Becker's ASC Review

59 Coding & Billing A mbulatory surgery center revenue cycle is like the inner workings of any machine, intangible and unnoticed until something goes wrong. ASC leaders may have a firm grasp of the basics, but there is always more to be done. Here are three pillars that support the step to next level revenue cycle management. Foundational metrics The place to start, as with any process, is at the core. Master the fundamen- tal revenue cycle metrics before moving on to more advanced processes. "If something in the revenue cycle is not working, always return to the basics," says Barbara Pulliam, BS, CASC, vice president of revenue cycle with Surgical Management Professionals. Essential metrics to track include: • Days in accounts receivable • Days in A/R over 90 • Total collections • Number of denials • Average reimbursement per case • Clean vs. denied claims Underutilized strategies and tools The ASC industry is brimming with expertly crafted strategy and innova- tive tools, many of which are underused. Here are three ideas to create a more robust revenue cycle man- agement approach. Days in A/R by payer type. Days in A/R has a general number is useful, but breaking apart that number allows ASC leaders to understand any problem areas and to create a line of attack to bring the days back to the target benchmark. Track A/R days by in-network and out- of-network payers. "Due to contractual agreement with in-network payers, days in A/R should be relatively stable on a monthly basis. Any volatility should be a giant red flag to management," says Rich Searles, a partner with Merritt Healthcare. "Conversely, OON network payer days are usually greater and more volatile. Management should be aware of the volatility and view monthly variance as expected, but not ignored." ASC leaders can push this strategy a step further and track A/R days by each specific payer. "The key is to thoroughly understand each individual payer contract," says LeAndra Stencel, regional operations manager — ASC with abeo. "From reimbursement allowances on implants to multi-procedure discounts ASC leaders need to understand contracts to maximize a center's reimbursement potential." Next-Level Revenue Cycle Management: 3 Approaches By Carrie Pallardy Joan Dentler Barbara Pulliam

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