By Angela Mattioda, Sr. Vice President of RCM Solutions & Client Experience
When partnering with an ASC billing company to provide revenue cycle management
(RCM) services for your ASC, it is critical that you work closely together
to build a strong foundation of trust and transparency. There are many
facets to the RCM process. Optimized performance requires the surgery
center and RCM provider to collaborate as business partners. Through a
successful partnership, the ASC billing company will eventually feel like
an extension of the facility's business office and not just a vendor
Below are the responsibilities for an ASC that will better enable you to
achieve such a partnership — one that will lead to improvements
in performance results, meeting and exceeding cash goals, and establishing
the level of trust needed for a long and healthy business relationship.
Following the discussion about these responsibilities is a section outlining
what an ASC should expect from its billing partner.
ASC Partner Checklist
1. Communication — Communication is the cornerstone to a strong relationship. It
is critical for an ASC to maintain open communications with their ASC
billing partner — and vice versa.
2. Share knowledge — Nobody knows your ASC better than your center's staff. Here
are examples of key information that should be shared by you with your
Contract changes. It is important for your partner to know if there are any contract changes
or renegotiations so those changes can be updated in the practice management system.
Staffing changes or interruptions. Whenever there are any noteworthy changes to staff who collaborate directly
with your ASC billing partner, this should be communicated to your partner
as soon as possible. Examples of staff changes include turnover and time-off.
Challenges. Any RCM-related challenges that the ASC has faced in the past or is expecting
to face in the future should be shared with the partner.
Leadership concerns. Specific concerns from the board and/or providers should be shared so it
is on the billing partner's radar.
New physicians/new procedures. Keep your partner informed about significant developments that will affect
coding and billing.
3. Be open-minded — Sometimes when you are working with a new ASC billing partner,
its team will suggest changes to some of your processes. Keep an open
mind about these changes and listen to the reasoning for suggestions from
your partner. These recommendations are likely based on their experience
and expertise. Both partners should be open to accommodating each other's
needs to the best of their ability.
4. Embrace review meetings — Come prepared and be actively involved with your ongoing performance
review meetings that focus on the overall health of your center. Some
- Avoid canceling meetings. They are critical to maintaining a strong partnership
and ensuring everyone is on the same page concerning your ASC's performance
- Communicate openly. Share your concerns and ask specific questions about
your center's performance.
- Be prepared. Review the monthly reporting in advance so you are equipped
to ask specific questions or discuss key topics. This will help you achieve
a highly productive meeting.
5. Ask for feedback — Create a transparent relationship with your RCM partner. In all
partnerships, openness and collaboration is essential to identifying potential
obstacles that should be addressed immediately. Always seek your partner's
opinion on how you can improve the working relationship. Examples of what
you can ask your partner:
- Is the center staff being responsive to requests to get claims paid timely?
- Is there anything that we could be doing better to help optimize our production?
- Are our providers dictating and responding to queries in a timely manner?
Feedback should work both ways to help ensure a smooth and consistent partnership.
Expectations of Your ASC Billing Partner
1. Trust from the start — The right ASC billing partner will be focused on building a foundation
of trust with your ASC and its staff. As noted, the billing company should
act like it's an extension of your center's business office. Below
are additional key steps you should expect your partner to take:
- Get to know your ASC by understanding its past performance, challenges,
metrics, benchmarks, and staff.
- Embrace its role as the RCM expert.
- Provide results-driven analytics.
- Create goals that both partners can achieve.
- Make it easy for your ASC leadership to understand the status of its accounts
receivable (AR) so they can answer questions from managing partners without delay.
2. Communication — Your ASC should not be expected to find billing issues and bring
it to your RCM partner's attention (although you should keep an eye
out for potential concerns). Here are a few steps your ASC billing partner
should take to ensure consistent and beneficial communication:
- There should be a minimum of one monthly call to review your center's
performance. A monthly review should include a review of valuable and
meaningful data that show the progress toward previously defined benchmarks
and goals as well as a discussion of the health of the entire RCM performance.
- Your RCM partner should provide full transparency into your data and performance.
This is imperative to achieving and maintaining a high level of trust.
Processes can break down, issues can arise, and human error is inevitable.
Your partner should be willing to communicate the good, the bad, and the
ugly, and it should have a plan to build on the good and a plan to address
and reverse the bad and the ugly.
- Any issues discovered that impact workflow and cash flow should be quickly
communicated by your RCM partner. The partner should come prepared with
recommendations and not rely on you to produce solutions. If there are
several issues being tracked (e.g., insurance verification/authorization
problems, medical necessity challenges, denials, contract discrepancies),
the billing partner should host frequent meetings to keep everyone on
the same page and maintain momentum toward achieving improvements.
3. Expectations — Your RCM company should set clear and concise expectations from
the start of your partnership. This is vital to building a long-lasting
relationship. Steps that an ASC billing partner should take to help achieve
a thriving partnership:
- Discuss process improvements to ensure best practices are utilized.
- Lay out the areas that may be affecting your cash flow and provide expertise-driven
recommendations for improvement.
- Collaborate to make the necessary changes to improve overall performance.
- Follow through on what it says it's going to do for your ASC and do
so in a timely manner.
4. Meet deadlines — An ASC billing partner should make it a priority to meet mutually
agreed upon deadlines. Here are ways the right partner will support your
ASC in identifying projects to tackle and accomplishing objectives:
- The partner will respond in a timely manner to outreach by your ASC.
- If research is needed in response to a question, the ASC billing partner
will let you know that its team is working on getting you an answer and
tell you when you will hear back. The partner will then follow through
and get back to you with the response on time.
- The partner will always follow through on its commitments to requests,
projects, and questions asked.
- When commitments are made, the partner will document them and ensure they
remain as open tasks until work is completed as expected.
To learn more about what you should expect from an ASC billing partner,
request a copy of our new e-book.