5 Best Practices to Improve Your ASC's Revenue Cycle

Melody Winter-Jabeck, administrator at Ravine Way Surgery Center in Glenview, Ill., shares five best practices ASCs can adopt to improve their revenue cycles.

1. Tighten up front-end revenue cycle management. Exercising diligence on the front-end of revenue cycle management will make a significant difference on your revenue cycle efficiency. This is particularly true when checking coverage and verifying patient information as soon as possible. Ravine Way Surgery Center collects all patient information and follows up with a phone call to the patient's insurance company to find out the patient's financial obligation.

"It's all about having really solid front-end management," Ms. Winter-Jabeck says. "This means your ASC has to be diligent with checking coverage and communicating well with patients so that there are no surprises for them. The more information you can verify with patients on the front end, the faster revenue comes around. Patients may not be aware that there is a $1,000 out-of-pocket fee for surgery."

2. Payment plans or alternative payments. Ms. Winter-Jabeck says if patients find they are unable to pay the rising cost of deductibles for surgery, ASCs should communicate early and often payment plan options or some other flexible payment arrangement to patients. Not offering up alternative payment methods or plans from the start can push back payment collection by a significant number of days, directly affecting the ASC's A/R.

"We are currently looking into setting up payment plans or some sort of financing in cases where there is a financial issue for the patients," Ms. Winter-Jabeck says. "The trend we're seeing is that more and more of the financial responsibility is being put on the patient with higher deductibles and out-of-pocket fees."

3. Explain the billing process to patients. Patients may not be aware that they should expect more than one bill from multiple entities, including the ASC itself. Ms. Winter-Jabeck says ASCs patients can receive multiple bills from the physician, anesthesiologist and pathology services.

"At our ASC, we're communicating with patients as soon as their case is booked by first providing them with a packet that includes ownership disclosure, general information about center and a sheet about billing coming out of our ASC as well as who else they might expect the bill from," she says. "Because patients often think it's simply one fee for surgery, it's important they receive that packet of information."

4. Focus on efficient and accurate coding. Ms. Winter-Jabeck says ASCs should also be focused on coding to ensure claims are being processed in a timely manner and are sitting in your ASC's A/R for as little time as possible.

"It's about really knowing your business," she says. "For instance, our ASC does mainly orthopedics. So for a scope or carpal tunnel procedure, our coders really have to know what is going to get paid, what will get rejected and not waste time on factors that companies will deny or slow up claims."

Ms. Winter-Jabeck says hiring the right staff members from the onset will help ASCs capture payments more quickly and build more efficient revenue cycles. In addition, more successful coding can be accomplished mainly by providing continuing education opportunities for your staff members. "Our ASC's investors understand that if we're not educating our staff members on coding issues, the facility is not going to be able to generate the best possible revenue. So we'll send staff members to receive coding certification and have them attend seminars and conferences throughout the year to stay up-to-date on coding issues," she says.

5. Examine EOBs carefully. Ms. Winter-Jabeck says her ASC closely monitors EOBs received by insurance companies for accuracy and trends. The ASC's office manager is continuously looking at EOBs carefully so that the facility is being paid in total for everything that is owed.

"It also allows us to see any trends, such as whether a certain insurance company reduced payment on second procedures for patients," she says. "Sometimes insurance companies don't notify you of changes in coverage or they have problem in their own computer system. These inaccuracies may not be huge dollar amounts, but those small dollar amounts add up and over a long period of time, your ASC can lose significant amounts of revenue."

Learn more about Ravine Way Surgery Center.

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