Four Ways ASCs can Leverage Pre-Service Functions to Improve Revenue

Recent data highlights a significant shift from inpatient hospital settings to ambulatory surgery centers (ASC). Why? Advancements in minimally invasive surgical techniques, cost-effectiveness, and patient preferences for outpatient care. In fact, experts expect the ASC market to grow by 21% to reach $55.3 billion by 2029. Outpatient surgical volumes are projected to reach 109.6 million cases by 2033, which represents an 18% increase from 2023 levels. And in the second quarter of 2024, there were more than 6,300 Medicare-certified ASCs nationwide. All of these changes point to the growing importance of ASC revenue cycle management, particularly the front end of the ASC revenue cycle.

As more patients receive their care in ASCs, these in-demand entities must have processes, and the supporting labor, in place to manage pre-service functions efficiently and effectively as patient volumes increase over time. Without a sustainable and nimble strategy for ASC revenue cycle management, ASCs run the risk of losing revenue and being unable to thrive in a highly competitive marketplace. Fortunately, investing in front-end processes now can set ASCs up for long-term success. More specifically, optimal pre-service functions can:

1. Accelerate prior authorizations, improve cash flow. ASCs handle a broad range of procedures and often deal with multiple payers, each of which may have varied and nuanced prior authorization requirements. Delays with prior authorizations can cause procedure cancellations or postponements, both of which negatively impact revenue and patient satisfaction. Focusing on timely prior authorizations in ASC revenue cycle management helps ASCs prevent denials and revenue disruptions while simultaneously ensuring patients receive the care they need without having to wait and/or reschedule the procedure entirely.

2. Enhance patient communication, satisfaction. ASCs often function with minimal administrative staff charged with performing insurance verification, patient intake, and scheduling as well as collecting patient payments simultaneously. Managing complex workflows in ASC revenue cycle management can cause fragmented patient communication that leads to misunderstanding, dissatisfaction, and no-shows. In addition, the high volume of back-to-back procedures in ASCs introduces the opportunity for scheduling errors (e.g., double booking) and omissions (e.g., failing to book procedures) that frustrate patients and providers alike. 

Promoting accurate staffing ratios in ASC revenue cycle management ensures patients receive the level of customer service they deserve regardless of whether they have a question about scheduling a procedure, understanding insurance coverage and financial obligation, signing up for a payment plan or financial assistance, complying with pre-operative instructions, and more. This enhanced communication throughout the front end of the ASC revenue cycle ensures patients show up where and when they need to and are prepared to undergo their procedures safely. High-quality communication also promotes a better overall patient experience which can lead to additional referrals, favorable online reviews, and reduced patient accounts receivable.

3. Improve data, revenue integrity. Overworked ASC revenue cycle management staff may make mistakes when collecting demographic and insurance information. These errors, in turn, can cause costly denials and require significant rework to ensure payment. Promoting accurate staffing ratios can reduce errors and help ASCs maximize revenue.

4. Drive process improvement. When ASCs don’t recognize the critical role of pre-service functions in overall ASC revenue cycle management performance, they miss out on valuable opportunities to enhance revenue and operations. Tracking and improving these metrics related to the front end of the ASC revenue cycle helps promote data-driven decisions and drive process improvement:

•    Days to schedule
•    Patient no-show rates
•    Patient satisfaction rates
•    Percentage of prior authorizations received on time
•    Upfront collection rates

Making the case for investing in the front end of the ACS revenue cycle

Improving front-end processes ultimately leads to:

 •    Better patient experiences
 •    Fewer cancellations and delays
 •    Higher staff productivity
 •    Improved cash flow and ASC revenue cycle management
 •    …and more

Want to learn more about how to leverage pre-service functions to improve overall ASC revenue cycle management and performance? Contact Global Healthcare Resources for more information about how ASCs can enhance the patient experience and maximize revenue using data- and KPI-driven patient call center services in the front end of the ASC revenue cycle.