Mr. Davis said it is critical ASCs maintain a strategic view of their revenue cycle, meaning surgery center leaders view the revenue cycle as a core competency of the ASC, as a customized solution with dedicated resources and as an investment in the business, rather than a commodity or an expense.
Although many in the healthcare industry may have different ideas on what optimization, in regards to revenue cycle, may mean, from Mr. Davis’ perspective, optimizing the revenue cycle means maintaining a perfect balance among three key factors: IT, sound processes and protocols and well-trained staff members.
Common ASC revenue cycle issues include inadequate patient information capture, inability to verify insurance or collect co-pays, inaccurate billing or posting of payments, untimely billing and/or appeals, incomplete physician documentation and more.
Mr. Davis then offered some best practices, tools and solutions, some of which were gleaned from HFMA’s revenue cycle initiative:
• Verify coverage and pre-authorization of services for all patients.
• Conduct a pre-op call from the business office with every patient to make financial arrangements on the front-end. This may seem like a hassle, but it is cheaper than collecting on the back end.
• Collect copayment and deductible at time of service. Poor communication can break this down.
• Enter charges on a daily basis. This is an important feature because if your workflow is even and consistent, you are less prone to making errors.
• Review and fix all claims and edits on a daily basis.
• Implement a revenue cycle training program.
• Develop process maps and policies and procedures.
• Implement a dashboard report to monitor revenue cycle measures.
• Have a business office assessment performed.
“It’s becoming harder than ever to do things today. Increasing costs and competition, increased regulation, a difficult economic environment, all these factors and more make it hard to maximize your business office,” Mr. Davis said. “And there is, rightfully so, a lot of emphasis on the clinical side, but the business side is equally important in order to have a successful venture or business.”
Read More from the ASC Conference:
Surgical Care Affiliates CEO Andrew Hayek: 6 Observations on the State of the ASC Industry
5 Best Practices for Revenue Capture at Endoscopy ASCs
Why Benchmarking Data is Critical for GI Centers
