Caryl Serbin, RN, BSN, LHRM, executive vice president and chief strategy officer for SourceMedical, recently spoke on outsourced and in-house billing for ambulatory surgery centers Becker's 18th Annual ASC Conference in Chicago.
"My goal for this talk is, that if you shouldn't outsource your billing, you will walk out of this room knowing it. You will walk out knowing everything you need to know to make this decision," said Ms. Serbin.
The most logical time to consider outsourcing is upfront, during the development of a new center. An existing center that is having a hard time retaining qualified billing staff may also consider outsourcing. The largest red flag that prompts most ASCs to consider outsourcing, according to Ms. Serbin, is special projects just to keep up with daily billing, even after adding more FTEs.
Another scenario in which outsourcing may seem appealing is when a surgery center is rapidly growing. "Growth can be that doubled-edged sword," says Ms. Serbin. Some of the largest messes she's encountered include large practices doing their billing in-house with three people for 550 cases a month in an ASC.
Other drivers of outsourcing include the departure of a valued staff member, cost of staff and benefits, spikes in volume, poor results in revenue cycle management and simply feeling fed up with unorganized billing. "It's not cheaper to outsource billing," says Ms. Serbin. "You outsource because you want more control and expertise."
Other benefits of outsourcing include strengthened compliance, more ability to appeal denials and fight large managed care companies, assistance with managed care contracting, less distractions from patients, assistance with state reporting and more internal and external audits of all processes. Ms. Serbin said it is still important to remember, however, that billing companies are the "back end" of operations while ASCs are still the front end. "You can't simply outsource and forget about billing," said Ms. Serbin.
Outsourced billing may alleviate some problems but it won't change everything. Outsourcing does not alleviate compliance concerns. It doesn't mean ASCs can let their entire front office staff go. ASCs will still need to be informed about accounts receivable, involved in major payor issues and able to assist in solving managed care problems.
When selecting a billing company, Ms. Serbin recommends ASCs review their reputation, length of service, experience with certain centers/specialties and experience in the ASC's state. "A good billing company should be seen as a partner," says Ms. Serbin. "If you don't have the mindset that you're going to work with this billing company, if you can't handle doing that, then don't outsource. It will be a nightmare," says Ms. Serbin.
One of the most important things to remember for successful outsourcing is that it's a relationship-based service, according to Ms. Serbin. ASCs can also talk to other clients and check references in their search for a billing company. ASCs don't want to be the first ASC customer to a billing company that has only handled billing for physician practices and hospitals. "If you can find a billing company with a little bit of ASC management expertise, than that's a better partner for you," says Ms. Serbin.
Ms. Serbin went on to explain "nightmares" with outsourcing. This includes billing companies with lack of experience and lack of infrastructure or staff. Ms. Serbin recommends ASCs look for billing companies that will dedicate an entire team to that ASC, and the team should work from an office -- not from home.
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"My goal for this talk is, that if you shouldn't outsource your billing, you will walk out of this room knowing it. You will walk out knowing everything you need to know to make this decision," said Ms. Serbin.
The most logical time to consider outsourcing is upfront, during the development of a new center. An existing center that is having a hard time retaining qualified billing staff may also consider outsourcing. The largest red flag that prompts most ASCs to consider outsourcing, according to Ms. Serbin, is special projects just to keep up with daily billing, even after adding more FTEs.
Another scenario in which outsourcing may seem appealing is when a surgery center is rapidly growing. "Growth can be that doubled-edged sword," says Ms. Serbin. Some of the largest messes she's encountered include large practices doing their billing in-house with three people for 550 cases a month in an ASC.
Other drivers of outsourcing include the departure of a valued staff member, cost of staff and benefits, spikes in volume, poor results in revenue cycle management and simply feeling fed up with unorganized billing. "It's not cheaper to outsource billing," says Ms. Serbin. "You outsource because you want more control and expertise."
Other benefits of outsourcing include strengthened compliance, more ability to appeal denials and fight large managed care companies, assistance with managed care contracting, less distractions from patients, assistance with state reporting and more internal and external audits of all processes. Ms. Serbin said it is still important to remember, however, that billing companies are the "back end" of operations while ASCs are still the front end. "You can't simply outsource and forget about billing," said Ms. Serbin.
Outsourced billing may alleviate some problems but it won't change everything. Outsourcing does not alleviate compliance concerns. It doesn't mean ASCs can let their entire front office staff go. ASCs will still need to be informed about accounts receivable, involved in major payor issues and able to assist in solving managed care problems.
When selecting a billing company, Ms. Serbin recommends ASCs review their reputation, length of service, experience with certain centers/specialties and experience in the ASC's state. "A good billing company should be seen as a partner," says Ms. Serbin. "If you don't have the mindset that you're going to work with this billing company, if you can't handle doing that, then don't outsource. It will be a nightmare," says Ms. Serbin.
One of the most important things to remember for successful outsourcing is that it's a relationship-based service, according to Ms. Serbin. ASCs can also talk to other clients and check references in their search for a billing company. ASCs don't want to be the first ASC customer to a billing company that has only handled billing for physician practices and hospitals. "If you can find a billing company with a little bit of ASC management expertise, than that's a better partner for you," says Ms. Serbin.
Ms. Serbin went on to explain "nightmares" with outsourcing. This includes billing companies with lack of experience and lack of infrastructure or staff. Ms. Serbin recommends ASCs look for billing companies that will dedicate an entire team to that ASC, and the team should work from an office -- not from home.
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