Six key revenue cycle from ASC experts:
1. Find causes of denials. Surgery centers can improve claims denial management by adopting proactive strategies, including identifying the root causes of denials, according to Mnet Health, a financial technology firm specializing in healthcare. Root causes may include flawed internal processes or technology errors.
2. Offer financial counseling. ASC management software developer Surgical Information Systems shared insights on improving financial performance. According to SIS, if physicians say they prefer that payments not be collected up front due to patients canceling, ASCs should ensure patients receive financial counseling so they understand the procedure cost.
3. Watch for revenue leaks. Undetected revenue leaks can hurt an ASC's profitability and cash flow, according to Serbin Medical Billing. To avoid them, ASCs should ensure the total dollar amount of the bill isn't increasing and the days bills are in accounts receivable are decreasing.
4. Follow up on unpaid claims. Gina Tolbert, a Regent RCM specialist serving the Center for Specialized Surgery in Fort Myers, Fla., recommended gathering information on claim status online and using electronic tools, such as calendar alerts, to prompt follow-up on accounts receivable.
5. Crack down on upcoding. ASC staff can handle upcoding — inaccurate coding to insurance companies to receive inflated reimbursement — by bringing in a third party to determine if there's wrongdoing, bringing up the issue to management or alerting CMS, according to Jessica Nelson, director of revenue cycle services for Surgical Information Systems
6. Give patients payment options. A key billing trend ASCs should pay attention to is increasing patient costs, according to Tyler Crawford, CEO of BHG Patient Lending, a patient-financing partner for hospitals and ASCs. Mr. Crawford predicts that patient responsibility for healthcare costs will increase to over 40 percent of the bill over the next five to 10 years. As a result, ASCs need to consider what kind of payment options they’ll offer to patients.