The success of your Ambulatory Surgical Center (ASC) depends not only on patient satisfaction but a reliable and proper medical billing process. When your ASC is losing money due to mismanagement of the revenue cycle, your facility gets put at unnecessary risk for losing more revenue than is earned, causing extremely stressful conditions.
Medical billing errors are just one of the many concerns that plague a private Ambulatory Surgery Center. Medical codes are changing all the time and without notice. Regulatory changes are continually being updated and can change how you handle your medical billing process. Not being able to keep up with these changes is costly.
According to a Black Book survey, approximately 80% of hospital leaders are considering outsourcing their revenue cycle management services. Some ASCs will still choose to handle their financial service internally, but there are several advantages to outsourcing your medical billing and coding.
Insurance providers naturally work to provide the lowest reimbursement amounts for OON services in multiple ways, sometimes unknowingly to the provider. This can happen because a patient’s policy has limited benefits, drastically lower rate agreements, or a specific bill reduction issue due to a previous clause.
A Revenue Cycle Management company can work with you directly to create a strategy to increase your facility’s revenue from OON. A number of things can be done to begin the process, for example, identifying which insurance providers potentially have been underpaying for services and sending out appeals to recoup OON reimbursements. Every ASC facility will have its process for developing the best practices to expand OON revenue overtime.
Streamlining the process will increase the reimbursement revenue on the charges that are billed by your facility. When an ASC can improve the overall billing productivity and efficiency, not only will this help with patient price transparency and medical billing, but it directly affects billing reimbursements from the providers.
Recycle Cycle Management companies like BrightDrive Healthcare Solutions, which use AI technology to automate the billing process, have found this to aid in the reduction of specific coding errors that delay charges billed by surgery centers.
Technology, when incorporated, reduces administrative burdens, improves data security, and streamlines the workflow. The costs to finance this type of healthcare technology prevents many ASCs from purchasing it. When you outsource, this eliminates this burden.
Timely and effective billing collection follow-up should be a strategic part of your ASC’s billing department to remain on top of realized uncollected revenue. Outsourcing prevents time gaps for making necessary changes and responding to medical claim appeals that are needed to recoup reimbursements.
Poor claims management plays a negative role in uncollected revenue. Creating a financial flow strategy implemented using AI technology will improve the accounts receivable process and help a struggling ASC.
A professional Revenue Cycle Management company will provide guidance to avoid billing for in-network patients under OON billing. Mistakes can happen for various reasons, from miscommunication to administrative errors, but when they are chronically made, red flags get thrown to insurance providers. Surgery centers are still legally responsible for keeping up-to-date with all governmental policy changes and inefficiencies within the organization. Over time, these mistakes will leave you open to medical insurance audits and penalties.
Revenue Cycle Management companies understand that these continuous changes can happen without notice. They will work to make sure mistakes like billing in-network patients under OON don’t happen along with the many other errors that commonly happen.
Spend time committing to serving your patients with the utmost care and leave the stresses that come will financial woes associated with medical billing to a professional revenue cycle management company. It’s a cost-effective and smart decision to hire a team of medical billing and coding experts.
ASCs require meticulous management to stay afloat and not fall into financial uncertainty. Outsourcing, in general, can free up your staff members for other clinically demanding patient care activities essential to your Ambulatory Surgery Center. An exceptional RCM company can help your facility create a strategy for increasing the overall cash flow and protecting the facility’s financial lifeline.
Do you plan to outsource your Ambulatory Surgery Center’s revenue cycle management? Share your thoughts and concerns about outsourcing in the comments below.