Collections Issues for ASCs

Collections can be a challenge. Collections issues can come from patients not paying their bills in a timely manner (or not at all) or insurance companies delaying the facility’s payment for unknown reasons or denying claims with unfair reasoning. ASCs must ensure their staff has the knowledge and tools necessary to maximize all possible ways of (legally) getting paid. There are many avenues to explore at your ASC (that you might not have considered), which can help you manage collections issues more effectively.

Insurance Verifications/Patient Financial Responsibility

The insurance verification process is extremely important to the ASC’s proper reimbursement for their cases. If your facility is not performing insurance verifications prior to every case, your facility is leaving money on the table.

It’s important to discuss benefits information with patients prior to surgery and thoroughly inform the patient of the amount he/she will be expected to pay. Make it clear that the owing amount is due prior to surgery. If the patient can’t pay the full amount, set up a strict payment plan, with the patient signing a promissory note. Make sure the patient understands that the fees you are explaining to him/her are for ASC facility fees only, and that he/she will receive separate bills from other providers. Financial responsibility information should be given to patients in writing.

You may be leaving money on the table if you wait until after the procedure to bill owing fees to the patient. The likelihood that you will be able to collect all of the owing fees after the surgery lessens with the wait. It is important to let patients know they have an obligation to promptly pay their owing portion.

Give patients options, such as:

>>Accept credit cards as a payment option for patients — this is very important!

>>Remind patients to bring his/her checkbook at the time you expect them to pay.

>>Work out realistic payment plans on the front-end with those patients who cannot pay the entire owing portion at the time of service.

>>Have the ability to accept cash payments (keep a cash lockbox locked up and have good reconciliation procedures in place with employee accountability) from those patients who pay cash.

There are very few situations where an ASC can charge Medicare patients for procedures that are not covered by Medicare in an ASC — it is a compliance risk to charge patients for these procedures. Be sure your scheduling staff has the Medicare ASC list and can head these procedures off at the time of scheduling.