Issue link: https://beckershealthcare.uberflip.com/i/170040
ASC Turnarounds: Ideas to Improve Performance erly coding could result in a center losing out on due revenue, over billing is the more pressing problem in centers today. Mr. Lipomi worked with a center that was unknowingly billing a bad code, which resulted in the ASC receiving about $500 more per case than they were entitled. "We caught it fairly early on," he says, "but they had to write about a $50,000 check. If they hadn't caught the problem for a year or two while incurring fees, then that could've been devastating." ASCs that over bill, or bill a bad code, could incur damaging penalties per case. 4. Employ highly qualified personnel. Since reforms and regulations are constantly rocking the healthcare system's customary practices, ASCs need to employ coding and billing personnel who are committed to staying up-to-date with industry changes. "How do you stay abreast with all of these changes?" Mr. Lipomi says. "You have to hire well-educated, highly-trained individuals that have a lot of time on their hands to track this. Going to the annual state association meeting just doesn't cut it any longer. Things change so rapidly." Smaller centers or those struggling to keep up with changes should consider hiring a consultant or management company with a reputation for being knowledgeable about reforms. As the industry becomes more regulated and complicated, it's not worth risking your business by shortcutting payroll staff, consulting or management, he says. 5. Stay on top of accounts receivable. Keeping accounts receivable days within a strict parameter could save an ASC from stunted cash flow. 15 Often, centers will be making money but have cash flow issues because claims are tied up in A/R for too many days. Adding personnel to the revenue cycle department or figuring out how to tackle claims more quickly can help A/R days drop dramatically, Mr. Lipomi says. Mike Lipomi 6. Get physicians involved in coding. Physicians need to get involved in the coding process to understand how to appropriately chart their patient encounters. Some physicians who were not trained to be fiscally conscious will balk at learning from coders, but gone are the days where missed codes do not impact an ASC's bottom line, Mr. Lipomi says. "Physicians in the office and surgery center must be charting the same codes," he says. "If a physician is doing something and not noting it in the operative report, we can't bill for it. It may be a procedure in addition to what they are coding that he or she does not chart." It's critical for physicians to understand what they get paid for and what they do not. If a physician has two equal options for patient care, then the surgeon needs to know what the best option is for reimbursement. "If you want to continue to provide service, then you are going to have to get enough reimbursement to pay for the services you are performing," he says. "When there's an option that is equal as far as care and better for reimbursement, they need to know that's an option." n YOU CANNOT AFFORD TO LOSE MORE REVENUE! Call the Expert in Revenue Optimization Billing | Coding Coding Reviews Managed Care Contracting Revenue Cycle Audits Fee Schedule Analysis Providing Custom Solutions Experts in Customized Revenue Optimization www.smpsd.com | 605.444.8207 | info@smpsd.com