Compliance guidelines that govern the Ambulatory Surgery Center’s reimbursement are wide-ranging, complex, and ever-changing. Hence, it’s important for ASCs to hire or partner with ASC medical billing and coding management consultants who understand the legal rules placed on ASCs, including the specialized coding, accreditation, documentation, and reimbursement care contracts.
Here are prominent billing function affecting your practice revenue
The rise in the number of Accounts Receivable (AR) days
AR basically refers to the average number of days that an ASC takes to collect payments for the services provided. Days in AR are one of the main methods that ASCs use to measure their financial performance. The factors impacting the AR days are procedure scheduling, patient pre-registration, insurance verification, patient financial counseling, patient payment plans, and patient collections. An important tip here would be setting up a patient financing solution that pays within just a few days of the service provided that can reduce days in A/R.
Surgery cancellations have always been a major cause of concern for ASCs. Facing high out-of-pocket costs for a certain surgery, many patients whose surgery is canceled, may not rearrange as they think that would incur more expense. Same-day cancellations of a scheduled surgery have a tangible, negative impact on your facility’s bottom line. Another suggested strategy is implementing patient financing options. Providing a secured loan to patients to cover their surgical costs can reduce cancellations, grow surgery numbers, lower the AR days, and increase cash flow.
Surprise Billing is a national problem
It has become common for patients to receive extra bills from out-of-network providers. This even after they have settled their copays and deductibles. Remember that surprise billing is a national problem and many states in the USA have passed laws to curb this practice. We as a dedicated ASC medical billing and coding organization caution that providers operating in these states should understand the laws to avoid lawsuits. ASCs should also be wary of surprise billing or risk losing patients.
Managing payer contracts
Managing payer contracts is a tough task and ASCs face many challenges that are subject to frequent changes. With regard to care plans, local coverage determinations (LCDs), preventive care, and bundled payments, payers also have different rules and conditions.
A recent report offers the following tips:
- Breakthrough narrow networks by letting the payer know why it is good for them to have the surgical center in their network. Highlight unique service benefits, geographic advantages, clinical/treatment benefits, and out of network patient counts and referrals.
- Think of blending direct commercial payer agreements and both primary and secondary complementary payer agreements.
- Put emphasis on any concerns about contracts’ language.
- Analyze the contracts periodically to keep track of alterations and contract expiry dates.