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August 30, 2024

Missed Revenue Opportunities in Surgical Services and Why They’re Overlooked

Do you know what your missed revenue opportunities are? Do you know where to look to find them? This is the tricky part of ambulatory surgery center management. But it can also be a treasure hunt. Finding where your center has revenue gaps takes some time and patience. But it’s well worth the effort to ensure you’re maximizing profits.

What Contributes to Missed Revenue Opportunities?

Billing and Coding

One of the primary reasons revenue opportunities are missed in surgical services is the lack of proper billing and coding practices. Even minuscule coding errors can result in huge revenue losses. When procedures aren’t coded to standard, ASCs struggle to capture the full extent of their services, potentially leading to underpayments or even denials from insurers. Even small errors in coding result in huge revenue losses. Incomplete or outdated patient records contribute errors like these, because they often lack those essential details to support proper coding.

Procedure Documentation

Another area where you might miss opportunities is procedure documentation. In the fast-paced environment of surgical services, it’s easy to overlook details. However, thorough documentation is essential for capturing all billable services and justifying the procedures performed. Without it, ASCs may miss out on additional revenue that could have been captured through accurate billing.

Scheduling Practices

Disorganized scheduling practices? Missed revenue opportunities. When surgical centers fail to sharpen their schedules, valuable operating room time is lost, leading to reduced procedure volumes.

Reasons These Opportunities Are Overlooked

Lack of Awareness

When you don’t have a full awareness or visibility of your revenue cycle management processes, there is a greater chance revenue opportunities are overlooked. Many ASCs focus primarily on patient care and clinical outcomes, often at the expense of financial management. Without a dedicated focus on the revenue cycle, ASCs are likely to miss capturing every potential revenue source.

Complex Regulations

There’s no surprise that healthcare regulations are complex. So are payer requirements. This makes it challenging to keep up with best practices in billing and coding. ASCs may miss revenue due to non-compliance or incorrect application of guidelines.

Staffing Shortages & High Turnover Rates

Staffing shortages and high turnover rates further exacerbate this issue. If your ASC lacks experienced billing and coding professionals, errors are more likely to occur, and revenue opportunities are more likely to be missed. Consistency in staff training and education is critical to mitigating these risks.

Addressing Missed Opportunities

To address these missed revenue opportunities, you should invest in expert surgery center consulting services that include regular audits of billing and coding practices. These audits can help identify discrepancies and provide actionable insights for improvement. Implementing advanced electronic health records (EHR) systems can also simplify documentation and ensure that all procedures are captured accurately.

Expert ASC Management and Consulting

Understanding the reasons why you’re missing revenue opportunities in your surgical services will help you greatly improve your long-term financial performance. But surgery center consulting services can play a significant role in identifying these gaps. If you need ambulatory surgery center management and consulting services, ASI is here to help. Get in touch at 352-567-1202 or visit our contact page.

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