The ASC reimbursement environment has changed significantly over the years. Twenty years ago, doctors had their ‘code set,’ everything was straightforward and they could code effectively on their own. But that is not the case today. Requirements differ and nuances continuously emerge making it impossible for doctors, and ASC billing staff, to keep up.
To maintain a steady revenue cycle, claims must be coded accurately and submitted on schedule. Consistent and diligent follow-up on outstanding claims is also a necessity. Otherwise, substantial revenue will be lost when claims sit uncollected. Effectively and efficiently managing these tasks in-house without adequate staffing is a difficult task at best. Staff members go on vacation, they become ill and turnover occurs. This is why so many ASCs, including Wyoming Surgical Center (WSC), are enlisting the help of an outside revenue cycle services partner.
By partnering with a team of revenue cycle experts, getting paid as quickly as possible for all the services a center provides can be a reality. Claims research and appeals, which most in-house staff simply don’t have the manpower to handle, become the responsibility of the revenue cycle services partner.
In our search for the right billing partner, WSC learned many things along the way. To help other ASCs, here are a few things we discovered.
1. Revenue cycle management should be a collaborative effort. Look for a partner that will work with you to build upon your center’s existing revenue cycle processes by incorporating industry best practices. This will help your center to experience tangible results, like faster billing, quickly. For example, with help from our partner we identified revenue cycle goals based upon commonly used key performance indicators (KPIs) including lag days and Accounts Receivable over 90 days. After partnering with SourceMed Revenue Cycle Services (RCS), WSC’s Accounts Receivable over 90 days decreased by 17 percentage points; we expect this number to continue trending down. Even more impressive, our monthly gross collection percentage almost doubled over the past year.
2. An end-to-end revenue cycle solution matters. Before partnering with SourceMed RCS, WSC was already using SourceMed’s AdvantX software for ASC financial and clinical management. Now, SourceMed RCS can easily pull all the clinical and financial data they need to manage the entire revenue cycle directly from our AdvantX system. As an integrated solution, we gain complete transparency for management, measurement and reporting, without any of the extra upfront interface costs and yearly maintenance fees which has resulted in hours of time and thousands of dollars saved.
3. You can’t measure what you can’t see. Visibility into billing and collections is important. Implementing a standardized process and making sure that the chart sheet, op notes and transcriptions are submitted to your partner team on a daily basis will help keep you on track. Our lag days have decreased by 40 days which has dramatically increased speed of payment.
4. Success takes time and effort. Partnering with a revenue cycle management vendor does not mean you’ll flip a switch and everything will immediately be perfect. Like most things, it is a process. Listen to advice from the experts and take advantage of the best practices they recommend.
As the industry continues to move toward value-based care, the reimbursement environment will become even more complex. With end-to-end solutions and an expert partner, the ability to maintain a healthy revenue cycle is more easily achievable for ASCs with a lean internal team.