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Case Study: New Jersey Ambulatory Surgery Center
OVERVIEW
This New Jersey ASC was operating as a strictly out-of-network facility. When the governing body decided to contract with several major managed care organizations, they opted to outsource the ASC's revenue cycle management to Serbin.
SERBIN INVOLVEMENT
This center had been operating as an out-of-network facility. Due to this model, there was no personnel experienced in insurance verification or patient financial counseling. Serbin was engaged and provided the following services:
Insurance verification job description
Patient financial counseling policies and procedures
Assumed full revenue cycle management, including outstanding out-of-network balances for collections from previous billing company
SERBIN DIFFIERENCE
As there had been no in-house, third-party coding, billing and collections prior to Serbin involvement, the only outstanding accounts receivable were out-of-network collections from insurance companies and patients. The administrator was concerned with compliance and meeting HIPAA regulations. Within a few months after retaining Serbin, the following was accomplished:
Total outstanding out-of-network accounts receivable (insurance companies and patients) decreased substantially
Coding was optimized
Third-party and patient collections were completed in a timely manner
Significant enhanced revenue stream
Serbin also provided the following:
Compliance and HIPAA policies and procedures
Additional business office policies/procedures and forms