Common Ambulatory Surgery Center (ASC) Challenges This Year

The coronavirus pandemic left many outpatient surgery centers financially crippled. Elective surgeries dropped dramatically across the U.S. There are still pandemic concerns to overcome in 2021, but many see it as a positive year. Now, more people are opting for outpatient surgeries. 

Ambulatory Surgery Centers (ASCs) have a brighter future, thanks to outsourcing their medical billing services, but many are still facing challenges. Here are some of them:

• Calling off schedules

Rescheduling elective surgeries may not always happen because of the expense. Patients sometimes have second thoughts and cancel. ASCs have to identify what is causing cancellations and take appropriate steps to fix it. There are two ways to cut it:

1.  Communication Planning– constant update on the health care process before and monitoring their medical progress after.
2.  Patient Financing – offering safe loans to support their surgical fees.

 These should help lessen drop schedules, volume up elective procedures, and increase cash flow.

• Keeping track of payer contracts

ASCs must constantly monitor payer conditions, security in healthcare, bundled fees, advance medical care, or Local Coverage Determination (LCDs). These are some suggestions from the American Association of Orthopedic Executives (AAOE) :

• Write notes of all changes to your contracts and the date they expire.
• Think about a combination of direct and complementary commercial payer agreements.
• Advise payers why joining their network would benefit them – emphasize unique benefits of the surgical center services, clinical/treatment benefits, and out-of-network patient numbers and referral sources.
• Know how payer conditions work.
• Make sure to focus on any concerns regarding contract language.

• Maintaining coding changes

ASCs must track Current Procedural Terminology (CPT) codes and ICD- 10 codes. As of January 2018, the American Medical Association (AMA) published 170 new codes, rewrote 60 codes, and deleted 82 codes. ASCs should be conscious of annual changes and implement them. They should update their software system with these new codes. ICD- 1- codes are also updated every October. Indeed, medical coding companies can assist in keeping track of code changes. They can also assure of implementing codes to remove mistakes in submissions. Moreover, they provide precise medical billing to gain maximum reimbursement.

• Total Accumulation Days in Accounts Receivable (A/R)

The average amount of time it takes for your ASC to receive refunds is called Days in Accounts Receivable (A/R). Ideally, days in A/R will be in the range of 30 to 40 days, but no more than 50. Consequently, the lower the amount, the faster you will receive payment. These are the usual tasks that affect A/R days:

• Organizing procedures, 
• Pre-registration system for patients, 
• Verification of insurance, 
• Financial counseling for patients, 
• Payment plans for patients
• Invoices of patients

Days in A/R are a great measure of performance for ASCs. Moreover, patients will be able to pay within a few days by implementing a patient financing solution.  

• Allotted budget for Personal Protective Equipment (PPE)

The prices of medical supplies are consistently going up as the pandemic lengthens. As a result, ASCs will continue to spend more to keep a stock on hand and secure new protective equipment. The primary medical supplies in need are:

• Facemasks (N95 masks)
• Alcohol
• Gloves
• Eye protection glasses
• Lab gowns

To accommodate these supplies, ASCs will need to adjust their budgets without seeing a rise in reimbursement rates.

• Lack of Growth of ASCs 

As a result of preventive measures like social distancing, PPE, or lack of supplies, surgery centers find it increasingly difficult to meet daily production goals. In addition, some patients lack insurance or the funds to undergo elective surgery because of job loss. The growth of ASCs may require additional services, partnering with employers, or accepting alternative payment plans.

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