Ambulatory surgery centers, or ASCs, are gaining popularity as many patients prefer to get surgery outside a larger, traditional hospital. Housing surgeries ranging from minimally invasive laser eye procedures to complex spine operations, ASCs have witnessed massive growth in the past five years, with the market size forecasted to surpass $117 billion by 2027. ASCs can provide same-day surgical care and have completely rewritten the surgical outpatient experience, attracting new patients with ease of care and lower risk of infection. With the growing demand for multispecialty ASCs, administrative staff must be armed with the best health tech solutions to help keep pace with the increasing number of patients flooding in to seek care.
ASCs need a strong revenue cycle management strategy that can move at a fast pace and keep up with increasing patient demand. Without a revenue cycle partner, ASCs are poised to face a number of challenges, including:
Integrated system requirements and lack of automation across the revenue cycle to handle high claim volumes
Constantly changing coding and reporting guidelines
Revenue recovery attempts chasing out of network payer payments directed to patients
Increase in denials and appeals
Increasing costs and lower reimbursements
Difficulty keeping up with price transparency regulations
By automating the revenue cycle, ASCs will be empowered to overcome these obstacles that have constantly undermined billing processes.
For ASC’s, prior authorization denials are extremely time-consuming , partially due to a lack of standardization among payers. The process can be a source of frustration for administrative staff and without timely and accurate execution, will bog down RCM efforts and impede bottom lines. It takes time to learn which services are considered medically necessary, which require prior authorization, and which require referrals. Establishing a protocol to consistently document data required for prior authorization in the medical record will help prevent claim denials. Likewise, streamlining the process by using digitization or electronic authorization to stay within the bounds of medical necessity will support the revenue flow of ASCs. Automating the prior authorization process will flag claims with discrepancies, ensuring claims with unauthorized billing codes are not sent off without a final review.
The health care industry has been ravaged by employee burnout, and ASCs will not be able to keep up with the expected growth if workers aren’t available. Taking measures to ensure that workers are well supported by their revenue cycle partner is critical. A revenue cycle partner will provide ASCs with better data management capabilities, enabling administrative workers to make more precise and timely decisions. Automated revenue cycle management can easily streamline tasks that previously created massive bureaucratic pileups for health care workers. The ever-changing regulations and complications of the health care billing process have also made it even more challenging for administrative workers to take on billing tasks successfully. A revenue cycle management partner enables ASCs to minimize wasted staff time, supporting a positive employee experience that increases retention while creating an attractive workplace for new employees.
It goes without saying that a revenue cycle management platform will improve billing and collections, but there are so many other positive impacts that automating the revenue cycle can have. By automating the revenue cycle, ASCs will be able to:
Identify denial trends with machine learning to identify complex patterns and automatically make sense of why your claims are getting denied. ASCs can reduce the amount of denied claims they see and boost their bottom line profitability. A claims denials management offering is crucial for providers seeking a revenue cycle partner.
Improve the patient experience by avoiding any confusion that improper billing practices may cause. Streamlining the collections process for your staff will, in turn, improve the billing process for your patients.
Track KPIs by boosting visibility on crucial business metrics through enhanced data capturing and analysis. ASCs, with the help of an automated revenue cycle, can identify inefficiencies in their operations that require further automation.
Administrative workers in ASCs no longer have to battle with input errors and denied claims; automation can take the wheel. Take the burden off your administrative workers by choosing the right revenue cycle partner. Contact us today to learn more about how SYNERGEN Health's deep domain expertise can help you investigate the opportunities for intelligent automation in your organization. https://www.synergenhealth.com/contact