The brain of your ASC is housed in the software system you purchase, which is why it is one of the most important investments you will make.
The right software can provide critical insight into financial and clinical operations that allow you to identify opportunities for improvement and catch problems before they take a significant toll on your center.
There are many brands of ASC software available. To make an appropriate, educated choice, it is important to understand your ASC’s short- and long-term needs and budget. Then you can perform proper due diligence into these various software options.
Here are seven tips to help you with this process and better ensure you choose the right technology for your ASC.
1. Form a team. Establish a team to assess the solutions. The team should include at least one representative from your provider staff and governing board; the administrator; the business office manager; clinical staff representatives from purchasing, the operating room, preop and recovery room; and, if your ASC is a joint venture with a hospital, a member of the hospital management team.
Team members should provide a list of what they feel is required from the software for their area of focus. These “needs” should be converted to a checklist that ranks them in order of importance. The checklist can then be used to more effectively evaluate different software platforms.
2. Don't overlook revenue cycle management (RCM). One area that is often overlooked when evaluating ASC software packages is RCM. The administrator and/or business office manager should focus on ensuring technology solutions under consideration will work to effectively serve and support the revenue cycle team for the long term while decreasing workload in various areas, including comprehensive revenue cycle functions.
Features that assist in increasing workload efficiency include ease of setup and separate modules for each area of the revenue cycle (scheduling, insurance verification, coding, charge entry, payment entry and collection activity) with streamlined flow and shared demographic information between these modules. Another feature that is paramount in the RCM portion of the software is that all members of the RCM team have easy access to managed care contract information, fee schedule amounts and other types of data essential to performing their job responsibilities.
Sophisticated electronic capabilities to look for in the software platform include ability to interface with other software programs (e.g., clearinghouse, inventory, insurance verification). The system should also deliver electronic and paper claims; scan and display documents; have the ability to attach documents to patient accounts; and provide a tickler system for collectors, posters, insurance verifiers and coders.
3. Ensure strong reporting capabilities. Comprehensive reporting capabilities is a necessary part of any software system. Accounts receivable reports should be available by payer, patient and amount, and with multiple filters. The system should also be able to measure and report accountability (e.g., productivity, missed cases, coding, billing, payment posting, collections). Ensure all reports can balance to each other and be easily manipulated and exported. Another important feature should be ease-of-month-end reporting, including locking transactions. This ensures month-end totals are not affected by future entries and allows accounting by billing period and date of surgery.
4. Prioritize goals. With systems offering a wide variety of functions and features, and with varying strengths and weaknesses, it is imperative to determine what you feel your ASC needs in a system, wants in a system and what might be nice to have in a system but is not essential. Use the team’s checklist, organized by priority. One ASC may prioritize finding a system that simplifies billing and collections. Another surgery center may choose inventory organization. Still others may feel that easily accessible analytics and metrics are the most important features. Whichever functions your ASC feels are most important to your short- and long-term success should direct and help narrow your search for the appropriate software system.
5. Perform due diligence. Assign a timeline for software selection to keep your team focused on completing its research. Use your checklist to compare systems to their advertised functions to eliminate programs that do not offer functions your ASC requires. Focus on ASC-specific software rather than evaluating physician- or hospital-oriented systems. ASCs have specific requirements in business and clinical areas not necessarily provided in other platforms. Research market penetration and longevity of vendor. It will be in your ASC’s best interests to purchase a well-established software package to avoid the headaches that often come with a software system not yet fully completed and market tested (and subsequently improved).
As part of the due diligence process, take the time to meet with vendors and ask representatives specific questions concerning the priority items on your checklist. Ask for an in-house demonstration. Gather your team and have them evaluate whether their priority needs would be met. This is also a good opportunity to have any questions answered. Request current ASC references from vendors. Contact references and ask questions. Interview ASCs similar to yours by phone or, better yet, visit one or more ASCs, if possible. Create an evaluation form, rating the performance of each area (such as using a "1 to 5" scale). Include ease of use, customer service, average time to resolve problems, billing, supply management and what tasks are automated. Ask references to comment on what they like most and least about the software.
Don't take anything for granted. A software program may include great medical records and/or supply management technology, but could have overlooked or neglected other key functionality, such as efficient RCM (which can severely affect an ASC’s cash flow). Also, do not rely on the software salesperson to understand what you need or the finite details of how the system works for billing or other areas. Get your sales promises in writing, especially if the software is new to the market and unproven in daily ASC use. Pay special attention to termination clauses, should you find that the software is not a good fit for your ASC (more on this below).
Joint-venture ASCs with a hospital partner should also consider the hospital’s reporting needs and ensure any system under consideration can provide such reporting.
6. Understand cost. When a decision on a software system has been made, examine the contract closely. Make sure your contract addresses what the base price includes and does not include. Understand the company’s pricing structure and how it will affect your ASC. Are there additional fees associated with number of cases, operating rooms or users, for example? Software vendors should not consider functions that are essential as add-ons. For example, if the package does not include basic month-end reports, this will necessitate purchasing an extra module, which increases your overall price. Such functionality should likely be standard. Before purchasing any add-ons, your ASC should ensure the extra features are pertinent to its needs and operation.
Also, understand your options if you find the software is not a good fit for your ASC or not meeting your expectations. How difficult would it be to unwind the project if that proves necessary? Does your ASC own the data, or does the vendor own it? Do you have a termination clause if you find the product is negatively affecting your revenue cycle and cash flow because of unresolved system problems?
7. Consider additional technology. In addition to the software system you choose for your center, you may also want to consider purchasing other software packages which address other business office tasks (e.g., online patient registration/payment portal, eligibility verification, mobile transcription, data analytics, patient cost estimator, insurance verification, check-in kiosk, and scheduling).
As you can see, there are many things to consider when making this all-important — and expensive — decision for your ASC. Hopefully the suggestions discussed here will assist you in selecting the best technology fit for your ASC.
Caryl Serbin, RN, BSN, LHRM, is president and founder of Serbin Medical Billing, an ASC revenue cycle management company. Serbin Medical Billing's primary objectives are to provide the best coding, billing and accounts receivable management services available to ambulatory surgery centers (hospital joint-venture, corporate-owned or independent) and anesthesia providers. Ms. Serbin has been a leader in the ASC industry for 30 years. She was the founder of the first ASC-specific billing company.