Situation The Advanced Surgery Institute, located in Santa Rosa, Calif., is a joint venture ambulatory surgery center partnership among Regent Surgical Health, area physicians and Santa Rosa Memorial Hospital, a 278-bed facility affiliated with St. Joseph Health. With continued growth across specialties including orthopedic and spine surgery, pain management, plastic surgery, cardiology and podiatry, ASI’s management team in 2013 began exploring a comprehensive revenue cycle management solution that would address all of the facility’s coding, billing and collections functions. Reducing the number of days in AR was considered a key priority by the facility’s management team. Regent Solution During the past three years, ASI has outsourced its billing operations to Regent on three separate, temporary engagements. Impressed with Regent’s results, the facility’s leadership team in 2014 solicited a proposal to address all aspects of the ASC’s revenue cycle, including:
- Core RCM functions: An extended revenue cycle can place considerable strain on an ASC’s ability to stay in business. Regent recommended a new model that included utilizing its expertise in the areas of billing, payment posting, insurance and patient follow-up
- Patient Financing: Cost-sharing efforts mean many insured patients are now responsible for a significant share of their medical costs. Regent recommended a turnkey financing option designed to reduce collections, increase patient satisfaction and improve cash flow
Results ASI adopted Regent’s recommended RCM solutions in July 2014. Since then, the results have been dramatic, says Ann Hurd, RN, Advance’s administrator and director of nursing. Regent’s RCM team was able to reclaim payments that were previously written off and AR aging has improved significantly, she says. Highlights of Regent’s work also included:
- Accounts receivable: Regent’s streamlined AR processes significantly increased cash flow. Within one year, Regent reduced the days in AR by over 15%. A recent audit revealed the center also is resolving 100% of patient balances within 60 days.
- Claims appeals: Regent proposed a systematic approach to appealing denied and underpaid claims from payers. The new procedure has increased overall revenue by 31 percent
- Cash Collections: In the month of October 2014, Regent had the second highest cash collection month in the five years the center has been open. The October 2013 collections were 54% higher than the five-year average, and 45% higher than the 2014 monthly average
“Regent’s RCM team provided an all-in-one solution for monitoring and managing our ASC’s cash flow,” Hurd said. “Their ability to work closely with payers and patients also gives us more time to do what we do best: treating patients.”