Opening a new ambulatory surgery center (ASC) is a marathon, not a sprint. Despite the laundry list of to-dos and endless obligations, there is one process that new ASC administrators should place at the top of the list: billing. Without due diligence in each step of the revenue cycle, leadership teams essentially guarantee that money will be left on the table — money they can’t afford to leave behind during this period when cash flow management is crucial.
For those embarking on the adventure of opening a new ASC, we’ve gathered a list of the top billing practices to master before opening day.
Revenue Cycle Management
Revenue cycle management is crucial to cash flow management. However, error-free revenue cycle management (RCM) is hard to come by, especially in the web of ASC billing complexities. Fortunately, starting strong is much easier than building momentum a few years in. That’s why your financial planning discussions should dedicate more time than you may think to RCM optimization. Constructing the perfect billing process requires ASC-trained RCM experts who know how to power your revenue cycle with strategies that deliver transparency, communication, and results.
As you probably know, ASC coding doesn’t follow one set of rules. A procedure may be coded one way for Medicaid, and then completely different for the exact same procedure sent to Aetna. Understanding these subtle differences can be a challenge, but accurate coding is the critical first step to getting paid for your services. An appropriately certified team with deep knowledge of how each specialty and procedure interact in the melting pot of ASC services and guidelines is required. Miscoding a patient visit doesn’t just add to the administrative burden — it slows time-to-payment and can even reduce your chances of getting paid altogether. On top of it all, the Centers for Medicare and Medicaid Services (CMS) regularly updates ASC coding guidelines, meaning your team must juggle shifting rules to avoid reimbursement barriers. This is where coding audits come in — a comprehensive look into your internal processes can spotlight missed revenue opportunities and revenue-threatening compliance issues.
Like any other business, your accounts receivable (A.R.) should be seated at the head of the table during all financial conversations. Keep a close watch over your A.R. days to assess the efficacy of your billing and coding functions, and use this information to fill in the gaps as quickly as possible. Lowering your A.R. days is an all-hands-on-deck endeavor requiring alignment between coding, billing, patient engagement, and payer communication teams. Starting from scratch in a new ASC provides the opportunity to establish best practices that ensure accuracy and timeliness from the start. These include error-free coding, following up on claims within 30 days, collecting patient responsibility before surgery, staying current on ASC-specific CMS reimbursement structures, and performing A.R. analysis daily.
Implementing a successful billing process can be overwhelming — not to mention the endless list of administrative and clinical tasks requiring undivided attention in your new ASC. Instead of tackling these challenges alone, give your team a much-needed boost by partnering with ASC-trained billing and coding specialists. The in2itive experts will walk alongside your team throughout the entire process, providing helpful resources and results-driven insights to guarantee your billing, coding, and revenue cycle processes are well-positioned for success.
Need expert help setting up your billing processes? Let’s talk! in2itive can help your ASC start off on the right foot and drive lasting revenue growth.