Becker's ASC Review

36 Executive Briefing Sponsored by: W hether it's a young, single-specialty ASC trying to get its financials in order; a large, multi-specialty center with years of success under its belt; or any other type of surgery center, all types of ASCs outsource their revenue cycle. And these different ASCs often have varying reasons for why they choose outsourcing over in-house revenue cycle management. Here are eight categorizations of ASCs and ways each benefit from outsourcing RCM. 1. De Novo When a new ASC outsources, it achieves upfront savings, reduces the work required to open and better ensures critical steps are not overlooked. Choosing to outsource before designing an ASC will support more effective business office space allocation. Owners can build a smaller facility or pursue a smaller space to rent, saving money on construction, mortgage/rent, utilities and more. Additional savings include reduced expenses associated with recruiting/training staff and purchasing technology. Staffing a new surgery center is also difficult as volume is typically lower and less predictable in the early months of operation. Outsourcing reduces unnecessary spending on staff, supplies and resources. With less resources committed to establishing the business office, more attention is focused on initial clinical and operational needs. 2. Mature When an older ASC moves to outsourcing, this serves to reset and clean up revenue cycle policies and procedures. It provides a fresh look at habitual processes, often replacing them with more effective practices. Outsourcing provides a mature center with instant cost savings via reduced or eliminated overtime and part-time work or scaled back business office staff. If a key member of the revenue cycle team leaves the ASC, outsourcing serves as an effective succession plan, providing an alternative to replacing the employee. And as a mature ASC undergoes clinical staff changes, outsourcing accommodates subsequent changes to operations (e.g., new physicians and specialties). 3. Struggling If an ASC's revenue cycle performance takes a turn for the worst, outsourcing can be the solution that rights the ship. The ASC gains access to experts who can pinpoint shortcomings and opportunities. These experts can coordinate their revenue cycle performance assessment and fast-track improvements. The ASC can also achieve cost savings by scaling back business office staffing. With a reduced administrative workload, focus can shift to other matters, including physician recruitment and inventory management. As the ASC turns around its business fortunes, it can weigh avenues for growth supported by the outsourcing partner. 4. Successful A strong-performing ASC can build upon its success with the right outsourcing partner. The ASC can pursue growth opportunities knowing its partner will deliver the services to support expansion. As the ASC grows, it will not need to worry about adding RCM staff. If growth involves new specialties, outsourcing eliminates finding staff with knowledge of billing intricacies or training staff on rules. If accommodating growth necessitates clinical expansion, outsourcing can free up business office space. If growth necessitates relocation, the ASC can reduce costs associated with purchasing/renting space and outfitting a business office. The most successful ASCs benefit from outsourcing. An unbiased perspective sheds light on problems and deficient processes. 5. Large For an ASC with several operating rooms, many physicians and high volume, outsourcing streamlines a significant aspect of operations. Business office management is simplified. The responsibility to oversee a team of professionals is shifted to the outsourcing partner. With a reduced business office staff, concerns about turnover, absences and other disruptions are alleviated. Each eliminated business office staff position translates into savings. If the ASC experiences significant changes to its clinical team and service types, outsourcing accommodates such changes. 6. Small For an ASC with a smaller operation, outsourcing reduces the potential for challenges that strain performance. Outsourcing allows ASCs to pay for the services it needs when it needs them (i.e., scalability). This can eliminate reliance on part-time business office staff and paying overtime. Outsourcing can reduce excessive staffing expenses when volume shifts. Outsourcing can also eliminate the need for a dedicated business office manager. A business-savvy administrator, director of nursing and medical director may be all the in- house management necessary. What ASCs outsource their revenue cycle management and why By Angela Mattioda, Vice President of Revenue Cycle Management Services, Surgical Notes

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