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DOING BUSINESS


The Billing Dilemma Outsourced and in-house processes offer both advantages


and disadvantages. Determine which is best for your ASC using the guidelines below. BY KEVIN MCDONALD


Many ASCs struggle


with the decision about whether to outsource their billing process or keep it in-house. For some facili-


ties, leveraging technology to bring the billing process in-house can provide substantial benefits, including increased revenue and greater management con- trol. For others, leveraging the expertise a billing company offers creates more efficient processes and alleviates the stress and significant amount of man hours required to manage the billing process. Outsourcing can also offer cer- tain financial benefits.


In-House Advantages and Concerns For those considering bringing the billing process in-house, technologi- cal advances have made it easier and more cost-effective for ASCs to imple- ment the tools needed to automate the entire spectrum of patient and payer business transactions. In addition to lower, predictable monthly expenses, ASCs benefit from a significant reduc- tion in manual tasks and an increase in staff productivity. With the right tools in place, a facility managing the bill- ing process in-house can substantially increase its revenue by reducing col- lection costs and billing backlogs as it pursues outstanding payments. For greater savings and convenience,


many facilities that bring their billing processes in-house leverage cloud-based technology, which shifts IT operations out of the facility and into a secure vir- tual environment. Facilities save money by eliminating the need to purchase or replace server hardware and software because a third party hosts and main-


24 ASC FOCUS MARCH 2013


tains the technology. The ASC needs to provide only an Internet connection and access via laptop, a personal computer or a tablet computer. Cloud-based solutions also remove IT-related concerns, such as technology upgrades, security and regulatory requirements while reducing server-related expenses, as these burdens are placed upon the hosting provider.


Advantages of Outsourcing On the other hand, outsourcing billing processes results in fewer management issues for ASCs, allowing facility staff to spend less time on billing and more on patient care. The experienced coding, billing and collections service enables clients to capitalize on an expert back of- fice staff while maintaining control over their financial data. Personnel issues such as finding and training expert collections and coding staff are eliminated. The bur- den of keeping up with regulatory chang- es and commercial payer requirements relating to the billing process moves to the billing company. Additionally, time- consuming processes such as verifica- tion, reading and posting payments from explanation of benefits (EOBs) forms and collections become the responsibility of the billing services company, thus freeing up significant staff time. With the right billing services company, ASCs can ex- pect to see a significant increase in billing and improved collection times resulting in increased revenue.


How to Choose The decision to outsource the billing pro- cess or to bring it in-house is an important choice as it can have a significant financial impact on your facility. Therefore, careful consideration and a clear understanding


of what you hope to accomplish is neces- sary before moving forward. To help you determine which is best for your facility, consider the following: What are your goals and require-


ments for billing? Start by defining specific goals and requirements for your ideal billing process. What do you need and want? Can these goals be achieved internally or do you need outside help? Do you have the space? When


bringing your billing process in-house, you will need a dedicated room to house billing staff, copiers, printers, fax lines, etc. Your space should be large enough to accommodate at least two staff mem- bers in addition to equipment. Depend- ing on the volume of cases, a larger space might be needed. Larger facilities and those doing verification should plan for a minimum of three staff members. If you anticipate a significant increase in case loads in the future, make sure you have room for expansion. Does your caseload support the


costs? In addition to the initial invest- ments (i.e., software, fax machines, phone lines, office furniture, etc.), fac- tor in ongoing costs associated with maintaining in-house billing, such as staff salaries, benefits and training. It is important to have the caseload to sup- port these costs if you bring the billing processes in-house. Do you have the talent needed to


oversee billing and collections? In ad- dition to billing staff, a business man- ager or a billing lead will need to over- see the billing and collections process. Most facilities can expect to increase headcount by a minimum of two when bringing billing processes in-house. Do you have a tech-savvy person


on staff? Acquiring and maintaining today’s complex IT environment can be a challenge as it requires time, finan- cial resources and knowledgeable staff.


The advice and opinions expressed in this article are those of the author and do not represent official Ambulatory Surgery Center Association policy or opinion.


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