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Uncovering Hidden Revenue Opportunities in your ASC

Sep 09, 2021 | Posted by Sarah Fifield in Revenue Cycle Management

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In our industry, cash is king. Chances are, no ASC would complain about seeing an increase in cash flow and revenue! Let’s dive into our top opportunities to help uncover hidden cash and find more money within your ASC.

 

Knowledgeable Coders

In any circumstance, an ASC will hope to have built a team of knowledgeable coders. Yet oftentimes, you may not see how a knowledgeable coder can ultimately affect your revenue.

Having knowledgeable coders in the ASC industry that can proactively navigate with a thorough understanding of various surgical procedures to decipher a surgeon's procedure notes and identify the correct CPT & ICD-10 codes allows an ASC to properly state revenue. This in term will result in cleaner claims with a faster turnaround time for reimbursement. 

If a coder was to assign an improper code, this error may hold up the entire revenue cycle / billing process; a wrong code may lead to a claim being denied, thus impacting the ability to enter charges and receive payment for the procedure. If this error happens repeatedly, you will be stuck in a vicious cycle of outstanding revenue.

Having top-notch, knowledgeable coders within your ASC typically means stronger coding with less errors, resulting in fewer denied claims, more likelihood of timely pay, etc. To ensure your coding team is as prepared as possible, make sure you have plan in place for team to routinely do trainings and update certification to stay on the ball!

 

A/R Clean-up

One of the arguably quickest ways to find more money in your ASC is with an accounts receivable (A.R.) clean-up opportunity. This allows you to review any outstanding A.R. and follow up in an attempt to collect on balances due. This process includes re-billing unreceived claims, appealing denied claims, following up on patient balances, and writing off accounts that are no longer collectible. You’d be surprised at how much cash a clean-up can bring in!

Not up to handling the task internally? With our A.R. Clean-up solution, our team digs deeper into the current landscape of your A.R. to find solutions to your pain points, collect on outstanding payments, and get your center back to world-class billing practices.

Learn more about our A.R. Clean-up solution here.

 

Up-front Collections

One of our favorite recommendations? Collecting patient responsibility PRIOR to services rendered. Collecting up front brings a multitude of benefits, including:

  • Increased chance of collecting
    • 70% chance of collecting patient responsibility at or before POS
    • 30% chance of collecting patient responsibility after discharge
  • Decreased Costs
    • Eliminates cost of statements/postage, staff/labor to call on balances due, and collection agency fees.

Not only does this ensure revenue is coming in, but it also keeps your billing office from chasing their tails trying to get patients to pay on what could be incredibly high-cost balances.

To learn more benefits of up-front collections, take a look at our dedicated blog post here.

 

Reduce Costs

It’s a no brainer – the less you spend, the better your margins. Finding ways to reduce costs within your ASC will allow you to profit more off of each procedure impacted. To reduce procedure costs, you need to first understand the cost breakdown – not only of supplies, but also the physician cost.

One tool that can help map out these costs is PREFcards, a digital preference card solution. This software not only automatically calculates the procedure cost based on physician and their preferred supplies, but also gives you a birds eye view of costs and high-dollar items that may be worth substituting out.

 

Auditing

A great way to catch more coins is to conduct regular internal audits! Performing audits of your billing office staff will not only help to find missed revenue potential, but also paint a big picture of areas of opportunity. We recommend auditing positionally, focusing in on key performance indicators (KPIs) of each position. These may include:

  • Patient Representatives – Phone evaluation
  • Revenue Cycle Specialist – Notations, denial & discrepancies
  • Medical Billing Specialist – Timely charge entry, claims generated daily, accuracy
  • Medical Payment Specialists – Balance daily, timely posting, log denials
  • Coders – Code accuracy

Example: When auditing your coding team – pull a random selection of cases across varying months, etc. and audit the coding to ensure all was coded correctly. If so – great! If not – what was the proper code and how would your billing have changed? Map out your loss of revenue due to the incorrect codes, and gain a better understanding of why these were coded wrong. Was it due to a misinterpreted line in the op note? Was it rushed? Was it coded correctly but input wrong? Dig deep to find the pain points so you can identify and correct the issue, in turn allowing for more revenue due to less errors going out the door.

We recommend performing 30 / 60 / 90-day audits to ensure progress and growth is occurring.

 

All in all, there is no shortage of hidden opportunities to find more revenue within your ASC. Start by choosing the opportunity that feels the most doable to you, and work from there. If you need assistance deciding where to start, don’t hesitate to reach out to us at info@in2itive.org or give us a call at 1(855)208-5566 to chat!

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