Before considering a partnership with a new insurance provider, take time to evaluate your revenue cycle management first.
Evaluating and improving your revenue cycle management processes before making such an important change can help maximize profit and minimize stress.
Start by looking at five key areas within your center. Each step is a chance to dive deeper and make improvements where necessary, empowering you to provide great care at your ASC while moving seamlessly through the billing cycle.
1. Review your overall operational timing.
Creating and maintaining a successful working relationship with insurance providers cannot be overstated. It is a key factor in reaching your financial goals. Because working with insurance companies can be challenging, it’s important to get satisfactory answers to critical operational questions to determine if your center and the insurance company are a good fit. Here are a few to consider.
- How many days does the insurer allow between patient encounter and filing? Does that number match with how long your business currently takes? Are the notes filed in a timely manner? Would you want to negotiate for 15 or 30 days based on how many patients you have?
- How many days after the information is sent does the insurer have before they are required to pay you? If you're just starting out and have a tight budget, it may be a good idea to negotiate for a quicker turnaround time to ensure more cash and enhance your revenue cycle management.
Beyond payment timing, you may be interested in contracting with an insurance company because their network includes many patients in your area, or they offer meaningful benefits. Before signing on the dotted line, read the details and negotiate the best agreement for the needs of your patients and your center.
2. Assess how you elicit and process patient information.
Discovering and processing patient information is vital to maximizing patient care and managing your business.
You can try collecting this data before appointment dates. Perhaps a member of your front office staff calls patients beforehand to discuss referral, insurance, and payment processing details.
No matter how it’s done, the work you do ahead of time will be mutually beneficial. It can reduce the chance that a patient will be surprised or confused by your fees and how much, if any, they will be required to pay out of pocket during their visit. Your office will also have this information early, making it faster and easier to collect payment.
Handling billing information before services have been provided makes revenue cycle management easier internally and more transparent to the patient.
3. Evaluate your billing and coding speed.
Billing must be completed by deadlines to keep business operations functioning smoothly. Take time to ensure your team has a clear standard operating procedure for acceptable and timely submission.
For example, you may decide that physicians in your center must submit diagnosis and billing codes within 24 hours of seeing a patient. Next, the administration team may have 48 hours to update the system with ICD-10 codes, prepare for billing, and send to the payer.
This part of revenue cycle management leaves no room for negotiation. This meticulous process is the most crucial when it comes to getting paid. Executing these steps will curb late billing and incorrect charges, thereby enhancing the productivity and success of your ASC.
4. Analyze how you manage payer collections.
No matter how busy your office gets, payments must be collected. Inputting and processing payment information must be done quickly and consistently.
Can you imagine a retail store waiting until Friday to run all the credit card transactions? While you're not a shop processing sale transactions, you are billing for services provided, which should be valued and recouped in a timely manner.
Finding the time to process payments can be difficult, especially in smaller offices. You may find it beneficial to outsource this work to a professional company to improve this area of your revenue cycle management. Outsourcing payment processing also frees up your time so you can focus on patient care.
5. Take a look at your payment systems.
Successful revenue cycle management includes a system for handling outstanding bills. Tracking what stands in your way of closing a transaction is an important task.
Leverage software to determine if a particular payer is always late. Do you have problems with self-payer patients running chronically behind on their bills? Find ways to renegotiate insurance terms or patient responsibility agreements to reduce outstanding transactions. You will reduce waste within your revenue cycle management and minimize stress.
How is your ASC’s revenue cycle management?
Before entering into a new insurance company contract, review these five key areas within your ASC’s current revenue cycle.
Identify where there is room for improvement, determine how to implement lasting changes, then negotiate the best terms for your business. This exercise of self-examination may be challenging, but your ASC will be better for it.
For help with your revenue cycle management, call in2itive Business Solutions at (913) 344-7837, or sign up for a free consultation to discuss your unique situation and the right solution for your surgery center.