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Best practices to get ASC’s next practices revenue
With the Patient Protection and Affordable Care Act insurance policies that now require stricter
verification of coverage details, and changes in allowable, deductibles co-pays and various prior
authorizations required, the Ambulatory Surgery Center reimbursements have been affected. Besides
these increased regulatory pressures and changes to private insurance coverages, they also face
inequitable treatment as compared to their HOPD counterparts. Further, the ASC reimbursements are
being impacted by their performance on five quality measurers under the CMS’ ASC quality Reporting
Program, which has been effective with the CY 2014 payment determinations. Hence, although investing in
ASCs is known to improve a physician’s lifestyle providing an ancillary income for their practice; and where
CMS and private players pay more when ASCs tend to provide specialty care services; the need for a
strategy to increase revenue, eliminate inefficiencies, and create effective processes, is still essential.
Following the below best Practices can push up the next source of revenue for ASCs:
Review your policies and procedures: It is essential in these changing times of healthcare reforms and
ICD-10 coding and billing system, workflow is efficient. Verification and eligibility checks are essential and a
patient payment policy in place. Also work closely with patients so that they understand the new policies
put in place that affects them
Review contracts & Workflow efficiency: Check out all underpaying policies, review procedure codes,
work closely with billers, and add services that can complement your revenues. Lack of follow up on
contracting renewals and amendments can turn out to be a costly affair. Cross-training staff and
employment of part-time staff, is a good way to increase efficiency at work
Budget for income: With the changing Medicare allowable, sequestration and PPACA multilevel coverage
policies, and seasonality of business, one needs to plan the entire year much in advance, as some quarters
will be better than others. So it is very essential to keep revenue reserves

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Enhance Documentation: With the new ICD-10 coding and billing system, documentation is very critical.
This also helps in denial claims, as proof is readily available for resubmission. So learn to start putting in
documentation as fine-grained as possible. Electronic Health Record (EHR) & Electronic Procedure
Documentation (EPD) software are essential in today’s changing healthcare climate. Analysis of the
situation before deployment is critical.
Employing Right Technology: It is always a good practice not to accept manufacturer claims at face value.
Adding new equipment and procedures is beneficial but it is always wise to spend the dollars. Do check
with colleagues and review studies carefully. When you join Group Purchasing Organizations (GPOs), that
have greater negotiating power with vendors, and demand for better rates, you can save a lot in terms of
expenses and effort.
Patient Satisfaction: One must see that the experience for the patient must be excellent and referrals
encouraged. The latter can be pushed in two ways: a) by hiring a part-time marketing representative who
can interact with the referral sources, keep in touch and bring in that personal touch which brings in
significant ROIs down the pipeline; b) patient referrals word-of-mouth is the most powerful and effective
way to increase the revenue of your practice.
Against this changing background of increasing costs, downward slide of reimbursements, and regulatory
scrutiny, ASCs following certain time honored best practices integrated with new technologies and
procedures will help in the next step forward towards increasing their medical revenue cycle management
needs for a more effective patient satisfaction.