How Our Dedicated Staffing Benefits Centers & Patients

Regent RCM is committed to improving the financial health of all the ambulatory surgery centers (ASCs) we serve and our dedicated staffing benefits centers & patients.

Our team has deep knowledge of the entire revenue cycle, from payment posting through payer follow-up, and we use our experience to find solutions to our partner centers’ pain points.

Regent RCM’s Dedicated Staffing

One solution that sets Regent RCM apart from other billing and collection service providers is our dedicated staffing model. Regent RCM assigns one revenue cycle specialist to manage a center’s complete revenue cycle, from start to finish. This specialist becomes an expert in the account, delivering exceptional and detailed service. Regent RCM’s revenue cycle supervisors also oversee high-level operations for a small group of ASCs.

Other companies divide the revenue cycle into tasks delegated to different people –with one employee managing charge entry, and several employees handling payment posting and accounts receivable for all centers.

“Our staffing model is definitely our differentiator,” said Erin Petrie, Regent RCM’s Director of Revenue Cycle Management.

“Our centers appreciate that they have a contact who knows everything about their revenue cycle. When centers need information, they don’t have to talk to four or five people who each managed one piece of a claim; they can just ask one person. And our team of revenue cycle specialists and supervisors have insight into the big picture: overall trends with payers, AR problems, or reasons cash flow is light.”

Partner centers benefit because they build strong relationships with the professionals working on their accounts. And patients receive better service when they have questions about a claim; they can speak directly to the person in charge of the revenue cycle, instead of being transferred to multiple people in an organization.

Our Hiring Philosophy

When hiring new team members at Regent RCM, we look for candidates who demonstrate technical knowledge, industry expertise, and our RISE corporate values (Respectful Caring, Integrity, Stewardship, and Efficiency). Successful candidates are also self-directed, proactive, and persistent. They know how to manage day-to-day and long-term account operations, and they are willing to work tirelessly to get the best outcomes for a center.

“We want someone who shows initiative and dedication; we make sure that whoever we assign to cover each center is really an extension of that center’s staff,” said Petrie.

“They’ll be here working every day to make the revenue cycle run smoothly. Because they’re responsible for the full cycle, they’ll notice trends with payers and denials, and know how to get timely payments. Often the biller is so in tune with the center’s revenue cycle that they can spot a code that a particular payer will deny. And they’ll go back to the coder to get the appropriate code, eliminating denial before the bill even goes out. That’s what we strive for.”

Learn more about Regent RCM’s services.

Reasons to Outsource

4 Steps of a Regent RCM Business Office Audit

A Regent Revenue Cycle Management (Regent RCM) audit goes beyond a traditional reimbursement assessment. “The benefits of an audit are clear,” said Michael Orseno, VP of Revenue Cycle at Regent RCM, “and we ensure that facility time commitment is minimal. Our ASC-specific expertise allows us to complete the process in about two weeks.”

This is a quick turnaround, particularly considering the potential upside. In the case of one client, a business office audit uncovered coding errors which led to recouping more than $590,000 in additional funds.

An audit is comprised of four steps:

  • Initial Data Request*. Access to information is vital, and centers will provide a variety of data including but not limited to year-to-date case count and payer mix.
  • Initial Analysis. After collecting and reviewing initial data, Regent RCM selects multiple cases for a more detailed review and analysis.
  • Full Analysis. Pinpointing a number of cases, the Regent RCM team dives deeper using an internal audit tool set.
  • Once the audit is complete, Regent RCM will present findings on-site and provide detailed, strategic recommendations to ASC leadership.

In an upcoming blog, Regent RCM will further define the four key components of an audit including reimbursement, coding, staffing and observation (workflow and process).

Ready to get started? Call Regent RCM’s dedicated team today (312) 882-7228 to schedule an audit for your center.

Regent RCM Logo

Regent Revenue Cycle Management Expands Service Infrastructure; Ensures Dedicated Staffing

Regent Revenue Cycle Management (Regent RCM), a leading provider of innovative, cost-effective revenue cycle management services exclusively for Ambulatory Surgery Centers (ASC) in the U.S., announced today that the company is investing in new talent to provide seamless service delivery to a growing customer base.

The company has hired Ivette Gomez to serve as Revenue Cycle Specialist.  In this role, Gomez will handle billing, payment posting, and accounts receivable for her surgery center, while delivering high-value and high-touch customer service to ASCs.

“Dedicated staffing is essential to achieving patient satisfaction and revolves around a team that possesses an all-inclusive knowledge of the revenue cycle,” said Michael Orseno, Regent RCM Vice President. “Ivette is a wonderful addition to our team and I’m certain her contribution will benefit our clients and enable us to continue to outperform industry benchmarks.”

Gomez will be responsible for a center in the Southeast. She previously served as Senior Reimbursement Specialist at Midwest Orthopaedics at Rush. In this position, Gomez followed-up on outstanding claims and performed reimbursement audits to ensure payments matched contracts and fee schedules.

“I am pleased to begin my new career at Regent RCM,” said Gomez. “There is an incredible team in place, and I’m truly excited to share ideas with them. Together, we will continue to provide the best solutions for our centers and their patients.”

Regent RCM’s services optimize ASC workflow and processes, and generate real-time analytical 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.

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.”

The Importance of Regent RCM’s Dedicated Staffing Model

Part one of a four-part series examines Regent RCM’s mission to improve the ASC revenue cycle service model

Dedicated exclusively to ambulatory surgery centers, Regent Revenue Cycle Management (Regent RCM) has built an innovative engagement model that leverages the latest industry technology and workflows. “Because we are in the trenches with our partner centers, we know their pain points and we know how to solve them,” said Michael Orseno, Vice President of Revenue Cycle. “Our unique revenue cycle management (RCM) model successfully lowers RCM costs, improves results, and increases patient satisfaction.”

The model is defined by four components:

  1. Dedicated Staffing
  2. Efficient Automation
  3. Real-time Reporting
  4. Industry Expertise

This first of a four-part series reviews the importance of Regent RCM’s dedicated staffing model designed to provide consistency, transparency and accountability.

“In order to provide the highest level of patient satisfaction, we knew we had to have a dedicated team that possessed an all-inclusive knowledge of the revenue cycle,” said Orseno. “Regent RCM understands that one action in the revenue cycle affects all others.”

Regent RCM’s dedicated team includes a revenue cycle supervisor who manages the revenue cycle specialists. Supervisors have expertise across the entire spectrum of ASC revenue cycle from payment posting and billing, to patient and payer follow-up.

Only revenue cycle veterans are hired by Regent RCM, and each supervisor has 10+ years of industry-specific experience. These supervisors leverage their industry acumen to become an integral part of Regent RCM’s business office team – monitoring and reporting on revenue cycle health for each ASC client, and using a series of benchmarks and KPIs in order to ensure optimal results.

Regent RCM implements thorough development and training programs to make sure the team stays ahead of ongoing industry changes and updates. “In addition to having dedicated professionals assigned to each account, we have redundancies in place including succession and contingency plans,” said Vianca Bautista, Revenue Cycle Supervisor. “Our staffing model ensures the financial health of a center, no matter what happens.”

Contact us to learn more about dedicated staffing or to speak with a revenue cycle team member, and stay tuned for the next blog in our four-part series: Efficient Automation.

Revenue Cycle Analysis

Case study: Undergoing the transition to outsourced RCM services

In 2012, a West Coast multispecialty ambulatory surgery center began working with Regent Surgical Health to manage and take minority equity in the center, but they chose to keep billing and collections in-house. However, the center was experiencing financial unhealthiness with key performance indicator (KPIs) metrics moving in the wrong direction, specifically high AR days and low net revenue.

In February 2013, the center realized its struggle with cash, revenue per case and proper business office staffing could not be righted internally so they made the decision to transition to outsourced revenue cycle management. They selected Regent RCM, an independent division of Regent Surgical Health, for a one-year contract to help turnaround their revenue cycle operations. During the contract period, Regent RCM was able to significantly reduce the center’s AR while increasing cash and net revenue.

Challenges of bringing RCM back in house

Once the center was financially healthy and back on track, administration opted to bring billing and collections back in-house by hiring a local revenue cycle specialist. Ultimately, the center was unable to handle the full extent of revenue cycle management on its own, and the KPI metrics almost immediately began to move in the wrong direction – revenue dropped while AR days were back on the rise.

Recognizing the need to permanently transition to outsourced RCM services

In February 2015, Regent RCM was brought back into the fold to investigate what went wrong and what steps could be taken to correct the issues. Regent RCM performed a business office audit and discovered that there was virtually no claim follow up. The center has never performed its own internal audits so they were somewhat surprised to learn that this was the case. Without the necessary training, experience and expertise, payer short pays and/or denials were not being appealed and follow-up either wasn’t happening or not following best practices, which ultimately left money on the table.

Benefits of working with an external RCM provider

When the center transitioned back to working with Regent RCM, the same revenue cycle specialist they had worked with previously was assigned. As a bilingual, seasoned specialist with experience working with this center, the Regent RCM specialist was a logical and natural fit to jump back into the position she formerly held.  Additionally, the Regent RCM revenue cycle specialist had a strong understanding of payers, contracts and California law likely to impact the center’s revenue cycle. Specially, she had significant experience working with Blue Cross and Blue Shield in California as well as California MediCal.

The transition back to outsourced RCM was smooth given Regent RCM familiarity of the nuances of the center. The center’s management information system (MIS) was cloud-based so Regent RCM was able to gain access seamlessly. Additionally, there was an accessible coding system in place, which allowed Regent RCM to receive timely notifications so the specialist can send out bills in a timely manner.

Since taking back over, Regent RCM has regularly scheduled internal audits to ensure timely and complete claim follow up, claims are billed appropriately and their revenue cycle specialist uses reporting and analytics tools that allow for customized reports to track progress.

Regent RCM has once again been able to drop AR days  – from 43 to 33 over the course of just two months! During this period, cash collections have also increased by 47 percent from $366,000 to $538,000 monthly.

concerns about transition to outsourced RCM

Top concerns about the transition to outsourced RCM

Changes in certain key performance indicators (KPIs), such as increased AR days and decreased revenue, may be negatively impacting your revenue cycle and your ambulatory surgery center’s bottom line. Recognizing the signs that your center may not be financially healthy can help you to take the necessary steps to correct the problems. After examining the situation, you may find that you cannot solve the RCM issues internally and that it’s time to consider outsourcing revenue cycle management.

As you consider working with an external provider, concerns may arise about the transition process. There are two main concerns we frequently come across:

Revenue

One of the biggest concerns that the transition creates the risk of a short term loss of revenue due to the inherent moving parts of the transition itself. Because of this, you might be concerned that revenue will fall short in a specific month.

Staffing

Another major concern is about staffing, which is twofold. You want to support current employees, but you recognize that your center may be experiencing revenue cycle issues because you don’t have the right staff members in the right roles. Additionally, if an integral employee retires, or your center is experiencing a high turnover rate, you may not have the resources to fill these necessary roles in a long-term capacity. Considering transitioning to an external RCM provider may leave you wondering what the future of your center may look like.

We understand that change can be challenging, and even though you recognize that your center could benefit from the transition to outsourced RCM, these concerns may serious hesitation in taking that first step.

Stay tuned for upcoming posts when we address these concerns and look at a case study detailing a successful transition to outsourced RCM services.

Becker's ASC Review Conference

Regent RCM’s recap of the Becker’s ASC conference

Last week, Regent RCM’s leadership team headed to Chicago, Ill., to the Becker’s 13th Annual Spine, Orthopedic and Pain Management-Driven ASC Conference & the Future of the Spine.

The Becker’s conference was a great opportunity for Regent RCM’s Director, Michael Orseno and Director of Business Development, Ed Tschan to network with other industry professionals and provide useful insight on how the benefits of outsourcing RCM can have positive long-term effects on a center’s financial health. Steve Taylor from ASCInsight was also on site to provide demonstrations of a real-time dashboard that monitors KPIs and assists with reporting and analytics.

There were certainly some conversational themes our team has noticed throughout the conference. Some of the key discussion points included:

  • Managed care contracting
  • Coding audits
  • How Regent RCM sets itself apart in the marketplace
  • Short-term revenue cycle needs and the flexibility and integrity needed to satisfy these needs
  • Constraints within an ASC that lead to a need for outsourced RCM, especially with AR days that are greater than 90 days

Becker’s proved to be a success for the Regent RCM team as we were able to provide valuable insight into how outsourcing RCM might be the right decision for your ASC’s billing and collections needs and the importance of reporting and analytics to your center’s financial health.

ASC billing department

A well-rounded interview process leads to successfully hiring the right revenue cycle specialists

In our last post, we looked at what qualities a successful revenue cycle specialist possesses. Today, we examine why determining if a candidate is the right fit for an internal revenue cycle specialist position can be a challenge. A potential hire who looks perfect on paper may not have the people or communications skills needed when it comes to the in-person interview, so developing a well-rounded interview process ensures that the candidate who is the best fit in all aspects gets the job.

Provide a skills assessment

Creating a skills assessment test provides you with a solid indication of their previous experience, knowledge and problem-solving skills. It’s not a matter of getting every question right, but rather assessing their critical thinking and thought process on the questions he or she got wrong. This also provides insight into whether or not the candidate will be teachable.

Complete a multi-person interview

In addition to the skills test and examining the candidate’s resume, the in-person interview helps you establish if this person possesses the necessary qualities and is a good fit for both the position and the team. It’s beneficial to have the potential new hire interview with a few different employees. At the conclusion of the process, the interviewers can discuss their thoughts and opinions to come to an informed decision on whether to hire the individual.

Tailor interview questions around the culture of the ASC

The in-person interview also gives the interviewers a chance to see if the candidate is well suited to the center’s culture. For instance, Regent Revenue Cycle Management (RCM) works with a one-to-one model, providing each ASC with a dedicated revenue cycle specialist. This allows the specialist to develop a strong, vested relationship with each center, and it’s important that any new hires can fulfill this model.

Another way to determine if the candidate fits in with the culture is to ask questions regarding the center’s values. Regent RCM, for example, tailors questions around its RISE (respectfulness, integrity, stewardship, efficiency) values. The individual’s answers to the interview questions will provide insight as the whether he or she possesses these non-negotiable qualities.

This well-rounded interview process provides a multi-dimensional look at each candidate to help you best determine who will be the optimal fit for your center.

medical billing and collections team

The Benefits of Outsourcing RCM: Smart Staffing and Avoiding the Need for Succession Planning

Over the course of March, we are diving deep into four key benefits of outsourcing revenue cycle management (RCM) for ASCs. Last week, we looked at the ways in which RCM providers can bring workflow and process optimization using best-in-class technologies to ASCs. This week, we will examine how outsourcing RCM provides ASCs with smart staffing solutions, and helps them avoid the need for succession planning.

For ASCs, an experienced billing and coding staff with built in redundancies is not just a luxury, it is a necessity. Hiring inexperienced staff or becoming dependent on just one or two good people could end up costing your center hundreds of thousands of dollars.

It can be incredibly difficult to find someone who can be an immediate contributor, especially if your ASC is in a rural area. You are likely to be in a position where your only choices are to hire someone with no experience or someone with experience only in a hospital or physician’s office setting. This means they will need to work on a fairly steep training curve, during which time your ASC could be losing thousands of dollars. There are a number of reasons for this problem, not least of which is that getting together the pay and benefits necessary to attract experienced professionals in this department may not be a priority for your center.

RCM providers have the resources to pay well, provide good benefits, and situate themselves in desirable locations. They know how to find and hire the best of the best, and often have a pipeline of eligible applicants waiting for a spot to open up. And while ASCs don’t necessarily get to choose their location- rural Virginia needs healthcare too- they can still hire, through outsourcing, talented individuals that may not be up for a big move.

Another issue faced by ASC billing and collections departments is that of succession and contingency planning. Your ASC may have a talented professional working on your billing, but what if he/she goes on vacation? Will the entire department be put on hold for a week? It is also worth considering what will happen when that person inevitably retires. Not only will you be faced with staffing issues, but the outgoing staff member may pass any bad habits they have onto the new staff member during training. If they are inexperienced, it will be very difficult for them to spot mistakes, and practices that leave money on the table for your ASC will continue.

A good RCM provider will have dedicated professionals assigned to your ASC, with redundancies in place so billing isn’t halted- no matter what happens. This also means that you have someone dedicated to your center’s billing and collections, and that person has a whole team behind them, providing support and resources. Requirements are constantly changing in the field, especially with upcoming ICD-10 changes, and an RCM provider will be on top of that. They will keep staff updated as well, and provide them with all required employee development and training.

As ICD-10 and other regulatory changes make billing and coding a more difficult and exacting process, it is increasingly important to have the right team, both internal and external, in place to ensure money isn’t being left on the table.