Outpatient Surgery Volume: Resolving RCM Challenges

I n 2024, CMS significantly expanded the list of ASC-covered procedures. As these procedures shift to ambulatory surgery centers (ASCs), revenue cycle management (RCM) hurdles continue to multiply.

These facilities must manage the increased volume of procedures, navigate the complexities of billing and coding, and deal with payer contract variabilities. In this blog, we’ll share essential tips on how ASC leaders can address these rising challenges.

Identifying Compliance Risks

The regulatory and operational complexities associated with the expansion of ASC-covered procedures can significantly impact RCM processes. It's crucial to understand the potential compliance risks that come with increased procedural volume and complexity.

Strategies for Success

To effectively address and mitigate these compliance and operational challenges, ASCs should consider:

  1. Enhanced Training Programs: Regularly updating staff on new procedures, billing codes, and compliance requirements.
  2. Standardized Processes: Implementing standardized protocols for billing and coding to reduce errors and streamline operations.
  3. Payer Contract Management: Developing robust systems, or working with a partner, for managing payer contracts and ensuring accurate reimbursement.

Leveraging Emerging Technologies

ASCs can also leverage new technologies to boost the efficiency and accuracy of their RCM processes. Advanced software solutions can automate coding, improve claim accuracy, and provide real-time analytics for better decision-making.

At MEDTEAM, we are committed to helping ASCs navigate these challenges with innovative solutions and expert guidance. By staying ahead of regulatory changes and leveraging technology, ASCs can optimize their revenue cycles and ensure financial stability.

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