Becker's ASC Review

23 Executive Briefing: Improving ASC A/R Sponsored by: I t's funny to me—in so many aspects of life, people love to talk about "the little things" and how "it's the little things that really matter," but it seems these are the first things people will dismiss, forget about or flat out toss through a window. The thing is, what people say is true. It is the little things that matter, especially when you're looking for success in a hos- pital or surgery center's accounts receiv- able (A/R) department. Within the realm of healthcare A/R, man- aging the little things is about keeping yourself, your team and your facility one (or several) steps ahead of bad debt di- saster. Usually that means minding the foundation on which your team is built— think about training, coaching and continu- ing education—and ensuring that every- one is following the same protocols and procedures. Here are some key focal points to keep in mind as you consider your facility's over- all financial health and how to best impact your bottom line. First we'll focus on what I call the basics, and then we'll shift to look at best practices related to the 120+ day bucket; looking at overdue accounts is an area that generally says a lot about what you're doing right, and what you need to be doing differently. Set Yourself Up to Be Paid: Verify, Optimize and Always Follow Up A short, simple article regarding A/R man- agement recently appeared on the Tricom Funding website; its opening line caught my attention. "Paid receivables are the lifeblood of your business." This is abso- lutely true of your facility. Healthcare is a business, and you can't afford to offer ser- vice for free. With that in mind, know that consistent A/R success begins with a solid founda- tion and, in my opinion, a solid foundation starts by following these five key princi- ples. 1. Verify insurance every single time. If you're consulting with a patient in office or scheduling a future procedure, take ad- vantage of the opportunity to collect and verify the patient's insurance. Failing to verify insurance can be costly in a number of ways, but what's most notable is that it can lead to payment delays, loss of funds or claim denials. What makes insurance verification so im- portant is that it tells you up front what a pa- tient's financial obligations and capabilities might be, not to mention it tells you wheth- er the patient has bothered to keep up with insurance at all. The insurance verification process will tell you things like whether the insured has switched jobs, failed to make COBRA payments, moved out of state or dropped insurance altogether. Remember your goal throughout the bill- ing and claims process is to stay one step ahead so, in the end, you've set yourself up for easy claims and timely payment. Collecting and verifying information up front, before any services are rendered, is always step one. 2. Ask for payment on or before the date of service. This is a subject that in2itive Business Solutions has highlighted over and over again in recent months, thanks largely to the high deductible health plans that are gaining impressive popularity. Early last year, there were almost 17 million health- care consumers enrolled in high deduct- ible health plans, compared to only a million in 2005. The number of enrollees is expected to rise yet again in 2014, as more employers offer this option, some- times exclusively. But why does that matter to hospitals or ASCs? And why does it increase the ur- gency to secure patient payment up front? With lower deductible health plans—those that have been the cornerstone of employer sponsored health insurance for decades— facilities could count on the insurance com- pany to cover as much as 90% of all service costs, which made the patient's portion less of a concern. By contrast, with high deduct- ible plans, it's the patient who is responsible for approximately 40% of the bill. Furthermore, in the case of ASCs, you're offering elective procedures. If a patient is scheduled for a knee arthroscopy because they're in pain, they're more inclined to pay before service is rendered. If you don't push for payment until after the pro- cedure—when the patient is no longer in pain—the likelihood of being paid on time is slim. The Little Things That Boost Big Payoff in Paid Receivables By Tracey Erbert, President of in2itive Business Solutions

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