by Plutus Health
Increasing revenue is crucial for medical practices to stay relevant and adequately funded. Updated technology has given ASCs the ability to perform more invasive surgeries. As a result, experts forecast growth in the ASC market for the foreseeable future.
The Center for Medicare and Medicaid Services (CMS) has recently committed to updating its ASC payment system. These updates are favorable to long-term income. However, ASCs must understand where to devote time and resources to capitalize on these changes.
Here are the top five tips for increasing ASC revenue in 2022.
Denial reduction is a timeless method of increasing revenue. Doing so requires strict adherence to standards. Make a habit of asking your patients about their benefits, making sure they are eligible, and performing prior authorizations before scheduling them for surgery.
Many patients don't know if their health plans are still active. If a patient's doctor was given prior authorization, ensure that the doctor is in-network and credentialed. If the procedure is going to be out-of-network, make sure you have a clear understanding of what the insurance will pay and the patient's responsibility.
When a patient gets the procedure performed and leaves your office, the chances of that patient paying a bill drop 40 percent. When researching benefits and eligibility, ask patients what their deductibles are. For those who have an overdue balance, ensure that they pay part of that balance before scheduling their next appointment.
Outpatient-surgery centers now perform procedures that hospitals once monopolized. Better technology and safety guidelines mean even mid-size ASCs can execute complex operations. However, many ASCs still perform limited surgeries and fail to use profitable alternatives.
Thanks to a 2017 ruling, ASCs can now receive Medicare coverage for more invasive cardiology, nephrology, and vascular cases. Experts suggest increasing high-acuity procedure volume will nearly double a mid-sized ASC's income. For example, an ASC could add a total joint program that boosts the center's monthly patients by 10 percent. In such a case, the practice would see a significant increase in income.
Before adding a new operation, ASCs must consult their state laws. Some states, such as Pennsylvania, require written notice months before adding a new procedure. Other states restrict procedure types that are common elsewhere.
Find a billing software that works well with your clearinghouse. Thankfully, many systems have free trial periods where you can test their suitability. Once you've settled on an appropriate system, ensure that the software is compatible with your most popular insurance agencies.
If you make it easy for your patients to pay for services, they'll be less likely to default. Financial technology (fintech) helps reduce the strain of bill paying. It lays out the reason for a charge and gives the payer an accessible way to pay. Depending on the system, fintech offers flexible payment plans. Adopt this technology to boost your patients' payment rates.
Many hospital patients are shifting from in-patient care to out-patient care. As a result, ASCs are receiving more traffic than ever before. However, practices must avoid a few common pitfalls when reaching this new consumer base.
Patients who once had quality insurance coverage may not have any under your system. Make sure to carefully review each patient's history and medical plan before committing to treatment. Also, adopt electronic health records to link with local hospitals. This setup will make transferring patient documentation easier.
Specificity in coding is crucial. Use ICD-10 and CPT codes to understand essential details. Failing to learn the difference between items can lead to a loss in funds. For example, using general terms for drugs instead of a specific analgesic may cost your practice. In the same vein, pay close attention to any code modifiers. Agencies like Medicare will deny claims that contain minor modifier inaccuracies.
Many ASCs consistently lose money through billing and coding mistakes. If your staff has this problem, hiring a professional billing service may be time. Plutus Health streamlines your practice's billing and coding to get the most out of each transaction. Our team of experts speeds up the reimbursement process while reducing denials.
1. Reduce the number of claim denials through strict adherence to standards.
2. Bring in more complex procedures to boost potential revenue flow.
3. Adopt medical technology to streamline processes.
4. Review hospital transfers' records and eligibility.
5. Be specific with medical codes and modifiers.
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