Becker's ASC Review

45 Executive Briefing: Making the most of revenue cycle assessments: Q&A with Surgical Notes' Angela Mattioda Angela Mattioda is vice president of revenue cycle management services for Surgical Notes. Question: How frequently should ASCs undergo a revenue cycle assessment? Angela Mattioda: You typically want to undergo an annual assessment. If you feel that your cash flow is solid and your metrics meet the benchmarks you've established, you could move to an assessment every two years. However, something to consider before making this decision: Your metrics might look strong, but there can still be numerous underlying and less visible issues impacting cash optimization. If you observe any potential problems, stick with annual assessments. Q: What are some questions ASCs should want answered by an assessment? AM: First and foremost, is every procedure performed being captured and billed? Are you being paid correctly per each contract? Is your accounts receivable follow-up timely and aggressive, and is escalation taken when needed? Are issues concerning contracted payments being escalated internally to management and the contract representative so they can be addressed? This is particularly important if there are more than a few underpayments and a pattern seems to be developing. If you're an out-of-network center or have a hybrid model (mix of in-network and OON), are strong appeals consistently submitted? What is the success rate of those appeals? What is the collection rate on OON cases, and are you getting paid fairly for those cases? If OON payments are low, what is the cause(s)? Is it the types of policies in your geographic location, such as a high volume of Medicare rate policies? That type of information would be important to determining whether you should pursue going in-network with an OON payer(s). Finally, how are you doing with meeting benchmarks? How do your ASC's metrics compare with industry standard metrics and/or metrics of other like centers? Q: How do ASCs maximize the benefits of a revenue cycle assessment? AM: Surgical Notes always ends our assessment presentations by sharing tips on actions the ASC can take to make improvements to its revenue cycle management. You should review that advice closely and ask questions. Then, if you perform in-house RCM, make sure you have the proper management to act on those recommendations and improve your revenue cycle. If you're outsourcing RCM, share the information with your vendor, provide benchmarks you want to meet, and discuss a reasonable timeframe to meet those goals. Contact Mattioda at angela.mattioda@surgicalnotes.com. 7. Discussion of findings. In addition to sending the report, the assessment provider should schedule a time to review it with you. This is to help ensure you understand the findings and recommendations, give you an opportunity to talk through and ask questions about what was discovered, and give the provider a chance to share additional thoughts and feedback. 8. Ability to add a coding audit. Coding is critical for your ASC's revenue cycle performance as it helps ensure correct, timely payments for your services. While a revenue cycle assessment can point to potential coding problems hurting cash flow, a coding audit will pinpoint those issues. When you schedule your revenue cycle assessment, you should have the ability to add a coding audit performed in conjunction. By combining the assessment with a coding audit, you will receive an even clearer picture of your performance and areas in need of improvement. 9. Examination of internal and external processes. If your ASC contracts with an outside billing service or has its billing performed by a management company, undergoing a revenue cycle assessment is still worthwhile as such services are not void of problems. An assessment provider should be willing and able to review both internal and external revenue cycle processes. Even if the assessment reveals that the service you are using is performing well, it's beneficial to confirm this rather than assume it to be true. 10. ASC expertise. To truly "turn over every stone," your revenue cycle assessment provider should have expertise in ASC revenue cycle management. An ASC's revenue cycle is different from that of other facility types. Someone with knowledge in hospital or practice revenue cycle management, for example, but lacking ASC knowledge is likely to overlook or misinterpret important KPIs and metrics that may point to one or more problems. 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 Surgical Notes is dedicated to providing best-in-class revenue cycle solutions for the ambulatory surgery center industry. By integrating Surgical Notes' suite of products and services, ASCs have access to an enterprise revenue cycle solution designed to maximize profitability, physician distributions, and business office efficiency.

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