also features examples of ASCs where the application of the benchmarks is already improving revenue cycle management. An out-of-network center in the southeast, for example, learned first-hand the impact Regent RCM’s benchmarks have on improving financial health. Since working with Regent RCM, the center has become more efficient in A/R. The center in March 2016 shattered a trio of records, achieving 42 days in A/R, $895,590 in collections, and at 26.3%, its lowest percent of outstanding accounts in A/R over 90 days.

To download the free white paper, click here.

About Regent Revenue Cycle Management

Regent Revenue Cycle Management (Regent RCM), an independent division of Regent Surgical Health, is a leading provider of innovative, 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.

ASC Revenue Cycle Benchmarking Series Video

Regent RCM Focuses on Net Collection Rate in Webinar Series

In the final installment of Regent RCM’s three-part webinar series on ASC industry benchmarks to determine the health of a center’s revenue cycle, Vice President Michael Orseno and Director of Business Development Ed Tschan examine how to interpret these key performance indicators (KPIs) and what they are really communicating.

“Performance benchmarking continues to be an integral part of the Regent RCM team’s operations and its focus on continuous improvement,” said Tschan, who introduced the webinar and Orseno.

Orseno recapped the five ASC revenue cycle metrics mentioned in the second webinar but went into greater depth, discussing which ones could stand alone and which ones could be manipulated. He added a sixth ASC revenue cycle performance metric, net collection rate, which cannot be manipulated and explained its significance.

“It’s nearly impossible for office staff to manipulate the net collection rate,” said Orseno. “That’s why we sometimes refer to it as the great lie detector. All the other metrics we discussed previously can be manipulated. The only way this metric can be manipulated is by the person doing the calculation.”

Multiple attendees of the three-part webinar series commented that they plan to immediately incorporate ASC revenue cycle benchmarks to improve the health of their ASC.

“I think it was an awesome series with so much helpful information,” said one attendee. “I couldn’t believe all the insight our center can gain from utilizing these metrics. We’re running reports right now to see where we stand.”

Tschan stressed the importance of a revenue cycle audit that utilizes these recommended metrics to allow a center to confidentially capture existing performance metrics and get a solid sense of where they stand.

“What we’ve found historically is that most centers don’t have the luxury of having a strong financial contact that has performed revenue cycle audits before,” said Tschan. “We recommend that a center looks for an auditor specifically in the ASC community to provide relevant qualitative and quantitative insights.” He went on to explain how to find the right auditor, including four key areas that should be part of the audit and what to expect at the end of the audit process.

Orseno finished up the webinar by putting ASC revenue cycle benchmarks in perspective, noting that they are a valuable tool, but only part of the picture.

“We want to make sure that you have the tools in order to measure these metrics and to be able to identify how these metrics can be manipulated,” said Orseno, “but I think the most important message we want to put out is not to be blinded by these metrics, either one by one or altogether. Use them as a tool but ultimately, focus on the revenue due to the center.”

Click here to listen to the full webinar with detailed information on assessing the validity of these ASC revenue cycle benchmarks and how to be mindful of those that can be manipulated.

ASC Revenue Cycle Benchmarks Defined

Regent RCM Webinar Series Addresses Five ASC Revenue Cycle KPIs

In the second of Regent RCM’s three-part webinar series, Vice President Michael Orseno examined five ASC industry benchmarks or key performance indicators (KPIs) that measure the health of a center’s revenue cycle.

“Focusing on these industry benchmarks has been an integral driver of our team’s success and in the continuous improvement cycle of our partner centers,” said Director of Business Development, Ed Tschan, who introduced Orseno.

Tschan added that many revenue cycle conversations with ASCs frequently include questions regarding recommended metrics to drive the financial health of a center, whether metrics operate independently or in an integrated manner, what metric tracking capabilities exist and how to leverage the information to benefit the center.

Orseno addressed these questions while discussing five of the ASC industry benchmarks: Days Outstanding/Days in A/R, % of A/R greater than 90 Days, Denial% and Clean Claim, Charge, Claims Lag, and Statement Lag. He explained how to calculate the metrics, why the information is useful, the Regent gold standard for each of these metrics, and why keeping a center’s numbers within target parameters will maintain a healthy revenue cycle.

“Once your center is measuring these benchmarks, they should be monitored monthly, at minimum, possibly weekly,” said Orseno, in response to an attendee’s question. “For collections, a standard should be set as a goal each month and metrics should be looked at weekly. Other metrics, such as days in A/R should be monitored monthly.”

Click here to listen to the full webinar with detailed information on these benchmarks and answers to more questions on how to utilize them. To register for the final webinar in the series, held May 3, click here.

ASC Collections

Diligent Appeals Process Accelerates ASC Collections and Minimizes Premature Write-offs

Revenue Cycle Supervisor Vianca Bautista has helped shape Regent RCM’s diligent appeals process designed to accelerate ASC collections and avoid premature write-offs. She supervises four revenue cycle specialists, while managing her own ASC client, so it’s no surprise that Bautista is highly skilled at getting claims paid. In the following post, Bautista shares her insights about successful insurance appeals, details about the Regent RCM appeals process and how diligence pays dividends for ASC clients.

“When a claim isn’t receiving reimbursement according to the contract or if it is underpaid, this triggers our diligent appeals process so we can get to the root of the problem and then pursue the expected payment immediately,” said Bautista. “Our process begins with a phone call to the payer and that takes place the very same day or the day following receipt of an underpayment.”

If the claim can be reprocessed with additional information, it’s sent back and Regent RCM’s revenue cycle specialist will then follow up 30 days later.

“These automated triggers, along with immediate follow-up fix most, but not all problems,” Bautista adds.

If the claim cannot be reprocessed, a first appeal is sent out and if the payer still maintains their position, Regent RCM will send a second appeal, and, on rare occasion, a third.

While no one can achieve a 100% clean claim rate, proper coding and using a robust clearinghouse to scrub claims prior to submission bolster success. The Regent RCM gold standard is less than 5% denials and a 98% clean claim rate.

“If there is a secret to our success, it is consistency. Our automation catches issues and we have steps in place that will get revenue cycle back on track,” stated Bautista. “We are determined to recover every dollar for our clients and write offs are a last resort.”

Are you interested in learning how Regent RCM revenue cycle specialists can leverage appeals to accelerate ASC collections and avoid premature write-offs? Call 312-882-7228.

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.

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