Becker's ASC Review

23 EXECUTIVE BRIEFING 3 EXECUTIVE BRIEFING How outsourcing revenue cycle management helps Through outsourcing their revenue cycle management, ASCs can further benefit from the value associated with ongoing benchmarking, monitoring and auditing. • An ASC billing company can help its clients establish effec- tive processes. The company can provide guidance thanks to its experience performing these processes for clients and its own internal operations, and from what it has seen work well with ASC clients. • An RCM partner will use technology such as business intel- ligence analytics to dive into an ASC's revenue cycle perfor- mance, focusing on RCM KPIs crucial to growth. These in- clude days to bill, days to pay, days in accounts receivable, AR greater than 90 days and denial rate. A billing company will benchmark these figures against an individual ASC's performance and externally against similar clients. • Since RCM companies perform ongoing monitoring of cli- ents' revenue cycle performance, ASCs can feel confident that any unexpected changes in their performance will be identified and acted upon quickly. • Ongoing auditing of clients' revenue cycle performance is an essential reason why RCM companies provide optimized services. Proper audits will look at an ASC's billing process from start to finish, covering all aspects of the revenue cycle. • An ASC billing company can help its clients determine contract renegotiation goals, including where payment in- creases would contribute most to growth and what reim- bursement figures should be targeted for coverage of new procedures. The company can provide clients with the bill- ing data to help determine these goals. • The company will also help identify and produce the data — KPIs and financial information — that can strengthen an ASC's renegotiating position and hold a payer accountable to the terms of a modified managed care contract. • An RCM partner also has data on reimbursement rates of other ASCs in a similar geographical location, which can help with contract negotiations and renegotiations. • The billing company helps hold payers accountable to new contracts by performing ongoing monitoring of contracts and outreach with payers when actions, such as slow pay- ment and improper denials, violate the contract and spirit of a good ASC-payer partnership. The ASC billing company will also take the lead on handling issues of payments com- ing in below contracted rates (i.e., underpayments) when such issues are identified through monitoring and auditing. • Through ongoing work and collaboration between an ASC and its billing partner, a surgery center can improve its long-term payer relationships. Payers will know the center is being supported by a team of ASC coding, billing and managed care experts who are working to make the billing process as consistent and accurate as possible — a benefit for the center and payer. When it's once again time for con- tract renegotiations, the payer knows the ASC will come to the table with the data and information needed to hash out a new contract that's fair for both parties. • A billing company will perform benchmarking on its own performance to assess the success of improvement mea- sures, establish goals for team members and identify un- derperforming areas and staff. • A billing company also conducts regular audits of the per- formance of its team members. Audit results are shared with team members and tracked to determine improvements or ongoing deficiencies. • Such audits will pinpoint areas for potential improvement. Examples include ways to strengthen collaboration with ASC clients and between company team members, further streamline processes and deliver training and education. • An audit may also identify metrics and KPIs to be scruti- nized, technology to be leveraged more effectively and the need to add team members to an account. Outsourcing RCM as a benchmarking, monitoring and auditing differencemaker Benchmarking, monitoring and auditing are critical processes for ASCs striving for growth. While seemingly simple in concept, achieving effective, ongoing execution of these processes is not. They require time and diligence, as well as the knowledge and expertise to identify what information outputs are worth act- ing upon. By outsourcing RCM, surgery centers gain a partner that can help maximize the value of these processes and allow an ASC to achieve the financial performance needed to be suc- cessful for the short and long term. 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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