Ambulatory Surgery Centers (ASCs) provide patients with same-day surgical procedures, offering convenience and cost savings. However, ASCs face unique billing challenges that can impact their revenue growth. Inadequate billing procedures, along with insufficient transparency and prolonged delays in claims processing, can lead to both revenue losses and elevated costs. To maximize revenue growth, ASCs need to streamline their billing operations and ensure timely and accurate claims submission.
The Center for Medicare and Medicaid Services (CMS) has recently announced plans to update its ASC payment system. There is a favorable impact on long-term income from these updates. To capitalize on these changes, ASCs must understand where to devote time and resources.
In this blog, we will explore how ASCs can optimize their billing practices to drive revenue growth and improve patient satisfaction.
- Simplify Patient Financial Clearance.
The initial step involves optimizing patient financial clearance. As patient responsibility increases, it is imperative for Ambulatory Surgery Centers (ASCs) to extend their services beyond verifying eligibility and incorporate a smooth workflow for comprehensive financial triage. This process encompasses authenticating identity, assessing eligibility and benefits, obtaining prior authorization or evaluating medical necessity, precisely estimating and conveying patient responsibility, and ideally receiving payment before the patient’s departure from the facility.
Establishing a culture of patient financial education and payment estimation holds paramount importance for achieving financial clearance success. Efficient financial clearance strategies at patient access result in increased transparency, thereby simplifying the patient billing cycle. Consistent processes implemented across all patient access areas can mitigate patient confusion, leading to a better care experience and improving front-end revenue cycle profitability through reduced denials, enhanced cash flow, and diminished costs.
- Mitigate Claim Denials
The mitigation of claim denials can significantly contribute to the enhancement of revenue growth in ASCs by promoting a streamlined cash flow, curtailing administrative expenses, and pinpointing deficiencies in billing procedures. When claims are denied, ASCs risk lost or delayed payments, and staff must spend valuable time investigating the reason for the denial and resubmitting the claims. This takes time away from revenue-generating activities and can result in lost revenue. By streamlining billing processes and minimizing claim denials, ASCs can improve cash flow and ensure that they are being paid in a timely and efficient manner.
In addition, medical billing professionals and companies can also help ASCs reduce claim denials by providing specialized expertise and resources to streamline billing processes, identify and resolve coding errors, and optimize revenue cycle management. They can assist in identifying opportunities for revenue growth and improving overall financial performance.
- Adoption of modern technology
Adopting modern technology can help streamline billing processes at Ambulatory Surgery Centers (ASCs) in several ways. Firstly, it can automate and simplify the billing process, reducing the likelihood of errors and minimizing the time it takes to create and submit claims. This can lead to faster reimbursement times and a reduction in denied claims. Additionally, modern technology can provide real-time visibility into billing and payment status, allowing ASCs to identify and address issues more quickly. It can also facilitate communication between ASCs and payers, ensuring that billing information is accurate and up-to-date. For example, Electronic Health Record (EHR) and Practice Management (PM) systems can be used to automate billing tasks and manage patient information, while Revenue Cycle Management (RCM) software can help ASCs monitor and track their revenue cycle. Overall, adopting modern technology can improve the efficiency and accuracy of billing processes, which can help drive revenue growth for ASCs.
- Usage of proper healthcare codes.
Using proper healthcare codes (mainly ICD-10 and CPT) can contribute towards the billing process in several ways. First, accurate coding ensures that the correct procedures and services provided are reflected on the bill, which can help prevent billing errors and denials. Second, correct coding can help maximize revenue by ensuring that all billable services are captured and appropriately billed. Third, proper coding helps ensure compliance with healthcare regulations and standards, which can help avoid penalties and legal issues. Finally, consistent and accurate coding can help improve data analytics and reporting, which can lead to better decision-making and revenue growth strategies.
- Monitor KPIs and Enhance the Patient Experience.
Improving the patient experience and tracking Key Performance Indicators (KPIs) are critical for driving revenue growth at Ambulatory Surgery Centers (ASCs). By avoiding any confusion that improper billing practices may cause, ASCs can ensure that patients have a positive experience and are more likely to return or recommend the facility to others. This can lead to increased patient volume and revenue growth.
Streamlining the collections process for staff can improve the billing process for patients. By implementing clear payment policies, providing patients with convenient payment options, and regularly monitoring accounts receivable, ASCs can minimize billing errors and payment delays, leading to greater patient satisfaction.
Tracking KPIs through enhanced data capturing and analysis can also help ASCs identify areas for improvement in their operations. By implementing clear payment policies, providing convenient payment options, and monitoring key metrics, ASCs can identify inefficiencies and implement targeted strategies to improve their revenue growth and financial health.
In conclusion, streamlining billing at Ambulatory Surgery Centers (ASCs) is crucial for driving revenue growth and ensuring financial health. By implementing the above-mentioned policies, ASCs can identify inefficiencies in their operations and implement targeted strategies for improvement. Furthermore, the role of technology and automation in improving revenue cycle management cannot be understated.
At iTech, we do offer expEDIum Suite of products and RCM Services that can help ASCs automate and streamline their billing processes, resulting in increased efficiency, improved cash flow, and reduced errors. By leveraging technology and best practices in billing and revenue cycle management, ASCs can achieve their revenue growth objectives and improve the patient experience.