Every year new procedures and technological advancements in healthcare are coming into the realm of ambulatory surgery centers (ASC’s). Some of the factors that are driving this shift to ASC setting include cost reduction, better safety and patient outcomes, technological advancement, as well as an aging population.

With the increase in technology also comes a significant cost reduction of a certain procedure. This makes surgery centers more cost-efficient for payers and cost-attractive to patients as it offers them options that fit within their budgets.

The challenge now for ASC’s is to secure their bottom line as they come up with growth in the healthcare space. Here are tips that should be considered to improve your ASC’s revenue cycle:

Improve Claims Denial Management by Adopting Proactive Strategies

Being proactive means evaluating your center’s practices ahead of time-based on the available data and identifying the risks present in your revenue cycle. Think of it as preventive care for your revenue cycle.

In denials management, most teams just focus their efforts on revenue recovery. To be proactive, you need to prevent denials in the first place. Preventing denials is always better for your bottom line than recovering them.

For example, your surgery center needs to have visibility into how many coded claims are denied and the financial impact those denials have on your organization. The need to accurately capture and record care is critical to ensuring complete reimbursement, but a large proportion of organizations are currently struggling in this area.

Improve Patient Engagement and Financial Communication

Patients are frequently asked or made to decide between having their procedure done in a hospital or surgery center. Most of the time, physicians provide no explanation of what that means. This means some patient engagement and education need to take place even at the physician’s office.

There’s also a big opportunity for ASC’s to educate patients and build their patient base by increasing digital presence through a website or social media outreach to partnering with medical device companies to do patient outreach.

Patients need to be educated about the pros and cons of each facility (whether surgery center or hospital), the track record of the facility with the procedure, the patient’s financial responsibility, etc.

Not all patients understand their insurance plan, their insurance coverage, and what their portion will be. Hence, patients also need someone to talk through about how everything works from a financial perspective. Having patient financial advocates and implementing early financial communication to patients will make for a better experience and help ensure that your ASC will get paid.

Improve Early Detection and Prevention of Revenue Leakage

Undetected revenue leaks can hurt your surgery center’s profitability and cash flow. In 2013, McKinsey & Company reported that revenue cycle inefficiencies consume 15 cents of every healthcare dollar – $400 billion out of the $2.7 trillion spent on healthcare annually in America.

Many providers typically do not receive full reimbursement because patient collections are leaking throughout their revenue cycle. Some do not even detect the source or depth of their revenue loss.

It pays to know how much revenue you’re truly missing out on and where they are coming from. Leakage could come from coding errors, manual payment and collection processes, unbilled revenue, and poor denials management.

It is important to conduct thorough audits that can find even fewer common areas where revenue leakage can occur. For example, unbilled insurance can lead to lost revenue. To solve this problem, your facility needs to create reports that track unbilled insurance. In the same way, you can also have a report that tracks unbilled patients, including self-pay, promissory notes and patient balances after third-party payor responsibility is met.

It’s essential that every procedure performed in the practice becomes a claim in the billing process. One medical billing expert notes that a facility could easily be losing 10% or more of its revenue if it fails to track interpretation reports and fails to have checks and balances in place to make sure every service provided is being billed.