With facility operating costs continuing to rise and the continued trend of lower reimbursement rates, facilities cannot afford to leave money on the table. Improving efficiency at each step of the revenue cycle process – Transcription, Coding, Billing, Payment Posting, and AR Follow-Up – can help you achieve the highest reimbursement and position your center for long-term success.
In this paper, we share key insights around an end-to-end solution that will maximize the accuracy and efficiency of your entire revenue cycle process. If you are weighing the benefits of a revenue cycle services partner, keep reading to understand how having a structured & proven solution will provide an organized workflow; ensuring clean claims are submitted and leading to faster processing times with fewer denials.
To select a full-service revenue cycle partner, ensure your provider meets four key criteria:
- Industry Experience
- Reporting & Analytics
- Seamless Integration
- Dedicated Service
The first step to selecting a partner is ensuring that a billing provider’s knowledge is relevant to your specific needs. Ask and verify key details such as:
- Do they have experience with billing for multispecialty Ambulatory Surgery Centers?
- Will they review your contracts & fee schedules, and analyze your AR?
- Do they have experience with in-network and out-of-network payors?
A billing company that knows the industry and has the ability to address your specific needs will deliver increased revenue and the highest possible reimbursement.
It is important to choose a billing company that is comprised of seasoned Coding Specialists, Billers and Collectors with extensive ASC experience. Understanding nuances related to LCD’s and payor-specific guidelines is critical to ensuring efficient claims processing. Additionally, possessing a knowledge of in-network and out-of-network payors is extremely valuable and can help provide guidance when negotiating in-network contracts or one-time agreements.
“Having industry-specific expertise and a firsthand understanding of the day-to-day needs of your facility allows us to take a hands-on approach and operate as an extension of your business office.”
Measurement is key to improvement. Knowing how a potential revenue cycle partner tracks, analyzes, and reports important metrics is critical.
- What are their KPIs?
- What are the standards they use to measure success – claim submission turnaround time, days in A/R, clean claim & denial rates?
- Do they aggressively and thoroughly follow up with payors to ensure claims are reimbursed at the maximum rate?
- Is outstanding AR being addressed in a timely manner to avoid delinquency?
Tracking these performance metrics is crucial to eliminating billing errors and ensuring full payment for services performed.
Maintaining full compliance with payor policies and the National Correct Coding Initiative (NCCI) is essential to maximizing your revenue cycle’s performance. Understanding the latest guidance will provide valuable insight into industry trends, which are key in helping you grow the financial health of your facility.
Keys to Success:
Accurate Coding – properly coded claims will significantly increase your first pass rates and lead to receiving full payment on initial submission
Low Days to Bill – constantly monitoring your average days to bill will assist in achieving your goal of submitting claims as quickly as possible
Aggressive & Persistent Collections – relentless follow up produces lower days in AR, allows for timely resolution of claims and reduces unnecessary write-offs
Trend Analysis – examining trends that lead to denials or delays in payment can prevent losses in revenue
Ideally, your billing partner should have an integrated workflow that allows you to connect all the pieces of your revenue cycle. How do you see them fitting into your current operations? What would the learning curve look like for your staff? Is the billing company flexible and willing to adjust their process to fit the needs of your center? Having an adaptable billing partner that can work within your current system and mold itself to your specific needs will guarantee a seamless transition.
Having a team of experts to assist with the transition allows you to identify weaknesses and areas for improvement, while maintaining the aspects of your revenue cycle that are working well. Whether it be working within your current software or providing recommendations for improved systems/workflow, understanding what works best for your center(s) is key.
Companies that provide complete revenue cycle management services, including Transcription, Coding, Billing and Collections, are best equipped to deliver immediate success. A billing partner must understand the details of your business from start to finish in order to maintain accurate checks & balances. This will make it easier to perform detailed reconciliations to ensure that you are paid on all services rendered, while also helping to achieve greater efficiency, transparency, quality, productivity, and most importantly higher reimbursement.
When evaluating an RCM partner, the quality of customer support that they provide should be a key determining factor. You should never have to hesitate to call on them for assistance. Use the following questions as a guide to understand if your revenue cycle partner is dedicated to delivering exceptional service:
- Do they offer a dedicated support team via live chat, email, and/or phone?
- Is someone always available to help you?
- How quickly do they respond?
- Do they provide clear answers to your questions?
Having a billing partner that is detail oriented and provides an excellent client experience will help improve and maintain the financial health of your business.
“At MedTek, we believe that the key to success is understanding our clients specific needs and then working tirelessly to exceed their expectations.”
If you are looking for a trusted billing partner with industry experience and a dedication to service excellence, we are here to help.
MedTek is a leading provider of RCM Services for Ambulatory Surgery Centers, Hospitals, Clinics and Specialty Groups nationwide.
To learn how MedTek’s Revenue Cycle Edge leads to an average reimbursement that is 10 days faster than the industry standard, email or call today.