An ASC's revenue and profits are directly linked to its front-end processes.
During a July webinar hosted by Becker's Hospital Review and sponsored by National Medical Billing Services, three National Medical leaders — all with significant revenue cycle experience — discussed how an ASC's front end affects its revenue and profitability:
- Lisa Rock, founder and president
- Kylie Kaczor, MSN, RN, senior vice president of clinical and regulatory affairs
- Aaron Davis, vice president of client operations
Four key takeaways:
1. An ASC's front end has an enormous effect on its bottom line. An ASC's front end is responsible for capturing patients' demographic information, handling patient eligibility and insurance verification, dealing with prior authorization, managing scheduling, and communicating with patients about financial responsibility. When an ASC's front end doesn't capture the appropriate demographic information or properly verify a patient's insurance or secure prior authorization, it can cost an ASC millions of dollars per year in revenue.
2. ASCs can improve their bottom line by implementing front-end best practices. In the spirit of "you can't manage what you can't measure," Mr. Davis suggested that ASCs create a baseline of their demographic and authorization errors to know where they stand. Facilities should evaluate their rejections and denials to isolate root causes and address these root causes with "training of staff, system configuration and automation," Mr. Davis said. Best practices exist for demographic entry, insurance verification, preauthorizations, patient estimates and managed care contracts.
3. Automation of front-end tasks can have a significant return on investment. "We have noticed a huge difference with our clients that automate the intake process compared to the ones that are doing it manually," Ms. Rock said. She suggested that ASC administrators and CFOs contact their practice management system vendors to ask about automation solutions. In her experience, "The cost is pretty low compared to the return you're going to get."
However, "you can't layer technology on a broken process," Mr. Davis said. National Medical suggests focusing on processes and staff routines before implementing technologies to automate front-end processes.
4. Focusing on the patient experience and patient collections at time of service can have a major difference. "The revenue cycle has a direct impact on patients' overall experience," Ms. Kaczor said. It is also important to recognize that "patients are a major payer today." Because of the importance of the patient as a payer, it is critical for ASCs to focus on payment at the time of service. Best practices include having and communicating financial policies, payment plans and financing options. Also, providing upfront cost estimates will increase patients' bill payment.
"We strongly encourage ASCs to evaluate their front-end operations and look for opportunities to automate patient eligibility and financial responsibility," Ms. Kaczor summarized. "Any improvement you make on the front end is going to go straight to the bottom line," Ms. Rock said.
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