Becker's ASC Review

49 Executive Briefing COVID-19's impact on the ASC revenue cycle: Q&A with Surgical Notes' Angela Mattioda Angela Mattioda is vice president of revenue cycle management services for Surgical Notes. Q: What are you seeing as the national trends in ASC revenue cycle management during the COVID-19 pandemic? Angela Mattioda: The good news is that while we're still seeing some decreased volume, ASCs are mostly back on track with their cases. But collecting is often proving difficult. One common pain point we're seeing across the nation is patient billing. So many Americans are struggling to continue paying their bills. On the payer side, the significant challenges we've been facing since the early days of the pandemic have generally not improved much. Collecting payments for workers' compensation cases is a struggle. The combination of adjustors moving to remote work and layoffs of these professionals has impacted the ability for adjustors to process the growing backlog of claims. We're also seeing many payers delaying implant payments. Like adjustors, the third-party pricers responsible for implants are significantly backlogged. While there's nothing we can do to move that forward any faster, it's important to document what we are told concerning timing and establish a follow-up workflow. Finally, internal business office staffing remains an issue. For those centers that furloughed their staff, some brought all of their staff back while others decided to clean house. Many ASCs are now trying to work understaffed. Q: For ASCs struggling with their revenue cycle performance, how are problems manifesting in their key performance indicators? AM: Accounts receivable KPIs are struggling the most. The "AR over 90 days" metric went sideways across the board after March. A lot of that is attributable to ASCs closing down, so they had no current charges to offset AR that is aging. That KPI affected many of the others. As of July, all KPIs are trending back toward their norm. It will essentially take double the time that ASCs were closed and/or had reduced operations to get back to where we were pre-pandemic. Another KPI that took a big hit and is taking longer to recover is overall cash flow rate. Payers seem to be milking the crisis as a new opportunity to delay payments. Q: How has the pandemic affected ASCs seeking revenue cycle management services? AM: We have a lot of activity in our pipeline. That's largely because ASCs managing their revenue cycle in-house or partnered with another revenue cycle management company had downtime during the slowdown to examine their revenue cycle performance. This helped them realize that their revenue cycle is not as healthy as they believed, which is motivating centers to reach out to Surgical Notes to undergo a revenue cycle audit and ask about outsourcing. Another motivating factor for the increase in outsourcing queries is the loss of staffing. ASCs are finding that outsourcing is an effective way to achieve the staffing levels they need to power their revenue cycle while avoiding the rollercoaster of staffing fluctuations they've experienced and worry about experiencing as the health crisis continues into 2021. Contact Angela Mattioda at angela.mattioda@surgicalnotes. com. greater than 90 days to catch significant payer issues. A KPI not regularly tracked is outstanding payments greater than 90 days because of the labor-intensive work often required for successfully collecting such payments. Yet, by choosing not to monitor the KPI, ASCs are leaving money on the table. Finally, since patient financial responsibility has increased, success with monitoring patient balances has taken on greater importance. Recommendations: Monitoring KPIs gives ASCs better control over revenue cycle performance, helps catch problems and supports faster recognition of improvement opportunities. ASCs should identify those KPIs it considers vital to understanding financial performance and track them. Partnering with a revenue cycle management company and undergoing an assessment can help. Give your revenue cycle the attention it needs A wide range of issues can disrupt an ASC's revenue cycle. When problems occur but go unnoticed, financial performance struggles. ASCs that want to keep their financial performance hitting all the right notes must ensure they are giving appropriate attention to all functions and elements of their revenue cycle, not just those that seem like the most important. Angela Mattioda is vice president of revenue cycle management services for Surgical Notes. Surgical Notes is a nationwide provider of revenue cycle solutions, including, transcription, coding, revenue cycle management (RCM), and document management applications for the ASC and surgical hospital markets. Mattioda oversees the SNBilling RCM service, the fastest-growing component of Surgical Notes' complete, best-in-class revenue cycle solution offering. Contact Mattioda at angela.mattioda@surgicalnotes.com. n

• Cover