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“We track and trend it on a rou- tine basis so we know we will be in a good position financially to adjust to any changes in the market in terms of reimbursement,” she says. “If we did not track what happens with our reve- nue cycle as it relates to these changes, we would not be able to intervene soon enough to keep us financially healthy. “Benchmarking tells us where


Benchmark Your Revenue Cycle


Gauge the health of your ASC’s collections, billing processes and contracts BY ROBERT KURTZ


I


f you do not know how your ASC’s revenue cycle is performing, you will not know how to improve it says Crystal Ewing, manager of data integ- rity for ZirMed, a provider of claims management solu tions based in Louis- ville, Kentucky.


“That is the ultimate goal of revenue


cycle monitoring,” Ewing says. “When you can identify problems—and every- one has problems—you can work to determine the causes and fix them.” ASCs can fall into a trap of thinking


they do not need to keep a close eye on the health of their revenue cycle when money is coming in, says Carol Ciluffo, vice president of revenue cycle manage- ment for Pinnacle III, a Lakewood, Col- orado-based ASC development, opera- tional management and revenue cycle management company. “You want to monitor your revenue cycle not only to make sure your facility


12 ASC FOCUS FEBRUARY 2017


Benchmarking needs to be embraced. Be friends with your numbers, even when they aren’t exactly what you want to see.”


— Carol Ciluffo, Pinnacle III


stays viable, but also to determine if the revenue coming in is what you expected and are owed,” she says. “By under- standing what lies behind your finan- cial data, you can identify processes to tighten or revamp and then create edu- cational opportunities that will allow you to continue to be successful.” Dianne (Wallace) Appleby, exec-


utive director of Menomonee Falls Ambulatory Surgery Center in Menomonee Falls, Wisconsin, says her ASC makes monitoring its revenue cycle performance a priority.


we have issues with our processes,” Appleby continues. “We use bench- marking to examine the whole patient experience from the very beginning, when we receive a referral, through to the end, when we actually collect our money and see if we brought in what we were supposed to receive. We trend the benchmarks we collect to tell us when we should evaluate a process further and consider making a change. Then we can make improvements in a timely manner.”


Areas of Focus There are many different revenue cycle benchmarks ASCs can track, says Ciluffo. One of the most commonly cited is accounts receivable (A/R) days. “Lots of ‘little’ things can erode


your collections progress. When I see a spike in A/R days, I immediately begin analyzing the data to determine the cause,” Ciluffo says. As a claim’s days in A/R increases, so does the risk of missing a timely fil- ing deadline, Ewing says. “This will depend upon the payer’s terms, which you need to be tracking. Some payers have a timely filing deadline of 90 days from the date of service. If you have a claim that is at 90 days in A/R and has not been filed or appealed, it can be at risk of being denied.”


Another critical benchmark to track is aging category percentages, Ciluffo says. “I break each aging category (e.g., 0–90 days, 120 days plus) down into payer and patient balances. If patient balances are rising, there may be a problem with upfront collections.”


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