With rising labor and supply costs, increasing market consolidation, and ongoing charge capture challenges, ambulatory surgery centers (ASCs) are under more intense pressure than ever.
These steps can help ASC leaders unlock revenue opportunities and establish a competitive advantage.
Healthcare leaders widely acknowledge that revenue cycle management (RCM) is essential to an organization’s success, yet many are not fully satisfied with their current technology. The top issues are consistently inefficiency, missed charges, charge lag, and coding errors. Organizations report spending significant time on RCM tasks, and physicians often dedicate several hours each week to billing documentation.
Ambulatory surgery centers are currently facing changing market conditions – growing volumes, rising costs, ongoing consolidation – that make RCM and charge capture essential to financial and physician performance.
This article will break down the key issues facing ASCs and then provide a clear, actionable roadmap for improving your RCM and charge capture processes to ensure organizational sustainability and success.
Volumes and Reimbursement Are Growing
Several factors are driving reimbursement increases, notably rising volumes of procedures and changes to payment systems that benefit ASCs, including operating expenses and revenue. ASC leaders must remain vigilant in their financial management to fully capitalize on this growth.
ASC Medical Supplies, Equipment, and Labor Costs Are Rising
While volumes and reimbursement have increased, other challenges persist. Recent inflationary pressures have hit both labor and supply costs, with many centers reporting significant rises in expenses. At the same time, denial rates have increased, presenting a persistent pain point for leaders.
Ownership is Shifting to Health Systems and Health Plans
Health systems and health plans are acquiring hundreds of ASCs every year. High-profile examples of M&A activity in the space are indicative of a broader market shift. A significant portion of the market is now owned by large chains, while many ASCs remain under physician or joint ownership.
Four Persistent Charge Capture Challenges
These factors, combined with the nuances of the ASC environment, highlight four persistent challenges that must be overcome to ensure financial health:
- Inaccuracy: Failing to accurately capture charges can lead to denials, lost revenue, and frustrated patients.
- Inefficiency: Manual charge capture processes are time-consuming and labor-intensive, which can lead to errors and delays.
- Compliance: Complex and shifting regulations can also be a source of denials and lost revenue.
- Cost: Expenses associated with charge capture software and services can be a barrier.
The increasing shift in ownership is driving more intense competition, making it even more critical that the following challenges are addressed to avoid missing revenue opportunities, decreasing patient satisfaction, and failing to comply with payment regulations.
Five Steps to Improve Charge Capture and Performance
Despite the increased competition and ongoing challenges, ASCs have a distinct competitive advantage over health systems and health plans: the predictability of appointment-based care.
These 5 steps can unlock the benefits of that regular schedule:
Step 1: Improving KPIs with Analytics
Executives and clinicians need appropriate data and analytics to monitor performance over time and benchmark against industry standards. A sophisticated charge capture and performance solution displays key performance indicator trends in visual dashboards that teams can leverage to track and improve financial metrics.
Step 2: Optimizing Patient Collections
Issues at the beginning of the revenue cycle create a significant portion of denials and patients are responsible for an increasing percentage of revenues. That makes it critical to have robust processes and revenue cycle management tools in place to enhance revenue and prevent billing questions. This includes collecting thorough insurance information, obtaining all necessary prior authorizations, and informing patients about all existing payment options.
Step 3: Leveraging Digital Tools for Charge Capture and Coding
With experienced coders and billers in high demand, the costs of hiring and retaining those professionals are increasing. To minimize errors and optimize coding efficiencies, leaders can automate charge capture with a point-of-care solution that reduces time spent tracking and implementing coding changes. An effective solution should consistently capture charges, provide automatic prompts and intelligent code filters, include reconciliation capabilities, and support internal audits. Looking toward the future, the greatest potential value of artificial intelligence relative to RCM lies in areas like coding, eligibility/insurance verification, and denials prevention.
Step 4: Monitoring Payor Contracts and Renegotiating When Appropriate
With effective charge capture and coding in place, ASC leaders can drive financial improvements by informing themselves with the necessary data to re-negotiate payor contracts. Key considerations include reviewing payment terms, comparing fee schedules across payors, benchmarking denial rates, and rejected appeals.
Step 5: Benchmarking and Enhancing Physician Performance
It is crucial for leaders to have sufficient insight into physician productivity. The right charge capture solution can establish trust in the data for building comparative performance metrics that ultimately incentivize physicians to deliver better health outcomes and reduce costs of care. Executives can readily identify high-performers and address any outliers as needed to drive overall improvements across the organization.
The shift toward outpatient care offers a massive opportunity for ASCs, but that growth is meaningless if it’s eaten away by rising labor costs and sloppy billing cycles. Staying ahead of the competition—especially as the market consolidates—requires more than just working harder; it requires smarter tech that actually works for clinicians rather than against them.
This is where the right partnership makes the difference. Born out of Emory Healthcare in 1999, Ingenious Med was built by physicians who understood these frustrations firsthand. Twenty-five years later, we’ve evolved into the industry’s most trusted charge capture platform. By using our AI-driven TRIO bundle, your center can finally eliminate charge lag and let your team focus on what they do best: patient care. Click here to see how we can help you capture every dollar you earn.
Written by: Ingenious Med, in collaboration with Sage Growth Partners