Ambulatory surgery centers (ASCs) have diverse processes to navigate, from front-end tasks such as collecting demographic information and verifying insurance, to coding and billing compliance in an ever-changing regulatory environment. In the complex world of surgical revenue cycle management (RCM), both standalone and hospital-affiliated ASCs need a comprehensive RCM solution to achieve peak financial performance and operational excellence.
Challenges with a Fragmented Approach
A nimble client with a multi-specialty mix, each with distinct billing requirements, faced significant challenges stemming from their fragmented revenue cycle strategy. The combination of in-house operations and third-party outsourcing resulted in inefficiencies, including:
- Sluggish Transcription Turnaround: Delays in transcription and subpar client service slowed the claim submission process jeopardizing timely filing deadlines.
- Billing Department Turnover: Frequent staff turnover disrupted established workflows and led to significant inconsistencies in revenue cycle management, impeding operational efficiency and financial performance.
- Revenue Cycle Bottlenecks: The multi-specialty ASC, managing mostly orthopedic cases, struggled to maintain operational efficiency with implants and complex cases that required swift action.
Benefits of Total RCM
Recognizing the need for a streamlined, end-to-end solution, the multi-specialty ASC partnered with nimble and implemented their Total RCM solution. This was a game changer that revolutionized the ASC’s revenue cycle management through:
- Front-End Optimization. nimble’s team restructured front-end processes, focusing on insurance verification and prior authorizations. These improvements reduced delays and set the foundation for a more efficient revenue cycle.
- Next-Day Completed Transcription. Using nimble’s mobile app, featuring custom push notifications and e-signature capabilities, the ASC benefited from guaranteed 10 a.m. next-day delivery of quality reviewed transcribed notes, eliminating transcription-related delays.
- Enhanced Billing Processes. Integrated, tech-enabled workflows and A/R management tools significantly reduced claim denials, improved clean claim rates, and increased collections efficiency.
- Accelerated Coding. Streamlining the coding and claim submission processes to complete within two hours of receiving transcribed notes meant swift and accurate claims processing.
Transformative Benefits of a Strong Revenue Cycle Partner
The ASC optimized its end-to-end revenue cycle process by leveraging nimble’s Total RCM solution. It accomplished faster claim submissions, improved accuracy, and reduced operational inefficiencies. The result was better financial performance and streamlined workflows across departments in the ASC.
- Lowered the Claim Denial Rate to less than 1%, highlighting the accuracy and thoroughness of the RCM processes.
- Reduced Total A/R % Over 90 Days to under 20%, while optimizing cash per case payments.
Investing in a Total RCM Solution
nimble’s Total RCM solution exemplifies the value of a unified approach to revenue cycle management. By addressing pain points such as front-end inefficiencies and transcription delays, ASCs can focus on what matters most—delivering exceptional patient care. The integration of advanced technology, a comprehensive payer strategy, dedicated specialists, and a commitment to operational excellence leads to measurable financial improvements.
Access a recent case study to see how multi-specialty ASC partnered with nimble solutions to significantly reduce front-end billing errors, increase transcription turnaround time, and maximize managed care contracts. Download the case study here.
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