ASC Revenue Cycle Management Outsourcing on the Rise: Why It's the Best Billing Model for Today and Tomorrow

ASC are increasingly outsourcing their billing and for good reason. Make that many good reasons. Outsourcing revenue cycle management (RCM) to the right ASC billing company can deliver extensive benefits that enable surgery centers to remain viable and competitive.

In this column, we'll highlight some of the most significant short- and long-term benefits ASCs can expect when they partner with an outsourcing billing company.

ASC Outsourced Billing Short-term Benefits

Here are five of the short-term benefits of outsourced ASC billing.

1. Attention to accounts receivable

One of the big motivators for ASCs to outsource RCM is poor accounts receivable (A/R). Cash suffers because AR is not being worked timely. It's not unusual for an audit of an ASC with in-house billing to reveal that the center has lost an eye-opening amount of money. Contributing factors can include missed timely filing deadlines, subpar coding, claims that take weeks on average to get out the door, and months passing in between the touching of open accounts. These problems point to issues like overwhelmed or underqualified staff.

When ASC billing is outsourced, AR quickly receives the immediate and then ongoing attention it needs. A billing company should excel in improving an ASC's collections and cash flow, and then deliver services that help ensure performance in these areas remain strong.

2. Other improved revenue cycle metrics

Key performance indicators (KPIs) tell the story of an ASC's revenue cycle performance. While revenue cycle KPIs fluctuate, they should generally either be improving or remaining steady when a high level of performance has been achieved. An ASC billing company will perform an initial assessment of its new client's KPI performance to identify areas of concern and then work to implement fixes to reverse any concerning trends. The billing company will also track their base metrics to compare the progress made on improving KPIs due to outsourcing.

3. Decreased staffing concerns

Outsourcing ASC billing instantly reduces the number of staff who must be recruited and retained. With access to and support from a team of ASC revenue cycle experts, a center can eliminate open in-house business office positions, reliance on part-time and as needed business office staff, and paying for overtime when staff are unavailable or unable to take on more work. If an existing business office staff member leaves the facility or wants to move to reduced hours, the ASC billing company can take over the available work.

4. Insight into performance

Reporting plays a vital role in an ASC's revenue cycle success, providing ongoing insights into what's working well and what isn't. An ASC billing company will bring with it tools to create timely, detailed, and accurate reports. The company will also have the people available to help clients understand the "stories" in the data and what actions should be taken to correct problems and build on successes.

5. Additional cost savings

If an ASC scales back full-time business office employees, additional financial savings include reduced expenses associated with recruiting, hiring, training, and employing staff; purchasing furniture and technology; and obtaining insurance. Outsourcing RCM may also provide an ASC with an opportunity to reduce its physical footprint, saving money on occupancy costs.

ASC Outsourced Billing Long-term Benefits

Here are five of the long-term benefits of outsourced ASC billing.

1. Strong, sustained metrics

By closely monitoring KPIs on an ongoing basis, executing strategies that can strengthen KPI performance, and taking fast corrective actions when performance declines, a billing company keeps its ASC clients in the best position to achieve year-over-year financial stability, profitability, and growth. The billing company will leverage advanced tools, like a next-generation analytics platform, that empower a more extensive analysis of KPI performance and potential issues.

An ASC billing company also brings experienced managers knowledgeable about ASCs and specialized in their departments. These include payment posting managers, billing managers, and A/R managers. Clients benefit from that expertise and their assigned senior manager who oversees the account and serves as the primary contact.

2. Capitalizing on growth opportunities.

Growing clinical operations is easier, less expensive, and more successful with outsourced RCM. As an ASC grows, it will not need to worry about finding, hiring, and training new revenue cycle management staff. A center can also take solace in knowing its outsourcing partner is prepared to deliver the necessary revenue cycle services to maximize the bottom-line benefits that come with expansion.

Adding a specialty or procedure is simpler since the responsibility for ensuring completion of the new ASC revenue cycle tasks falls on the shoulders of the outsourcing company.

Outsourcing ASC billing also alleviates the workload of center leadership. This reduced workload can help leadership more effectively develop proper expansion plans. ASC leadership is also freed up to work more closely on building the right project team, physician recruitment, equipment research and purchasing, clinical staff hiring and training, and the other responsibilities that are part of expansion projects.

3. Strengthened payer relationships.

Through the ongoing work of an ASC billing company and collaboration with its surgery center client, an ASC can see its long-term payer relationships improve. Payers will know the center is being supported by a team of ASC coding, billing, and managed care experts who are working to make the billing process as consistent and accurate as possible — a benefit for the center and payer. When it's once again time for contract renegotiations, the payer knows the ASC will come to the table with the data and information needed to hash out a new contract that's fair for both parties.

4. Improved physician recruitment

Publicizing the partnership with an ASC billing company can help attract surgeons. They may appreciate knowing a team of experts will be handling the center's billing, which will help ensure consistent, accurate billing and collections; consistent ownership distributions; and improved patient satisfaction with the billing experience. Surgeons may value that the RCM partner has expertise in their specialties and procedures, which can help expedite the completion of documentation required for billing. Surgeon owners may also like knowing that billing staff turnover will not be an area of potential concern that can lead to increased expenses and strained financial performance.

5. Ongoing support, feedback, and education

A good ASC billing company delivers support to clients and shares timely feedback and education with ASC clients on ways they can improve processes that may contribute to optimizing metrics and cash flow. The billing company will also be open to receiving feedback and answering questions from clients about account results and improvement efforts. The right outsourced RCM provider works to ensure its ASCs feel like their revenue cycle management team is a partner and extension of the business office, not a vendor solely providing services.

Winning With Outsourced ASC Billing

ASCs that decide to outsource RCM will find that they have options for billing partners. RCM companies vary greatly in the types and quality of services provided as well as their levels of ASC expertise and experience. ASCs should ensure the billing company they select as their partner is well-equipped to provide significant, sustainable improvements to their revenue cycle. The right ASC billing partner will ultimately bring a surgery center the financial and efficiency improvements that continuously deliver a positive return on investment.