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Improving Revenue Cycle Management at Ambulatory Surgery Center

May 20, 2020

RCM at ASCAccording to, Ambulatory Surgical Centers (ASCs) are in a position to be extremely successful in the coming years. Trends like the ability to expand offered procedures, increasing reimbursement for ASCs, growing consumer demand, and migrating care delivery are all weighing in favor of ASCs. However, despite being poised for even great success, it’s always critical to make sure you have your eye on your revenue cycle management to keep your ASC in the green. 

One of the best things you can do is make sure you’re monitoring key performance indicators (KPIs), such as days to bill, days to pay, and claims denials. Beyond simply monitoring them, it’s essential to know some of the common problems that may be hurting you in these areas and the solutions that can help you improve your bottom line. Here’s a closer look at some essential tips you can use to improve revenue cycle management at your ASC in 2020. 

Tip #1 – Reduce Your Days to Bill Lag 

When you’re working to improve revenue cycle management, one of the big problems you may encounter is the length of time it takes you to actually bill services provided. Every day it takes to get bills out is costing your practice money and disrupting your revenue cycle. 

The Challenges

A few of the challenges that may be increasing the time it takes to bill include: 

  • Length of time that it takes providers to dictate patient notes. If your providers aren’t providing same-day dictation, it costs you time. 
  • Providers fail to respond to required amendments on operative notes or coding queries when requested.
  • Issues with the billing team, such as workflow insufficiencies, lack of knowledge, or lack of resources.
  • Documentation that’s missing, such as medical history, pathology reports, etc. 

Fixing the Problem 

All of these challenges can be fixed to reduce your days to bill lag and bring in revenue faster.

Solutions include:

  • Requiring all providers to offer same-day dictation after surgical procedures and have a policy in place that penalizes those who don’t provide timely dictation. 
  • Have efficient ways that office staff can request amendments on operative notes or coding questions to providers to ensure a timely response. 
  • Deal with any deficiencies with the billing team or consider outsourcing your billing to improve efficiency. 
  • Track missing documentation carefully to ensure you can provide timely responses at the requests of payers. 

Tip #2 – Address Problems That Affect Days to Pay 

ASCs also need to improve the time it takes to get payment from payers to enhance revenue cycle management. This means you’ll need to identify and address problems that are affecting your days to pay KPI. 

The Challenges

A handful of challenges stand in the way of improving days to pay include: 

  • Demographic or charge entry errors that result in denials or rejections.
  • Using paper claim submissions. 
  • Delays in billing. 
  • Failing to follow up after the submission of initial claims. 

Fixing the Problem

Some helpful tips you can use to eliminate these challenges and reduce the days to pay include: 

  • Doing a quality assurance review of the charges before you submit claims. 
  • Submitting electronic claims whenever possible. If paper claim submissions are required via mail, ensure you follow up with payers within two weeks to ensure the claim was not only received but filed. Paper claims submissions are one of the biggest culprits that increase days to pay.
  • Before you submit claims, ensure you review all insurance ID and insurance information that’s been entered to verify its accuracy.
  • All claims should be followed up on within three weeks after submission to ensure the claim was not only received but is also processing. This helps to identify any denials faster.

Tip #3 – Reduce Claims Denials

While your ambulatory surgical center is focusing on optimizing revenue cycle management, government and private payers are trying to contain their costs by using utilization strategies like increasing or changing requirements for pre-authorizations. While most ASCs never see a 100% clean claim rate, it’s not impossible to see rates in the high 90s if you work hard at it. Reducing claims denials offers an excellent way to improve revenue cycle management. A few tips ASCs can use to minimize claims denials include:

  • Stay Vigilant – It’s easy to accept denials as a part of doing business, but you must go into it with the mindset that your ASC deserves to be paid for all services that were provided. 
  • Have Processes in Place – Be sure your ASC has processes in place that identify and follow up on denials quickly. Don’t let them slip through the cracks. 
  • Ensure Staff Members are Educated – Team members need to be educated on how to deal with denials and handle appeals so everyone’s on the same page, and you can work as a team to turn denials into payments. 
  • Keep Track of Performance – Check on staff members to ensure they’re following appropriate procedures to prevent claims denials in the first place and track performance in how claims denials are handled. 
  • Consider Outsourcing – Preventing and addressing claims denials in-house can become overwhelming for ASCs, especially when denials claim more time from staff, which can hurt the overall bottom line. Many ASCs find that outsourcing billing and coding reduces denials and improves the outcomes of appeals when denials do occur.

When it comes to providing medical billing and coding services for ASCs, M-Scribe is a leading provider and services centers across the country. We offer cloud-based software and state-of-the-art technologies that make it possible for us to work with practically all current platforms. At M-Scribe, we’re proud to provide comprehensive claims management services and additional add-on services to help your ASC with revenue cycle management and more. We’re committed to helping your ASC stay in full compliance while reducing denials and increasing revenue. Contact today to learn more about how we can help your ASC remain on top of revenue cycle management and improve your bottom line.


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