Whether it’s a young, single-specialty ASC trying to get its financials in order; a large, multi-specialty center with years of success under its belt; or any other type of surgery center, all types of ASCs outsource their revenue cycle. And these different ASCs often have varying reasons for why they choose outsourcing over in-house revenue cycle management.
Here are eight categorizations of ASCs and ways each benefit from outsourcing RCM.
1. De Novo
When a new ASC outsources, it achieves upfront savings, reduces the work required to open and better ensures critical steps are not overlooked. Choosing to outsource before designing an ASC will support more effective business office space allocation. Owners can build a smaller facility or pursue a smaller space to rent, saving money on construction, mortgage/rent, utilities and more. Additional savings include reduced expenses associated with recruiting/training staff and purchasing technology.
Staffing a new surgery center is also difficult as volume is typically lower and less predictable in the early months of operation. Outsourcing reduces unnecessary spending on staff, supplies and resources.
With less resources committed to establishing the business office, more attention is focused on initial clinical and operational needs.
2. Mature
When an older ASC moves to outsourcing, this serves to reset and clean up revenue cycle policies and procedures. It provides a fresh look at habitual processes, often replacing them with more effective practices.
Outsourcing provides a mature center with instant cost savings via reduced or eliminated overtime and part-time work or scaled back business office staff. If a key member of the revenue cycle team leaves the ASC, outsourcing serves as an effective succession plan, providing an alternative to replacing the employee. And as a mature ASC undergoes clinical staff changes, outsourcing accommodates subsequent changes to operations (e.g., new physicians and specialties).
3. Struggling
If an ASC’s revenue cycle performance takes a turn for the worst, outsourcing can be the solution that rights the ship. The ASC gains access to experts who can pinpoint shortcomings and opportunities. These experts can coordinate their revenue cycle performance assessment and fast-track improvements.
The ASC can also achieve cost savings by scaling back business office staffing. With a reduced administrative workload, focus can shift to other matters, including physician recruitment and inventory management.
As the ASC turns around its business fortunes, it can weigh avenues for growth supported by the outsourcing partner.
4. Successful
A strong-performing ASC can build upon its success with the right outsourcing partner. The ASC can pursue growth opportunities knowing its partner will deliver the services to support expansion.
As the ASC grows, it will not need to worry about adding RCM staff. If growth involves new specialties, outsourcing eliminates finding staff with knowledge of billing intricacies or training staff on rules.
If accommodating growth necessitates clinical expansion, outsourcing can free up business office space. If growth necessitates relocation, the ASC can reduce costs associated with purchasing/renting space and outfitting a business office.
The most successful ASCs benefit from outsourcing. An unbiased perspective sheds light on problems and deficient processes.
5.Large
For an ASC with several operating rooms, many physicians and high volume, outsourcing streamlines a significant aspect of operations. Business office management is simplified. The responsibility to oversee a team of professionals is shifted to the outsourcing partner.
With a reduced business office staff, concerns about turnover, absences and other disruptions are alleviated. Each eliminated business office staff position translates into savings.
If the ASC experiences significant changes to its clinical team and service types, outsourcing accommodates such changes.
6. Small
For an ASC with a smaller operation, outsourcing reduces the potential for challenges that strain performance. Outsourcing allows ASCs to pay for the services it needs when it needs them (i.e., scalability). This can eliminate reliance on part-time business office staff and paying overtime. Outsourcing can reduce excessive staffing expenses when volume shifts.
Outsourcing can also eliminate the need for a dedicated business office manager. A business-savvy administrator, director of nursing and medical director may be all the in- house management necessary.
7. Multi-Specialty
An ASC with multiple specialties benefits from an outsourcing partner with experts in all aspects of ASC operations. Challenges associated with performing cases across specialties include keeping current on coverage requirements and educating staff on rule changes. An outsourcing partner prioritizes staying abreast of revenue- cycle related developments across specialties and payers and ensures its staff is trained.
If a multi-specialty ASC has team members trained in particular specialties, they may struggle if the ASC experiences volume swings that require billing for a “weaker” specialty. An outsourcing partner can quickly adapt to such changes.
8. Single-Specialty
A single-specialty ASC will value how outsourcing reduces internal responsibilities. With less attention required for managing the business office, the ASC can focus on what makes single-specialty centers successful: streamlining patient throughput to maximize volume.
If the ASC chooses to transition to a multi-specialty facility, accommodating the new specialty(s) will be easier since the responsibility for RCM functions will fall to the outsourcing company.
Is outsourcing right for your ASC?
While all types of ASCs can benefit from outsourcing, the questions you should set out to answer are whether your surgery center would benefit and by how much. Worthwhile initial steps to take to begin gathering information are to undergo a revenue cycle audit to gain a better understanding of your performance and speak with outsourcing companies about their services and results delivered to like ASCs. From there, you can decide whether to further pursue outsourcing.
Even if you choose not to outsource right away, this due diligence process should leave you knowing more about outsourcing RCM and the role it may eventually play for your ASC.
Angela Mattioda is vice president of revenue cycle management services for Surgical Notes. Surgical Notes is a nationwide provider of revenue cycle solutions, including, transcription, coding, revenue cycle management (RCM), and document management applications for the ASC and surgical hospital markets. Mattioda oversees the SNBilling RCM service, the fastest-growing component of Surgical Notes’ complete, best-in-class revenue cycle solution offering. Contact Mattioda at angela.mattioda@surgicalnotes.com.
This article was sponsored by Surgical Notes.