ASC billing software is no longer a nice-to-have — it is essential for navigating today’s complex revenue cycle environment. The right surgery center solution can reduce errors, speed up reimbursement, and free up staff to focus on patient care. But not all ASC billing software is created equal. Finding a solution that offers ease of use, purpose-built functionality, scalability, and actionable data insights is key to making the right investment.
Ambulatory surgery centers (ASCs) have a complex billing landscape to navigate, from overly complicated medical coding rules to intricate insurance requirements and beyond. But gone are the days of managing this process manually. A variety of technology solutions exist today that can help ASCs streamline the complexities of revenue cycle management and better ensure accurate and complete collections.
However, not all solutions are equal. Whether you’re investing in one for the first time or seeking a new option to replace a legacy system, here’s how to evaluate and ultimately choose the right ASC billing software for your institution.
According to the Deloitte Center for Health Solutions, revenue cycle workflow processes are a particularly ripe area for modernization and digital transformation, because these tasks are “repeatable, frequent, and possible to standardize.”
To demonstrate the productivity boost that could be achieved with revenue cycle management technology, Deloitte developed a model that could estimate time savings. Based on this analysis, Deloitte estimated that technologies could save 41% to 50% of staff time across the revenue cycle function. For example, at the front end of the revenue cycle, where staff members work with patients on appointment scheduling and pre-registration, technologies could help save 700 to 870 hours a year per scheduler. That’s a significant amount of time that ASCs could allocate to other initiatives, including those that can enhance the patient experience or the bottom line.
However, while technology can support healthcare staff, it can also lead to distrust and anxiety for its users. These feelings can be caused by poor technology onboarding, but they can also be the result of choosing the wrong software.
Too many healthcare organizations select software based on short-term needs, but it’s important to be methodical with new technology additions. ASCs, in particular, need to make sure they adopt software that’s built specifically for ASC operations, especially regarding the revenue cycle, because they are specialized facilities with highly specialized billing workflows.
The right ASC software should offer tailored surgery center functionality, long-term scalability, a high level of interoperability, an intuitive interface, and fast and efficient ASC billing services and features. In doing so, the technology can deliver a strong return on investment by introducing efficiencies across the revenue cycle, from helping ensure compliance and clean claims, eliminating workflow bottlenecks, strengthening cash flow, and beyond.
This is why software selection matters. It’s an investment, and you should feel confident in knowing you made the right choice for your surgery enter. That confidence can come from understanding what exactly to look for and prioritize in an ASC billing company and its software options.
Top-tier ASC billing software can deliver a host of benefits, including the following:
The claims process is fraught with complexities that can snag productivity and cause bottlenecks, and one mistake anywhere along the line can lead to lengthy denials and appeals that can delay payment or even lead to a loss of revenue. The right ASC software can streamline the claims process and create tailored workflows to ensure no required detail is missed, making it simpler for users to navigate and collect the correct information and shepherd claims through to approval with ease.
Insurance verification and pre-authorization are key steps in the early stage of the ASC billing cycle. These steps are required to reduce the likelihood of denials and ensure the rest of the billing experience goes according to plan. With ASC billing software, verification and authorization can be automated and optimized, saving both the patient and staff time through instant, real-time verification of coverage, including any recent changes, and access to co-insurance, copay, and deductible details. Getting this validation and crucial information upfront can also help simplify compliance.
ASC revenue cycle management is all about balancing speed and accuracy. Accuracy, though, can take time. Staff, for example, may feel compelled to double- or even triple-check codes or patient data before moving forward. Human error can also throw a wrench into the equation, as even the most detail-oriented person can make a mistake. The right billing software can perform checks automatically, pre-populate information from payer contracts, validate patient information, and more. This capability can help minimize errors, catch mistakes before they impact the ASC billing process, remove the burden of human error, and deliver faster, complete reimbursement at scale.
From schedulers and coders to surgeons and beyond, ASC software can introduce efficiencies to help staff not only do their jobs better, faster, and more accurately but also focus on higher-value tasks. Surgeons, for example, can spend less time in the software and more time performing procedures or completing their dictations and other required work. Frontline staff can also focus less on tedious data collection and verification and more on delivering high-quality patient services that can improve both surgeon and patient satisfaction.
Once claims are submitted and patient statements are sent out, ASCs can lose visibility into the status of approvals or payments. Billing software that’s designed for ASCs is built from the ground up to help provide that critical transparency. For example, the use of billing trackers can help guide collectors on follow-up and collections, and revenue cycle features can help leadership keep track of key performance indicators, such as days in A/R by payer or net collection rate.
Understanding business and operational performance is essential to improving ASC billing services, and software can provide that insight. With surgery center software, you can establish benchmarks that indicate performance quality, automatically track results over time, and gain insight into those priorities at a glance via intuitive dashboards. Software with advanced data analysis can help identify areas for improvement based on this data and automatically generate actionable next steps to help drive continuous optimizations.
These benefits free staff to focus on high-value work and reduce the repetitive tasks that often bog down ASC revenue cycle operations.
When evaluating ASC billing software, look for the following differentiators to ensure you select the solution that’s right for your organization.
Look for software that has a comprehensive feature set. While it’s possible to piece together software from one ASC billing company and another, doing so often results in interoperability challenges when systems don’t work well together. Even if you don’t need every feature the software offers right away, it’s good to have extra bells and whistles if you need them in the future. Ideally, the software will also show room for growth — a feature set that continually evolves by adding new advanced applications, such as AI-driven functionalities, can help you maintain a competitive edge.
What does a comprehensive feature set look like? Seek out a product that provides the following: claims management, coding tools, error detection, clearinghouse portal integration, patient payment estimator, alerts and notifications, customizable reporting, automated data collection, electronic requests for information, advanced analytics, and monitoring and auditing capabilities.
Software in any type of healthcare setting must prioritize ease of use; otherwise, adoption may suffer. For example, one study that examined poor health information system adoption found that perceived ease of use and perceived usefulness were two of the primary factors affecting adoption. If the technology seems too complex to use and difficult for employees to understand and navigate, they may never have a positive attitude toward it and may struggle with adoption.
This is why it’s critical to ensure that ASC billing software offers an intuitive user interface and has a relatively easy learning curve. Having training, resources, and support available from the ASC billing company behind the software available can also help empower staff.
ASCs have unique needs, and as such, they need tailored solutions. Don’t settle for software that was designed for another setting and cannot do exactly what you need it to do. Instead, seek out software built from the ground up with ASC workflows in mind. The more customizable, the better.
It’s also important to consider scalability and interoperability. For example, cloud-based software solutions are typically better for growth, as they can scale without physical limitations while making it easier to share data. Software with strong interoperability can simplify integration with existing ASC technologies, like EHRs and other management systems. This can speed up implementation and deployment and deliver superior configurability.
In a field that deals with highly sensitive information, including patient data and, in the case of billing, financial data, security is paramount. Before selecting any software, evaluate the system’s security features. What security standards does it adhere to? What fail-safes are in place to protect data? Does the software offer role-based access controls and data encryption?
In addition, consider compliance. Does the software comply with the regulations that apply to your ASC, such as HIPAA and other federal requirements? Establishing these baseline needs ahead of time can help narrow down which software is ultimately right for your ASC.
A robust analytics suite can take ASC software to the next level. For example, billing software with built-in analytics can help flag error trends and identify potential bottlenecks. Systems that can translate that analysis into data-driven insights can help staff make better decisions and take advantage of improvement opportunities, too. Look for software that features interactive, intuitive dashboards, automated reporting functions, and benchmarking tools that can help set and track KPIs. Gaining visibility into performance on a regular basis can help ASCs understand the intricacies of their billing processes and how to optimize them.
Procuring a complete software platform that features the above is a great option, but it's not the only one. For ASCs that want to start small, it’s possible to use software that contains just the billing software component, such as SIS Office. Doing so can empower your ASC to streamline revenue cycle management and drive success — value that can be magnified when paired with ASC billing services, such as SIS Revenue Cycle Services.
ASC billing doesn’t need to be difficult. With the right ASC billing software and the right company and people behind it, the process can be greatly simplified, delivering a variety of benefits that can directly impact the bottom line and surgeon, patient, and staff satisfaction. But making the right decision is half the battle. By knowing the key differentiators to look for in an ASC billing company, you can effectively evaluate your software options and make an informed buying decision that will better ensure billing success for your ASC over the short and long term.
Looking for a comprehensive solution that can solve the toughest challenges? Schedule a personalized demo of SIS Complete to see how our award-winning software can transform billing.