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Using the 'science of revenueology' to improve ASCs

Proper revenue cycle management is essential to keeping a steady cash flow in an ASC.

Zotec Partners' Jeff Fowler, vice president of business development and Rich Masson, vice president of client services, discussed best practices in the "science of revenueology" — revenue cycle management, billing and collections — at Becker's ASC 23rd Annual Meeting: The Business and Operations of ASCs on Oct. 28.

When it comes to managing the financial health of an ASC, successful administrators need to decide whether to manage their revenue cycles in-house or outsource it. The data and process are the same, but administrators have a wealth of options and technologies available to use.

"Paying attention to that is important to everyone in the organization; whether you're the manager of the center, an owner or a physician, it is important and a subject that should be touched on in your organization," Mr. Fowler said.

It makes sense to outsource revenue cycle management if a center is facing several impending events. For example, if the revenue cycle manager retires, it may make more sense to outsource the entire process than training another person in-house.

ASCs may also have outdated technology, and it wouldn't make sense to purchase an infrastructure upgrade; instead, it could be more economical to outsource.

Benefits of outsourcing revenue cycle management include lower operating costs, improved access to technology and reporting, industry expertise and an improved revenue flow.

"It's [the revenue cycle management company's] business to ensure their technology is up-to-date and they can focus on what is happening," Mr. Masson said. "They can manage your revenue cycle while you focus on running your business."

Minimizing security risk is another important element a revenueologist handles. According to the Bitglass 2016 Healthcare Breach Report, one in three Americans were victims to a healthcare data breach in 2015. From a revenue perspective, any type of cyber event could cost millions and permanently hurt a center's reputation.

"We believe this is the main job of a revenueologist is to make sure the security is addressed," Mr. Masson said.

Ensuring a center is HIPAA compliant and securing a patient's financial information is of the utmost importance to a revenueologist. Proper security processes should need to be in place and frequently checked. Successful centers will work with a reputable data vendor to backup their data systems.

Zotec Partners has an implementable practice to prevent any sort of credit card theft. An employee of Zotec will not accept a credit card payment over the phone. Instead they transfer their client to a computerized system, where the client will enter their credit card for processing.

The changing healthcare arena is affecting revenue cycle managements. High deductible plans are the "hottest fire right now" that revenueologists need to address.

Over the last decade the high deductible plans have increased by 360 percent, and that increase is making patients one of the largest payers in healthcare.

"We know that patients are becoming the largest payer in the overall healthcare system. If you haven't changed your process to deal with the patient and you haven't gathered that information to get that payment from them then you're definitely falling behind."

Adapting to the patient may mean implementing new-to-healthcare technologies. Patients want their healthcare experience to be like Uber, Amazon or Google, Mr. Fowler said.

"You can't treat a high deductible balance like a self-pay balance you did five years ago," Mr. Fowler said.

For example, in a traditional billing process, centers had a process which took several months. But when a text message billing system replaced that traditional system, returns dropped to within 24 hours.

The science of revenue cycle management is vast, but by devoting time to developing data-driven processes, ASCs can make immediate and long-lasting gains.

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