National Medical Billing Services attended and participated on several panel discussions at the Becker’s ASC 26th Annual Meeting: The Business and Operations of ASCs in October. National Medical’s Vice President of Clinical and Regulatory Affairs Kylie Kaczor, along with Michael Graziano, Administrator for Clifton Surgery Center and JoAnn M. Vecchio, Administrator for ASC of WNY discussed how to improve billing and collections.
• High deductible health plans. People tend to select high deductible plans because it is less out of their pocket every month. However, they end up with deductible that they are unable to pay. One recent study shows that roughly 70% of patients are not paying their financial responsibility once services have been provided. That forces the surgery center to shift the focus to pre-service or time-of-service collections.
• Patient education. The last time people regularly had insurance coverage that was no deductible/100% coverage was 20+ years ago. Patients have become one of the primary payers in our space today. But most patients do not understand their plans. Starting the education process at the very beginning to make sure they’re informed on what their financial responsibility is going to be, so they’re not surprised, is key. Automation tools are available to help determine patient eligibility and patient responsibility. These tools provide documentation of exactly how those numbers are generated and that allows you to walk the patient through his financial commitment.
• Payment options. Changing the culture of patient financial responsibility to make it a more collaborative process. Have the conversation. Say, “This is what you owe. How can we help you?” There are financing options available. Having policies and following them and applying them consistently will protect you in the regulatory landscape. Routinely waiving copays and deductibles, offering discounts and professional courtesies are not the routes to go. You may want to explore financial and medical indigency and implement those types of policies.
• Pros and cons of outsourcing coding and billing
o In house can be beneficial because the coders get to know and understand the center works. The codes change on a yearly basis if not more frequently and more complicated procedures are coming into the ASC space so there is the potential for lost revenue.
o Third-party audits are great opportunities to evaluate how the ASC is doing. A fresh pair of eyes with expertise in that ASC’s specialties can help make sure you are not losing revenue.
This post was first published October 23, 2019 and was updated July 29, 2020.