At the 20th Annual Ambulatory Surgery Centers Conference in Chicago on Oct. 25, Tracey Erbert, president of In2itive Business Solutions, discussed how ambulatory surgery center leaders can gain more money without the addition of new service lines.
"Focus on the basics. The basics haven't changed, but they have become vital to a surgery center's bottom line," she said.
1. Streamline the A/R process. An A/R process that lacks fine-tuning often lets money slip through the cracks. Accounts should be worked to completion once every 28 days. Surgery centers benefit from having a staff member dedicated to the A/R process. Ms. Erbert has found that surgery centers need one FTE for every 800 active accounts. A/R follow-up is a full-time job for a dedicated staff member.
Incorrectly entered patient information and failure to verify insurance in a timely matter can lead to denied claims and a backlog in the A/R process. "It doesn't make sense to add a new product line when you haven't perfected what you are already doing," said Ms. Erbert.
2. Consider collecting money prior to date of service. Many surgery centers do not collect money upfront, preferring to avoid the possibility of sending the patient a refund. Ms. Erbert demonstrated that collecting the full amount, or as much as possible, of a patients' bill prior to surgery increases money a center receives. "The cost of sending a single statement is $8 to $12," said Ms. Erbert. Collecting money upfront saves the cost of sending monthly statements and increases the likelihood that patients will pay the full amount. After receiving the service, patients tend to be more reluctant to pay.
3. Communication with staff and physicians. Communication with staff and physicians is critical. Leaders can set expectations with staff members to ensure everyone at the center is invested in the correct processes.
There may be a disconnect between physicians and the billing process. Ms. Erbert gave the example of a center where two physician investors were incorrectly authorizing a number of procedures, and as a result the center was not receiving reimbursement. The issue was cleared up at a meeting with the physicians. Clear communication is key to a profitable surgery center.
4. Consider partnering with an implant management company. Payers no longer providing reimbursement for implants is a large issue in healthcare. Implant management companies, such as Access MediQuip, can help cut expenses. Careful review of the payer requirements for implant reimbursement can also lead to additional funds. Ms. Ebert discussed a facility that was in the process of switching billing systems and were prepared to write off several cases with implants that had not been covered. Ms. Ebert found that three large payers required manufacturers' implant invoices to receive reimbursement. She was able to recoup nearly a million for the surgery center.
"Focus on the basics. The basics haven't changed, but they have become vital to a surgery center's bottom line," she said.
1. Streamline the A/R process. An A/R process that lacks fine-tuning often lets money slip through the cracks. Accounts should be worked to completion once every 28 days. Surgery centers benefit from having a staff member dedicated to the A/R process. Ms. Erbert has found that surgery centers need one FTE for every 800 active accounts. A/R follow-up is a full-time job for a dedicated staff member.
Incorrectly entered patient information and failure to verify insurance in a timely matter can lead to denied claims and a backlog in the A/R process. "It doesn't make sense to add a new product line when you haven't perfected what you are already doing," said Ms. Erbert.
2. Consider collecting money prior to date of service. Many surgery centers do not collect money upfront, preferring to avoid the possibility of sending the patient a refund. Ms. Erbert demonstrated that collecting the full amount, or as much as possible, of a patients' bill prior to surgery increases money a center receives. "The cost of sending a single statement is $8 to $12," said Ms. Erbert. Collecting money upfront saves the cost of sending monthly statements and increases the likelihood that patients will pay the full amount. After receiving the service, patients tend to be more reluctant to pay.
3. Communication with staff and physicians. Communication with staff and physicians is critical. Leaders can set expectations with staff members to ensure everyone at the center is invested in the correct processes.
There may be a disconnect between physicians and the billing process. Ms. Erbert gave the example of a center where two physician investors were incorrectly authorizing a number of procedures, and as a result the center was not receiving reimbursement. The issue was cleared up at a meeting with the physicians. Clear communication is key to a profitable surgery center.
4. Consider partnering with an implant management company. Payers no longer providing reimbursement for implants is a large issue in healthcare. Implant management companies, such as Access MediQuip, can help cut expenses. Careful review of the payer requirements for implant reimbursement can also lead to additional funds. Ms. Ebert discussed a facility that was in the process of switching billing systems and were prepared to write off several cases with implants that had not been covered. Ms. Ebert found that three large payers required manufacturers' implant invoices to receive reimbursement. She was able to recoup nearly a million for the surgery center.