Becker's ASC Review

47 12th Annual Spine, Orthopedic and Pain Management-Driven ASC Conference + The Future of Spine - call (800) 417-2035 Heather Keidel Hayes ASC M&D Company Financial Report Update: AmSurg & USPI By Carrie Pallardy USPI Reports $616.2M Net Revenue for 2013, Up 14% United Surgical Partners International announced $616.2 million in con- solidated net revenues for 2013, up 14 percent from $540.2 million at the year-end of 2012. The company's operating income increased 8 percent to $263.8 million, compared to $245.2 million in 2012. Cash flow from operating activities was $159.9 million, compared to $180.3 million in 2012. USPI and its consolidated subsidiaries invested $11.3 million in maintenance capital expenditures and $11.1 million to develop new facilities and expend or invest in existing facilities. For the fourth quarter of 2013, USPI reported consolidated net revenues of $164.9 million, up 9 percent from $154.5 million in 2012. Operating income increased 18 percent in the fourth quarter from $69.2 million in 2012 to $81.9 million. In 2013, USPI acquired two facilities, opened a de novo facility and sold its interest in one facility. The company owns or operates 215 facilities. USPI expects 2014 to be a more active year, according to the report. AmSurg Revenue Grows 17% in Q4, Acquires 6 Centers in 2013 AmSurg announced its financial results for the fourth quarter and year end at Dec. 31, 2013. AmSurg's fourth quarter revenue was $242.8 million, up 17 percent from the same period in 2012. Revenues for the fiscal year 2013 were $1.08 bil- lion, up 17 percent from $923.2 million in the fiscal year 2012. The company demonstrated a 22 percent increase in fourth quarter earn- ings per diluted share. "This increase reflected 10 percent growth in pro- cedures, mainly attributable to centers acquired in the prior year," said Christopher Holden, CEO of AmSurg, according to the report. AmSurg acquired six centers in 2013 and completed an additional acqui- sition on Jan. 2. The acquisitions are expected to produce $20 million in annualized operating income. As of Dec. 31, 2013 AmSurg owned and operated 242 centers. n mated solutions are available to aid in facilitating this process. Co-pays and other patient respon- sible portions such as deductibles also should be collected upfront. 3. leverage an electronic health record. EHR systems that feed information to a billing department or billing services partner provide valuable and necessary information. The ability to document details including what procedure was performed, any ancillary procedures performed, materials collected for pathology, etc., and share this information electronically with your facility's billing team eliminates unnecessary paper chases and speeds billing processes. Cases can be evaluated faster and procedure codes inputted along with any necessary modifiers for a procedure based on the operative notes provided within an EHR system. With transactions posted, claim files can be generated and submitted elec- tronically to the insurance company. 4. Know your contracts. Billing staff should be familiar with payer contracts which will help mini- mize denials. To avoid denials, there are a number of applications available for facilities that ensure coding is correct prior to submitting claims. An- other option, which is becoming very popular, is contracting with a billing services company. Outsourcing billing enables facilities to avoid time-consuming coding issues completely as the billing services company takes over the responsi- bility for ensuring cases are properly coded and processed. Billing services staff are also respon- sible for follow-up, monitoring reports to make sure outstanding AR is not aging beyond a rea- sonable amount of time, as well as assisting with reporting processes. Using a billing services com- pany is a very cost-effective way to run your facil- ity's billing operations. 5. Monitor claims submissions. Monitor- ing claim submissions to make sure payments are made on time is an essential component of any billing process. Key to the process is understand- ing and monitoring the typical collection turn- around time for each payer. If payment is not received within a reasonable window based on past performance of that payer, that should serve as red flag for staff something is wrong. With knowledge in hand, your facility's billing team can pursue collection activity by fol- lowing up with the payer to determine the cause of delay and work to resolve the issue(s). 6. Stay on top of unbilled patient ac- counts. Patient accounts with balances should be monitored and billed on a regular basis. Facili- ties have an option to process electronic patient statements through a clearinghouse vendor from their practice management system or they can print paper claims right from their own facility. How often this is done can vary by facility; most facilities will do it weekly or bi-weekly. Your facility should be aware of the costs associated with col- lection activities to identify a cut-off point where balances can be written off to avoid pursuit of an amount that does not justify the costs associated with the activity — saving valuable time and money. 7. Measure and manage information. Two of the most critical components of a successful billing process are the measurement and manage- ment of information. Goals should be set for col- lection activity and for consistent reporting, and staff should be held accountable for acting upon that data. Collection activity should be followed-through from start to finish, not just after the insurance has been billed. It is important to note that col- lection starts at the beginning of a case, with any co-pays or other financial obligations identified to the patient upfront. This allows for greater ef- ficiency and holds the billing team accountable, which creates a more effective and efficient billing process. n

• Cover