Becker's ASC Review

17 EXECUTIVE BRIEFING 1 EXECUTIVE BRIEFING ASC billing vendor shortfalls: What to watch out for By Angela Mattioda, Senior Vice President of Revenue Cycle Management Services and Client Experience, Surgical Notes To increase collections, reduce internal staffing issues and improve financial performance, ASCs are increasingly outsourcing their billing. Unfortunately, many are finding that not all billing vendors are created equal. By the time an ASC discovers this truth, it may have experienced considerable damage to its bottom line and other ramifications. Fortunately, ASCs do not need to settle for suboptimal outsourced billing. They have options, and while changing vendors requires work, transitioning to the right partner will be worth the effort. Warning signs How can an ASC determine if a change in its billing vendor is warranted? Some red flags to watch for: Poor communication. Your vendor should keep you current on issues including your overall revenue cycle performance, shifts in key performance indicators, changing payer requirements and problems requiring your assistance. The vendor should be transparent about these topics and never keep information from you. Reporting problems. Report shortcomings, including delayed reports, inaccurate reports, lack of report detail and lack of interpretation — or proper interpretation — of data, can contribute to untimely filings that cause lost or reduced payments and higher-than-expected accounts receivable days that contribute to cash flow issues. Your vendor should have processes to streamline workflows and access to next-generation analytics to closely monitor key performance metrics. Disorganized management and staff turnover. If you're unsure who is serving as your account manager, or you struggle to get questions acceptably answered, these are reasons for concern, as is excessive staff turnover. Significant staffing changes point to culture or other issues motivating staff to pursue new positions, or the company may struggle to hire intelligently, all of which could significantly affect your account's performance. Declining collections and strained cash flow. When you entrust revenue cycle management to another company, billing issues should never occur without an adequate explanation, and the vendor should develop an action plan and timeline to address the cause(s). Trends should be identified and communicated by the revenue cycle management team, not called out by the ASC. Unsure how your revenue cycle is or should be performing? Undergo a third-party assessment. This will help you gain an understanding of the revenue cycle's health and whether your billing partner is meeting your needs. Transition process It's a fair amount of work to initially outsource revenue cycle management, so it's probably not surprising to learn that the same can be said for transitioning to another company. Even though switching is an undertaking, the right partner will take on the bulk of the work and make the transition smooth. When researching alternative companies, ask about their transition process. Expect to hear about an onboarding experience coupled with careful tracking of tasks and deadlines. The company should make it clear what work is needed from your ASC and what work the vendor's team will manage. The number of tasks for your center should be low. The billing company should make you feel confident that they will provide any support you need to complete tasks and maintain ongoing communication throughout the process, so everyone stays aligned. It's important for the vendor's operations team to participate in onboarding. If a company tells you it has one team completing onboarding and then you will be transitioned to an operations team, this should be cause for concern. Choosing the right ASC billing partner How can you better ensure the new company you choose won't also deliver an unsatisfactory experience? A few characteristics have emerged as differentiators between ASC billing companies. These have taken on increased importance in helping ASCs elevate their financial and operational performance. Four of the most important differentiating characteristics are: 1. True partnership. From the start of the engagement, a billing company should work to develop a strong relationship with its client by providing exceptional support and services. The right company's customer service will transform it from a vendor to a partner that integrates with and functions as a seamless extension of your business office. 2. Team expertise and structure. An ASC billing company with a skilled staff, managed in a way that maximizes productivity and effectiveness, will be in a better position to provide a service experience that meets or exceeds your expectations. 3. Best-in-class security. Considering the cyber threats facing ASCs, centers need a billing company that treats security as a priority and takes steps to strengthen protection of sensitive data. Evidence of such prioritization can include achieving SOC 2 Type II compliance, treating security and compliance as complementary, and ongoing investments in security. 4. Next-generation analytics. Next-generation analytics enable a billing company and its clients to take deeper dives into revenue cycle performance, unearthing insights that are more time- consuming or even impossible to reveal through legacy platforms. Don't wait to protect your bottom line If your revenue cycle performance isn't where it should be, and you're not closely collaborating with your current vendor on how to get it there, a change may be warranted — and fast. Unaddressed revenue cycle problems grow and multiply. It's not much different than a leak. Unless fixed, the water keeps coming in and spreading. Don't wait to act if your revenue cycle is struggling. Doing so could eventually cause your ASC to experience bigger and potentially irreversible damage.

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