Effective and efficient ASC billing is contingent upon numerous factors. Billing staff must be skilled in their craft and receive ongoing education to keep them current with changing rules. Physicians must understand what information the staff needs to effectively fulfill their responsibilities. Information technology (IT) systems that drive an ASC's revenue cycle must be configured to support an ASC's specific needs and requirements.
Even when all these and other critical elements to ASC billing success align, there are inevitably opportunities to improve revenue cycle performance. Follow these 10 steps to help give your bottom line a boost.
1. Collect data
The ability to collect relevant, accurate financial data (e.g., payer mix, service mix, physician productivity, implant usage) is vital to spotting issues that negatively impact revenue cycle performance. If information is entered incorrectly on the front end, you will likely experience a "garbage in, garbage out" scenario. This is where poor data captured up front generates poor, inaccurate, and misleading reports on the back end.
2. Analyze data
Assuming your ASC uses a specialized IT solution designed for surgery centers, you should be able gather financial performance data and generate reports you can use to drive strong decision making. This can be a big process, so consider choosing one topic at a time for analysis.
For example, let's consider days to bill. The best practice in the ASC industry is three days to get a bill out the door. Most ASCs average around five days. If your data shows that you're at seven or more days to bill, that would be a good area to focus on for improvement.
3. Benchmark results
Benchmarking performance data is essential to enhancing ASC billing and overall revenue cycle performance. Benchmarking should not be a one-time activity; rather, it must be ongoing. At least once a year — best practice is quarterly — collect your data, analyze it, benchmark the results, and then set success goals. Even if you believe you're performing well, most ASCs have room for growth and improvement.
4. Set goals
To help ensure you achieve growth and improvement, set reasonable billing goals. This will provide a target to strive for, and you can measure whether your efforts are moving you closer to this objective.
Let's revisit days to bill as an example. If you're at 10 days to bill and want to get to at least the industry average of five days, then set "step" goals for the next few months. Since you're at 10 days, target getting down to nine next month. With the goal established, work to determine barriers to meeting this goal. Problems with higher days to bill could be attributable to a physician who is slow to document, delays in bringing invoices for implants forward, or staff members not working efficiently enough.
5. Train and educate
With a goal set and barrier(s) identified, provide the training and education that can help remove those barriers and drive progress toward your goal. We'll stick with discussing reducing days to bill as our goal and examine how to approach training and education if a physician is not dictating timely.
One approach that often works is to benchmark internal physicians against each other and against the industry average. Discuss this plan with your medical director before you publicize those results as you might cause a little storm in your ASC if one or more of your physicians do not agree with the sharing of their numbers. Usually physicians will come around as they tend to be very competitive and will embrace the opportunity to compete against colleagues.
You can take a similar approach to lagging staff productivity. If you have the ability to equally — and responsibly — divide billing work between staff, then you can judge their days to bill against each other. This will provide a way to internally and externally benchmark performance and you can focus training and education on improving productivity and output.
6. Monitor ongoing results
Accomplishing steps one through five will take a lot of work. But the next several steps discussed are critical to ensuring your efforts pay off.
Once you have set a goal, established a time period to achieve that goal (e.g., 90 days), and put everything in motion you believe will be necessary to meet the objective, don't wait until the end of the time period to measure your progress. If you do, there's not only a good chance you won't achieve the goal, but you will likely miss opportunities for improvement along the way.
That's where monitoring ongoing results pays off. Set aside time — weekly is best practice — to provide feedback to those individuals working to improve their performance and bring your ASC closer to the goal. Share feedback no less than every two weeks. Take longer and staff may lose focus and start to believe that the goal was only a short-term matter of interest.
7. Hold staff accountable
This is probably one of the most difficult responsibilities for managers. If you've gone through and become vested in the improvement process outlined thus far, you may have found some staff members are not meeting expectations. Do not simply accept poor performance. Not only will you likely fail to achieve your goal, but you will also lower the bar of what is expected from your staff. Other team members may not feel as compelled to work hard if other staff members are not carrying their weight. If individuals are coming up short in their performance, explain the ramifications and stick to them, if necessary.
A potential benefit of holding staff accountable is that it can help team members come up with ideas for improvement or identify obstacles. When this happens, pull your team together to brainstorm on how to execute good ideas or solve problems.
8. Audit performance
While you may get the impression that staff are improving in their performance just by watching them, looks can be deceiving. Examine performance data and review the actual results. If the data backs up your observations, that's great. But if there's a disconnect between the data and what you thought was occurring, at least you now know there is a problem and can work to pinpoint and fix it.
9. Communicate frequently
Communication with and between staff is essential to a successful ASC billing improvement effort. That includes communicating with individuals about their performance and bringing the team together to discuss progress and shortcomings.
Everything done in ASC revenue cycle management is a team goal. Going back to days to bill, bringing that figure down from 10 days to five days involves everyone who plays a role in the revenue cycle. When goals are met, celebrate as a team. When work is left to be done, the team should come together and support one another, brainstorming ways to keep proceeding toward the goal.
10. Repeat
The nine steps discussed thus far should be repeated frequently. Improving ASC billing and revenue cycle performance is not a one-and-done activity. Best practice is to repeat these efforts quarterly. Analyze your revenue cycle services, look at your data, set new goals, and work to achieve them. If performance is strong, repeating this process every six months should still keep you going in the right direction. At a minimum, go through these steps annually.
