Angela Mattioda is vice president of revenue cycle management services for Surgical Notes. Here she answers three RCM-focused questions.
Question: What can all types of ASCs do to gain a better understanding of their revenue cycle performance?
Angela Mattioda: There are a couple of fundamental steps worth taking. First, perform ongoing revenue cycle key performance indicator trending to gain an accurate understanding of their performance and the trend of their performance.
Second, undergo an audit — such as a revenue cycle assessment — conducted by an experienced third party, particularly one with ASC expertise. Such an unbiased audit will take a deep dive into revenue cycle metrics and processes to discover issues negatively affecting cashflow. ASCs are best served by undergoing revenue cycle audits at least annually.
Q: What do ASCs with strong and poor performing revenue cycles tend to have in common?
AM: Strong ASCs tend to have well-defined internal business office processes — regardless of whether they are performing revenue cycle management in-house or via outsourcing. In other words, they have strong management overseeing RCM. That starts with performing insurance verification and case costing to determine whether a case is financially viable; securing the appropriate authorizations, which is the first step to ensuring you are going to get paid; and then ensuring all of the remaining ASC revenue cycle functions are completed properly and efficiently.
Meanwhile, poor-performing ASCs are generally missing this strong management. For such ASCs with in-house RCM, their management often does not have the time to oversee the RCM process effectively. For ASCs outsourcing RCM, they often put too much trust in their outsourcing company and do not obtain their KPIs in a trending format to allow for effective monitoring and evaluation of the outsourcing work being performed.
Q: How difficult is it to change outsourcing vendor partners?
AM: It may seem daunting to transition from one outsourcing company to another. However, there are ways to make the switch a smoother process.
When you are changing vendors, performing your due diligence is critical. Ensure that the new vendor knows what they must do to help make the process as seamless as possible. That includes providing an onboarding plan to check off all of the necessary steps prior to the new vendor go-live date and timeline requirements for the ASC and outsourcing company.
Another step that can help make changing vendors easier is to seek out a true business partner, not just an outsourcing vendor. The right RCM company will approach its relationship with your ASC as a partnership, with the vendor considering itself as an extension of the business office. Such a mentality that emphasizes collaboration can help eliminate roadblocks that have the potential to make changing outsourcing companies much more difficult than it needs to be.
This article was sponsored by Surgical Notes.