4 Tips for Increasing Surgery Center Revenues in 2014

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With the New Year quickly approaching, many ambulatory surgery center owners and managers are looking for ways to increase revenue in 2014.

From outsourcing to the implementation of technology, there are a number of options for centers to help speed reimbursements and streamline billing processes. To get started, considering the following:

1.    Negotiate contracts. Outsourcing billing processes is an appealing option for many ambulatory surgery centers as it alleviates the stress and significant amount of man hours required to manage a busy billing department. By leveraging the domain expertise offered through an experienced billing company, staffing issues are avoided and processes are more efficient which results in significant financial benefits.

For centers considering outsourcing billing processes, lock in billing rates for as many years as you can when negotiating with outsourced billing companies. With the ICD-10 implementation date quickly approaching, rates likely will climb as the potential pool of available coders is expected to decline. Longer-term agreements can provide significant cost savings in the years to come. For centers already outsourcing, now is the time to renegotiate terms to secure a longer-term agreement at a fixed cost.

2.    Automate insurance eligibility certification. An often overlooked process which can have a significant impact on cash flow is insurance eligibility. For example, when demographic information submitted by a center differs from the payer's demographic information, claims are denied. This leads to staff spending substantial time trying to determine the cause of the denial and/or searching for the correct information.

Automated eligibility checking technology reduces claim denials by ensuring information submitted is current. Centers using these automated solutions report a significant reduction, up to 80 percent, in the amount of time staff spend verifying insurance eligibility. A fully automated solution will manage all of the workflow around insurance verification. In addition to automatically checking benefits at the time of booking, these systems alert staff to any changes prior to the date of surgery. Using these systems, facility staff can view eligibility details in a matter of minutes, copy it and have it ready so that co-pays and deductibles are processed correctly the first time around.

3.    Bring post-operative reports online. Obtaining the necessary details to code cases has always been a challenge. With the move to ICD-10 slated to take effect Oct. 1, 2014, it will be significantly more difficult. Specificity requirements will increase substantially, which means surgeons will have to provide coders with much more detailed documentation. Without the necessary details in hand, coders will be left chasing surgeons for information, claims may be denied, and reimbursements will be delayed.

Leveraging technology to automate the development and distribution of post-operative reports can minimize the impact of ICD-10 documentation pains and help improve cash flow. Rather than waiting for several days or more for information to be transcribed and distributed, surgeons easily create an op note at the time the surgery is completed thus eliminating billing delays. Reports are more accurate and detailed as they are developed while information is still fresh, decreasing the likelihood of denials caused by errors on a submitted claim. Because information is available immediately, cases can be converted to a claim much quicker and missing details identified early on to minimize billing delays.

4.    Evaluate staffing needs. When significant regulatory changes such as ICD-10 are made, it is a good time to evaluate existing staffing needs and whether an outsourced billing solution is an effective option. Otherwise, facilities that are unprepared on the go-live date will likely experience billing delays which will impact revenue.

In addition to making sure that staff are trained well in advance of October 1, management should evaluate whether or not their existing staff can handle the additional work that will be required for ICD-10 or whether temporary staff is needed. Another area to consider is coders. For coders on the brink of retirement, it is highly likely they will forego learning the new coding system in favor of retirement. To minimize revenue disruptions, now is the time to start evaluating current staffing and labor costs against other options such as training needs of existing staff, bringing in additional staff or temporary staff, as well as outsourced billing services.

More Articles on Surgery Centers:
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6 Reasons to Be Optimistic Regarding the Future of Surgery Centers

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