Situation The Robert Wood Johnson Endosurgical Center, located in East Brunswick, NJ, is a 6,800 square foot, state-of-the-art ambulatory surgery center offering the highest quality of care with the most advanced medical technology and equipment. A joint venture among Regent Surgical Health, local physicians and Robert Wood Johnson University Hospital, the center offers fully equipped operating rooms, a recovery room, a post-recovery room and a spacious waiting room. To meet growing demand and streamline its financial operations, the RWJ ASC in 2013 began looking into revenue cycle management solutions that would strengthen the facility’s cash flow, standardize administrative and coding processes, lower denial rates and maximize revenue. Regent’s Solution Working with its joint venture partners, Regent in 2013 began developing a comprehensive revenue cycle management solution that would arrange for payment prior to the date of service. Using Regent’s management information system, the solution would allow staff to instantly verify benefits before procedures are performed. It also would allow the ASC to capture important patient documents such as drivers’ licenses and insurance cards in one central database. Other Regent RCM recommendations included:
- Patient Financing: Cost-sharing efforts mean many insured patients are now responsible for a significant share of their medical costs. Regent proposed a turnkey financing option designed to reduce collections, increase patient satisfaction and improve cash flow
- Coding: Looming ICD-10 implementation, training and compliance is forcing many healthcare providers to rethink their coding strategies. Regent proposed partnering with a third-party coding specialist to process all of the ASC’s cases
- Lockbox: Labor-intensive, manual payment processing remains standard in many facilities. With RWJ ASC processing more than 500 checks per month, Regent proposed a HIPAA-compliant solution that would streamline the process and shorten the ASC’s revenue cycle
Results Once Regent’s RCM recommended solutions were implemented, the results were almost immediate, RWJ ASC Business Manager Linda Reid said. After a review by Regent’s RCM experts, several existing claims were immediately resubmitted, including a $12,000 initial payment that was later reimbursed for $30,000. Several other RCM successes included:
- Enhanced contract negotiation: The collaboration between RWJ and Regent resulted in increased negotiated rates for the RWJ ASC
- Expedited coding and billing: Third-party certified coding specialists allow RWJ ASC physicians to review codes within 24 hours. Operative reports are reviewed by the coding specialists, and diagnosis and billing codes are submitted to the center and the physicians’ offices using virtual private network. HITECH ACT and HIPAA regulations are followed. This process ensures uniformity in medical documentation and billing for both the ASC and the physicians’ offices. Subsequently, patient bills are issued and paid more quickly.
- Improved staff efficiency: A new centralized patient software system reduces duplicative staff data entry and limits keystroke and billing errors. In addition, RWJ ASC’s new lockbox system streamlines the payment process, reduces payment posting time and provides an accurate snapshot of the facility’s daily finances
- Shortened revenue cycle: RWJ ASC’s lockbox system allows payments to clear in as quickly as 24 hours. Payments are received as soon as 48 hours with new flexible patient financing options, while improved patient check-out processes, also initially recommended by Regent, has improved cash flow.
“With Regent’s help, we’re collecting more revenue – and we’re doing it faster,” Reid said. “Even more, the relationship between our business office and Regent’s revenue cycle specialists are remarkable.” For more information on Regent’s RCM solutions, please contact Ed Tschan at firstname.lastname@example.org.