Becker's ASC Review

37 Executive Briefing Improving ASC revenue cycle performance: Q&A with Surgical Notes' Angela Mattioda Angela Mattioda is vice president of revenue cycle management services for Surgical Notes. Here she answers three RCM-focused questions. Question: What can all types of ASCs do to gain a better understanding of their revenue cycle performance? Angela Mattioda: There are a couple of fundamental steps worth taking. First, perform ongoing revenue cycle key performance indicator trending to gain an accurate understanding of their performance and the trend of their performance. Second, undergo an audit — such as a revenue cycle assessment — conducted by an experienced third party, particularly one with ASC expertise. Such an unbiased audit will take a deep dive into revenue cycle metrics and processes to discover issues negatively affecting cashflow. ASCs are best served by undergoing revenue cycle audits at least annually. Q: What do ASCs with strong and poor performing revenue cycles tend to have in common? AM: Strong ASCs tend to have well-defined internal business office processes — regardless of whether they are performing revenue cycle management in-house or via outsourcing. In other words, they have strong management overseeing RCM. That starts with performing insurance verification and case costing to determine whether a case is financially viable; securing the appropriate authorizations, which is the first step to ensuring you are going to get paid; and then ensuring all of the remaining ASC revenue cycle functions are completed properly and efficiently. Meanwhile, poor-performing ASCs are generally missing this strong management. For such ASCs with in-house RCM, their management often does not have the time to oversee the RCM process effectively. For ASCs outsourcing RCM, they often put too much trust in their outsourcing company and do not obtain their KPIs in a trending format to allow for effective monitoring and evaluation of the outsourcing work being performed. Q: How difficult is it to change outsourcing vendor partners? AM: It may seem daunting to transition from one outsourcing company to another. However, there are ways to make the switch a smoother process. When you are changing vendors, performing your due diligence is critical. Ensure that the new vendor knows what they must do to help make the process as seamless as possible. That includes providing an onboarding plan to check off all of the necessary steps prior to the new vendor go-live date and timeline requirements for the ASC and outsourcing company. Another step that can help make changing vendors easier is to seek out a true business partner, not just an outsourcing vendor. The right RCM company will approach its relationship with your ASC as a partnership, with the vendor considering itself as an extension of the business office. Such a mentality that emphasizes collaboration can help eliminate roadblocks that have the potential to make changing outsourcing companies much more difficult than it needs to be. Contact Angela Mattioda at angela.mattioda@surgicalnotes. com. 7. Multi-Specialty An ASC with multiple specialties benefits from an outsourcing partner with experts in all aspects of ASC operations. Challenges associated with performing cases across specialties include keeping current on coverage requirements and educating staff on rule changes. An outsourcing partner prioritizes staying abreast of revenue- cycle related developments across specialties and payers and ensures its staff is trained. If a multi-specialty ASC has team members trained in particular specialties, they may struggle if the ASC experiences volume swings that require billing for a "weaker" specialty. An outsourcing partner can quickly adapt to such changes. 8. Single-Specialty A single-specialty ASC will value how outsourcing reduces internal responsibilities. With less attention required for managing the business office, the ASC can focus on what makes single-specialty centers successful: streamlining patient throughput to maximize volume. If the ASC chooses to transition to a multi-specialty facility, accommodating the new specialty(s) will be easier since the responsibility for RCM functions will fall to the outsourcing company. Is outsourcing right for your ASC? While all types of ASCs can benefit from outsourcing, the questions you should set out to answer are whether your surgery center would benefit and by how much. Worthwhile initial steps to take to begin gathering information are to undergo a revenue cycle audit to gain a better understanding of your performance and speak with outsourcing companies about their services and results delivered to like ASCs. From there, you can decide whether to further pursue outsourcing. Even if you choose not to outsource right away, this due diligence process should leave you knowing more about outsourcing RCM and the role it may eventually play for your ASC. 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

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