Outsourcing ASC Revenue Cycle Management: Key Considerations and Questions

When you’re contemplating outsourcing your ASC's revenue cycle management (RCM), here are some key considerations and questions you should ask about any company you are considering as a partner:

• How much experience does the company have? Is it ASC-specific experience?

• Is the company experienced in your ASC’s specialties? Get references from other ASCs they serve.

• Is all work performed in the United States?

• Does the company outsource any of its work to other companies or countries?

• If coding is included, does the company use certified coders?

• Does the company have an ongoing education program for their employees?

• Does it have a written compliance/HIPAA plan?

• Does it have written policies and procedures? Ask for a copy.

• Is the company properly insured?

• Does the company understand managed care contracts? Fee schedules?

• What reports does the company provide? How often?

• Concerning transparency, can you see what is going on with your patient accounts at any time?

Questions to ask the company include:

• Where does the billing service’s responsibility end? What responsibilities are to be performed by the ASC?

• How many times do you appeal claims? Once? Twice?

• How aggressive are you in resolving contract disputes?

• How are financials recorded? Note: Be sure the billing service and accounting service align with your ASC’s policies and procedures dictate.

Review the proposed agreement thoroughly and question any areas of concern. It is advisable to have your ASC’s attorney review the agreement.

Not all surgery center RCM companies are equal. Do your homework before signing on the dotted line.

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