Qualities to Look for in an ASC Revenue Cycle Management Company
By Caryl Serbin, RN, BSN, LHRM
What should you look for when considering outsourcing your ASC's billing to a revenue cycle management (RMC) company? All billing companies purport to offer similar services, but how they deliver these services and what you are actually receiving for your money differs greatly.
The following is a list of services you should, at a minimum, expect from an RCM company:
Coding
Claims submitted within 24-48 hours after receipt of necessary billing information
Oversight of claims processing through the clearinghouse and verification of receipt by payer
Collection activity begins within 15 days of submission and continues regularly thereafter
Payment posting completed within 24 hours of receipt of payment
Immediate follow-up of denials or incorrect payment
Regular patient statements
In addition to the services listed above, Serbin Medical Billing offers the following value-added services at no additional charge. These supplementary services help change the relationship between our company and clients from service provider/service recipient into a true partnership.
Value-Added Services:
All coding performed by certified coders whose credentials can be authenticated
Evaluate fee schedule and make recommendations; notify center of any required changes
Educate center regarding upcoming changes (e.g., Medicare or managed care organization reimbursement)
Assess and update third-party payer contracts, as necessary
Provide complete, real-time transparency of all coding, billing and collection transactions and access to reports
Reports are CFO/CPA verifiable
Provide special reports, when needed (e.g., payer trends, comparison to national benchmarks)
Assist in state reporting, where required
Provide ASC with detailed business office policies, procedures and forms which meet regulatory compliance guidelines
Assist in recommending solutions that can help streamline workflow, such as verification products, banking options, patient payment services and billing software
Make recommendations on hiring business office staff and provide detailed job descriptions for those positions
Assist in billing software setup, loading of contracts and fee schedule and updating necessary data tables
Identify and provide educational resources for staff, including physicians, based on denials of claims received
Provide unmatched customer service and maintain consistent and reliable communication
Additionally, Serbin Medical Billing has the following safeguards in place:
Continuing education concerning CPT, ICD-10 and HCPCS for applicable staff
Written and enforced compliance and HIPAA plans, with continuing education in-services for employees
Red flag policy (identity protection)
Written ASC-specific coding and billing policies and procedures
Disaster plan identifying how data is protected during emergencies
When researching ASC RCM companies, be thorough. Make a checklist and ensure the companies you interview offer all of the services you want and need — and make sure you get the services offered and promised in writing.
