Ambulatory practices and ambulatory surgical centers (ASCs) have specific revenue cycles that require unique attention and consideration. ASCs are booming outpatient facilities that provide same-day surgical care as an alternative to a hospital stay. The Medicare Payment Advisory Commission reported that in 2013, “5,364 ASCs treated 3.4 million fee-for-service (FFS) Medicare beneficiaries, and Medicare program and beneficiary spending on ASC services was $3.7 billion.” Consider the following 5 tips to help strengthen and maintain a prosperous revenue cycle:
1. Focus on Patient Quality, Not Quantity: The implementation of EHRs could actually decrease productivity for ambulatory practices as many are slow to integrate implementation greatly due to financial concerns. Many practices are receiving more reimbursement mostly because they are seeing fewer patients. A solution to reimbursement issues is to advance EHR functionality to incorporate analytics, so that doctors see the right patients.
2. Front-End Training Should Be a Top Priority: Most claim denials can be traced back to problems with front-end staff who do not fully understand the billing system. This is why training is so critical when implementing new software, so that claims are not denied and practices do not waste valuable time and money.
3. Develop an ICD-10 Payment Strategy: ASCs should develop a 3-month game plan following ICD-10 implementation. If a staff member leaves suddenly or there is a software crash, having a comprehensive plan will be vital to the success of the practice. Expect the unexpected and consider bringing in a consultant or an administrator to lead internal training.
4. Educate & Reevaluate Implant Discounts: "One key strategy in reducing implant costs is to develop a capitated plate and screw plan with a key vendor," states Larry Taylor, President and CEO of Practice Partners in Healthcare. Continuously reevaluate surgical implant discounts and educate physicians about cost matters to increase financial understanding and ultimately increase case volume to enhance business growth.
5. Never Let Outstanding Balances Slip Away: It is imperative to run statements for patient-due balances frequently in order to stay on top of outstanding balances. Consider writing off outstanding balances as bad debt so that receivables are not inflated and then place the account with a third party collection agency. If money is recovered by the agency, deposit the funds in your accounting system as ‘bad debt recovery.’ Collectability significantly declines after a 3-month period, which makes it critical to establish a schedule for statement production and collection phone calls or payment plans.
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