3 Critical ASC Revenue Cycle Mistakes

Terry Rajendran is co-founder and CEO of the revenue cycle technology company LaClaro. The company recently introduced its product Lighthouse to the ASC marketplace; Lighthouse offers workflow automation to the collection process, oversight reporting and an analytic suite to administration. Ms. Rajendran discusses three mistakes ASCs make in the revenue cycle and how a data analysis tool can benefit surgery centers that may be losing money without realizing it.

1. Don't assume implants enhance your revenue stream. It's assumed that because most contracts state they will pay implants on a cost-plus basis, they are profitable. Making this assumption can lead to an unfavorable financial scenario for a center. "Implants are expensive and the length of time it takes to get them paid creates a cash flow drain," Ms. Rajendran says.  

In order to avoid losing money on implants, Ms. Rajendran says one solution may be to go beyond what the contract states it will pay. It's important to evaluate A/R days for claims with and without an implant. The time value of money plays a key role in the evaluation, as does an understanding of the true financial performance of implants. "Just one denial on an implant claim removes assumed cost-plus margins," Ms. Rajendran says.

2. Don't rely on information gatekeepers.
While it's important to trust your staff and believe that every account has been effectively worked, it's equally important to verify. Reliance on the same individuals working on the accounts to provide updates creates a dangerous "information gatekeeper" model for administration.

"Data always speaks the truth," says Ms. Rajendran. Back office oversight is difficult but imperative. One solution is to deploy workflow automation and oversight tools. This can help reduce costs and potentially bring a center to a whole new operating level where productivity is measured daily in conjunction with sound decision making.    

3. Don't rely on static data. Today's healthcare environment creates the need for dynamic information. Centers are now forced to negotiate contracts based on different methodologies, and given this fact, it's important that centers have a reliable mechanism for obtaining analytics in a simple form. "Not only is it incredibly time consuming to populate spreadsheets to analyze data, it's also wrought with potential error," Ms. Rajendran says.

She says one possible solution is to implement a tool that allows you to view the same data often and from many different angles. Outcomes data can change quickly, and having the ability to spot issues before they become too large creates the opportunity for a center to become proactive. A data management tool that does the work for you can help free up time toward the solving problem rather than unraveling the problem.

Learn more about LaClaro.


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