How a Multispecialty ASC in Alabama Turned Its Revenue Cycle Around in 6 Months
In 2024, a multispecialty ambulatory surgery center in Alabama found itself facing a growing set of revenue cycle challenges. The center had been managing its billing in-house but staffing shortages and turnover created inconsistencies in claim submission, payment posting and follow-up. As a result, days in accounts receivable were rising, over‑90‑day A/R was increasing and claim turnaround times were slower than industry expectations.
For a multispecialty center handling cases across several surgical disciplines, these issues compounded quickly. Each day that reimbursement sat uncollected represented real money not available for operations, staff, and growth. The center’s leadership recognized it was time for a different approach and began looking for an ASC-specific revenue cycle management partner.
Why the Center Chose Serbin Medical Billing
After evaluating its options, the surgery center partnered with Serbin Medical Billing. Several factors drove the decision. The center needed a partner with deep, ASC-specific expertise. Serbin Medical Billing brought more than 30 years of focused ASC revenue cycle experience, along with a dedicated team model that assigns each client its own group of billing professionals rather than routing work through a rotating call center.
Serbin Medical Billing took full responsibility for the center’s revenue cycle, including:
• Expert coding by certified ASC coders
• Accurate and timely charge posting and clean claim submission
• Efficient payment posting with contract-level verification
• Proactive A/R follow-up on both legacy and current accounts
• Patient billing and collections
The Results: Measurable Improvement in Six Months
Within six months of the partnership, the surgery center achieved results that reflected a fundamentally stronger revenue cycle:
• Days in A/R dropped below industry benchmarks.
• Over-90-day A/R was significantly reduced.
• Claim turnaround accelerated, with clean claims exceeding national standards.
This center moved to surpass the benchmarks, and it did so within half a year.
What Made the Difference
Revenue cycle turnarounds do not happen by accident. Several specific practices drove the improvements at this surgery center.
Clean Claim Submission from Day One
Through rigorous manual review and clearinghouse scrubbing, claims were submitted without errors the first time. Clean claims eliminate the back-and-forth of resubmissions, reduce days in A/R, and allow payers to process reimbursement faster. Every rejected or returned claim adds days to the collection timeline and increases administrative cost.
Proactive Payer Follow-Up
Serbin Medical Billing’s collectors began following up on submitted claims in a timely manner. Working through the current and the legacy AR, following ASC standard follow-up time frames and adhering to payer time frames. Rather than writing off aged claims, Serbin Medical Billing’s team worked through the center’s legacy accounts receivable systematically, identifying underpayments, filing appeals on denied claims, and pursuing outstanding balances that had been sitting untouched. This approach converted previously stalled revenue into actual cash flow.
A Dedicated Team
Due to Serbin Medical Billing team dedicated team model, communication quickly became direct, reliable, and highly efficient. Unlike traditional outsourced arrangements—where rotating staff often create delays, misunderstandings, and frequent explanations—the Serbin team was fully immersed in the center’s operations. They understood its unique payer mix, specialty‑specific billing patterns, and the complex nuances of its managed care contracts.
This level of familiarity meant there was no learning curve to teach, no repetitive onboarding of new representatives, and no gaps in knowledge when issues arose. The consistency was especially valuable given the center’s previous challenges maintaining an in‑house billing staff leading to workflow disruptions, and recurring training demands that strained both productivity and revenue cycle performance.
With Serbin’s dedicated team in place, those staffing issues were eliminated. The continuity, expertise, and stability resulted in smoother operations, clearer communication, and a far more predictable and effective process.
What ASCs Can Learn from This Case
Every ambulatory surgery center faces revenue cycle challenges, whether it is rising patient financial responsibility, increasing claim denials, or the difficulty of retaining qualified billing staff. This case study illustrates several takeaways that apply to ASCs of any size or specialty.
Do not ignore legacy A/R. When transitioning to a new billing partner or restructuring your revenue cycle internally, aged accounts receivable still represent collectible revenue. A disciplined approach to working those claims can produce a meaningful cash infusion during the transition period.
ASC-specific expertise matters. General medical billing and ASC billing are not the same. ASCs operate under different payment systems, face unique coding requirements, and deal with managed care contracts that require specialized knowledge. A billing partner without deep ASC experience will leave money on the table.
Speed and accuracy at every step compound over time. Clean claims should be submitted within 72 hours or less of the date of service. Payments should be reviewed by managed care contracts and posted as they are received. All follow‑up must be conducted promptly and in accordance with each payer’s specific guidelines. Each of these individual practices removes days from the A/R timeline. Together, they create a revenue cycle that moves at the pace your ASC’s cash flow demands.
Audit your revenue cycle regularly. Whether you bill in-house or outsource, every component of the revenue cycle, from fee schedule accuracy to denial trends to payer contract compliance, should be reviewed on a consistent schedule. Problems that go undetected for months become far more expensive to fix.
Staffing challenges do not have to stall your revenue cycle. Turnover, vacancies, and the constant demand of training new billing staff create workflow disruptions that directly increase days in A/R. A dedicated team model with an experienced RCM partner eliminates the learning curves, onboarding gaps, and productivity losses that come with managing billing staff in-house. The result is continuity, consistency, and a revenue cycle that does not reset every time an employee leaves.
Is Your ASC’s Revenue Cycle Performing Where It Should Be?
If your surgery center’s days in A/R are climbing, if your over-90-day A/R is growing, if billing staff turnover is disrupting your workflows, or if your team is spending more time chasing claims than caring for patients, it may be time for a closer look at your revenue cycle operations. Staffing shortages and inconsistent coverage are among the most common reasons ASCs fall behind on claim submission, payment posting, and follow-up. A dedicated RCM partner can resolve those challenges while improving every metric across your revenue cycle.
Serbin Medical Billing offers a complimentary ASC accounts receivable and revenue cycle evaluation that covers coding practices, charge posting accuracy, collections effectiveness, payment posting timeliness, and a detailed A/R analysis with specific recommendations for improvement.
To schedule your complimentary evaluation, contact us at caryl@serbinmedicalbilling.com.
Frequently Asked Questions
What does an ASC revenue cycle management company do?
An ASC revenue cycle management company handles all billing and collection functions for ambulatory surgery centers. This includes certified coding, charge posting, clean claim submission, payment posting, third-party payer collections, patient billing, denial management, and appeals. The best ASC-specific RCM companies also provide additional services such as:
Fee Schedule Optimization and Management
Managed Care Support and Guidance
Business Office Policies & Procedure Manuals assistance and guidance
Workflow Optimization guidance
Clearinghouse Setup & Management
Business Office Staffing Guidance
Billing Software Recommendations, Setup, and Maintenance
Targeted Education & Staff Training
How long does it take to see results after outsourcing ASC billing?
Results vary depending on the condition of the ASC’s existing accounts receivable and the complexity of its payer mix. Many surgery centers begin to see measurable improvements within three to six months of outsourcing their revenue cycle management. Improvements typically include reduced days in A/R, faster claim turnaround, lower denial rates, and stronger cash flow.
What are the benefits of outsourcing revenue cycle management for an ASC?
Outsourcing ASC revenue cycle management provides access to a full team of experienced reimbursement specialists, including certified coders and managed care experts. Key benefits include reduced days in accounts receivable, improved cash flow, optimized coding that can increase revenue, elimination of disruptions from staff turnover or absences, and freeing business office staff to focus on patient care and operations. Outsourcing also scales with your caseload without requiring additional in-house hires.
How often should an ASC audit its revenue cycle?
ASCs should conduct internal audits of revenue cycle functions on a regular basis, including monthly reviews of end-of-month reports and quarterly reviews of reimbursement accuracy. Key areas to audit include coding accuracy, charge posting timeliness, payment posting accuracy, collections effectiveness, denial trends, and fee schedule alignment with current payer rates annually.
What should I look for when choosing an ASC billing company?
Look for ASC-specific experience rather than general medical billing, certified coders with ASC expertise, a dedicated team model (not a rotating call center), U.S.-based operations, transparent reporting with real-time access to your data, a track record of reducing days in A/R and improving collections, and value-added services such as fee schedule development, managed care guidance, and compliance support.
What is legacy accounts receivable and why does it matter during an RCM transition?
Legacy accounts receivable refers to the backlog of aged, unpaid claims that existed before a new billing partner takes over an ASC’s revenue cycle. These claims still represent collectible revenue. A billing company that actively works legacy A/R during the transition period, rather than focusing only on new claims, can recover significant revenue that might otherwise be written off.
Why does ASC billing require specialized expertise?
ASCs operate under different payment systems than hospitals or physician practices. They face unique coding requirements, specialty-specific managed care contracts, and reimbursement structures such as Medicare’s ASC payment system that require specialized knowledge. A billing company without deep ASC experience may miss billable services, misapply modifiers, or fail to identify contract violations, all of which reduce revenue.