COVER STORY
Improve Your Revenue Cycle
Use key performance reports and benchmarking to enhance your bottom line BY ROBERT KURTZ
T
he ability to obtain detailed reports on revenue cycle performance is vital to maintaining an ASC’s financial success, says Gregory P. DeConciliis, CASC, administrator of Boston Out- Patient Surgical Suites in Waltham, Massachusetts. “You need to have some oversight
of all of your billing,” he says. “When you have the means to review key data points on a regular basis, you can catch when performance starts drifting downward or away from a benchmark, and then you can act on it. Report- ing provides an audit process that can certainly be helpful in spotting when things start going awry.”
The period of time that data col- lection and reporting is valuable in an ASC’s revenue cycle extends from the time a patient’s appointment is first scheduled through claim adjudication, adds Kenneth Bulow, group vice presi-
12 ASC FOCUS MARCH 2015
dent, revenue cycle, for Deerfield, Illi- nois-based surgical solutions provider Surgical Care Affiliates (SCA).
Three Categories To make the process more manageable, Bulow breaks revenue cycle report- ing into three categories: productivity, quality and inventory reporting. “After we schedule a case, we per-
form a complete insurance verifica- tion,” he says. “Productivity reporting looks at how many cases each teammate (staff member) verifies on a given day. The quality component assesses how well the verification was completed. The third is inventory, how many sched- uled cases still need to be verified.” ASCs, Bulow says, can carry this same concept through each portion of the revenue cycle as an effective means for monitoring performance.
“When billing teammates arrive in the morning, their unbilled cases are the inventory,” he says. “You can run a report to look at the teammates’ work over the last day, week or month, so that is the productivity compo- nent. Then you have the quality com- ponent—you can use reports to run a manual check, and you can also look at third-party and clearinghouse deni- als to determine billing quality.” From a follow-up perspective, Bulow
says the number of cases that need to be touched (followed up on) represents the inventory. “At the end of the day, the cases the teammates touched, that is the productivity. Quality is whether or not claims are getting paid and whether accounts receivable (A/R) is going down. At SCA, we review a report of the sta- tuses being placed on each case to pro- vide an indication of quality.” Bulow notes, “Most ASC patient accounting systems provide standard reports that capture the information required to monitor productivity, qual- ity and inventory. Begin with the inven-
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