Opening a new center is a challenging endeavor, especially if the center is new construction.
With a seemingly never-ending list of to-do items, it is easy to become overwhelmed. There are policies and procedures to draft, staffing and technology decisions to be made, space planning, and if you are managing a build-out, you'll face the intricacies of supervising construction.
As the administrator of the recently opened KU Eye Surgery & Laser Center, LLC, I am all too familiar with the many tasks a new center requires. After evaluating our list, one area that quickly made sense to outsource was billing.
Managing billing in-house requires a substantial amount of work and manpower. Had we not outsourced our billing, everything would have had to be created from ground zero. There are a lot of steps that an outsource billing partner does regularly that would have otherwise taken us a long time to figure out and set up; things you don't normally think about as a new center or maybe just don't have time to think about. Identifying and hiring a clearinghouse, setting-up electronic claim entry, obtaining Medicare and managed care credentials, and hiring a biller and a coder are just some of the tasks.
Handing billing over to an experienced team meant there was one less thing for us to worry about. Hence our decision to outsource billing to SourceMedical's Revenue Cycle Services team. If you are contemplating outsourcing as well, there are some things to consider when selecting a billing partner. The following points should help you in your search:
1. Experience matters. The ASC industry is very unique; therefore you will want a billing partner that focuses exclusively on the ASC industry. It is equally important that you select a partner that knows your specialty. As ophthalmology billing is very complex (billing for both eyes, multiple surgeries, etc.), we knew we needed a billing partner that was also experienced in ophthalmology.
2. Get involved up front. Hopefully, the partner you have selected has been in business for quite some time and has a proven track record of success. Ask the billing services company for best practices. While not all best practices will work for your center, chances are you will find something that does. Capitalize on your billing partner's knowledge. Inquire about templates to get you started and the ability to tailor them to your center's needs.
3. Require reports. Ensure the billing company you work with provides you with regular reports on their billing efforts; we prefer quick, weekly reports. Having this information in hand, we are able to monitor our A/R and know things like which payors are paying promptly and why claims are being rejected. Ideally, you want a billing company that will work with you to customize these reports to your specific needs.
4. Don't be afraid to ask questions. There are no dumb questions. For the first several months, we were very involved in the billing process; we carefully reviewed bills and questioned things frequently so that we knew what was happening. As with any relationship, communication is important. Having someone you feel comfortable working with is absolutely essential.
5. Remember, this is a partnership. It is important that you are as available to your billing partner as they are to you. The more you communicate with all levels of the department (including coders and eligibility staff), the better your billing process will be. We consider SourceMedical's Revenue Cycle Services staff an extension of our team, which is ideally how it should be.