out, you are more likely to hit and exceed your financial goals.”

Optimize Your Billing Workflows

Collect upfront and make technology your friend BY ROBERT KURTZ


ara Ebert knows that nothing good can come from inefficiencies creep-

ing into her ASC’s billing workflows. “If we are not working optimally,

we will fall behind on completing what is required for our ASC to get paid and then we will face an uphill battle to catch up,” says Ebert, business office manager for Mankato Surgery Center in Mankato, Minnesota. “When our work- flows are optimized, we have fewer denials, more prompt payments and fewer issues with patient collections. We also want to maintain a positive rep- utation with our patients. They can usu- ally recognize when a facility has poor billing workflows as that makes their payment experience more difficult.” With the growing importance of patient collections, ASCs must ensure their billing processes make such efforts as easy as possible, says Kevin McDon- ald, senior vice president of sales and marketing for AdvantEdge in Warren, New Jersey. “Over the past several years, as we have witnessed the significant increase


in patient deductibles, workflows have needed to change accordingly,” he says. “In the past, an ASC could see the patient, file a claim and then worry about col- lecting whatever was left over from the patient. ASCs are now finding that they need to collect that responsibility when patients check in or before patients even get to the ASC. If you do not effectively collect from patients, a profitable proce- dure can end up costing you money.” Claims errors is another way to hurt your bottom line, says Rebecca Over- ton-Geise, president of NSN Revenue Resources in Tampa, Florida. “They are the reason ASCs typically lose the most revenue,” she says. “Errors can come in many forms, such as docu- menting incorrect CPT codes, omitting information about supplies and implants and not properly following payer guide- lines. One small mistake, such as failing to bill Exparel to some payers, can cost an ASC a few hundred dollars per case. That adds up very quickly. When you consistently get complete, clean claims

Elevating Your Performance To help strengthen its billing work- flows, Mankato Surgery Center is rely- ing more on cost-effective and user- friendly technology, Ebert says. “For example, we use technology to elec- tronically verify patient insurance infor- mation. The results come quickly. The technology saves us tremendous time on the front end and reduces the chance for errors that can trigger denials.” McDonald also advocates for the use of technology. “The ability to elec- tronically check patients’ eligibility and determine their deductibles allows an ASC to inform patients about the total cost of the procedure, what insurance will cover and what their portion will likely be. Using this information, ASCs can more effectively secure payment before patients arrive at the facility or a commitment to the manner in which patients will pay when they arrive.” Success in all aspects of billing often comes down to the processes an ASC puts in place, Overton-Geise says. “Ensure staff know how to gather all necessary information for a claim. When you have payers that require invoices to cover implants, the ability for billers to quickly put their hands on those invoices is vital for avoiding delays. A good cod- ing compliance program is critical. Cod- ing must be performed accurately or you can lose a significant amount of money and never realize it.” With strong processes in place, claims get out the door fast, Overton- Geise says. This, she says, is critical to getting paid promptly and having enough time to appeal denials or sub- mit additional information requested by payers. “If your average days to bill is higher than three, you likely have a problem. Either your doctors are not dictating fast enough, or your billing and coding is delayed. Your workflows should allow the business office to com- plete what it needs to without encoun- tering significant, recurring kinks.” Ebert says getting to such a place requires a focus on staff training. “We

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