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Myndshft Blog

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May 26, 2023

Boost Your Bottom Line: The Power of Prior Authorization Software for Ambulatory Surgical Centers

by Susan Lawson-Dawson | Healthcare Technology, Prior Authorization, Revenue Cycle Management

The evolving healthcare landscape has seen a notable shift towards Ambulatory Surgical Centers (ASCs). This pivot has been primarily fueled by increased efficiency, cost-effectiveness, and a heightened focus on patient-centered care. And now, more than ever, ASCs are becoming the preferred venue for a growing list of services. Of course, that also means that the number of prior authorizations that ASCs must obtain has also increased. How do you keep operational expenses low when the administrative burden keeps growing? Prior authorization software helps you strike the right balance.

More approved services yields more prior auth paperwork

The first freestanding ambulatory surgical center (ASC) opened in 1970. It took nearly a decade for the number of ASCs in the country to hit triple digits. Then, as Medicare began expanding the list of procedures approved for ASCs in the early 1980s, growth accelerated. Today, thousands of procedures can be performed at ASCs. 

Other than a few hiccups tied to economic conditions or the pandemic, ASCs have continued to expand their reach. What’s fueling the growth? 

  • Convenience: Most ASCs are located in the communities they serve, making it easier for patients to reach them. It reduces the need for long commutes to large hospital centers. Even getting around an ASC is easier with convenient parking and easy navigation compared to a hospital. 
  • Efficiency: ASCs often specialize in certain types of surgeries, which leads to more streamlined processes. They also typically have fewer administrative hurdles, which can make scheduling surgeries easier and faster.
  • Time-saving: In ASCs, surgeries are scheduled, not emergent, which means they’re less likely to be delayed or rescheduled due to unforeseen emergencies, as can happen in a hospital setting. Moreover, because ASCs are often smaller than hospitals, patients usually spend less time waiting.
  • Quality of Care: Many ASCs have a specialized focus which can lead to high expertise in certain surgical procedures. In addition, the more personal, less rushed atmosphere of ASCs can contribute to a better patient experience.

Of course, as McKinsey points out in an article about the rise of ASCs, the biggest factor is financial. The article notes, “Perhaps most persuasively, costs to both patients and payers can be significantly less at ASCs, as their entire operating chassis is often configured at a lower cost base across staffing, space, and some types of supplies, while margins for healthcare providers can often be the same or higher.” 

In fact, Becker’s ASC notes that as of 2022, 48% of common ASC procedures take place in stand-alone ASCs rather than hospital outpatient departments (HOPDs). But the American Academy of Orthopaedic Surgeons predicts that within the next few years, 68% of orthopedic surgeries will take place at ASCs because of the potential savings.  After all, numerous studies put the cost of treatment for a total joint replacement 40% lower when done in an ASC rather than a hospital setting. 

Of course, that’s precisely why ASCs need meticulous revenue cycle management. You’re operating within tight margins. Wasting time and resources on inefficient processes isn’t an option. This is where prior authorization software comes into play.

Prior authorization software puts you in prime position to keep your revenue cycle moving smoothly

Despite the benefits ASCs offer, managing expenses remains a challenge you need to meet head-on. Prior authorization software has emerged as a powerful tool to address this challenge. This software automates the prior authorization process, eliminating manual errors, reducing time spent on administrative tasks, and accelerating reimbursements.

Prior authorization software isn’t just about expense management; it’s also about putting ASCs in a prime position to enhance their revenue cycle. With this software, ASCs can submit authorization requests more efficiently, track their status in real-time, and ensure quicker approvals. Fewer delays or denials means less rescheduling or cancellations.  

Additionally, the use of prior authorization software reduces rework due to preventable errors (typos or missing information) and leads to more accurate billing, ensuring a smoother revenue cycle. It enables ASCs to keep up with the pace of increased services and ensures they’re able to capitalize on the financial opportunities these services offer.

You have a golden opportunity ahead as more patients (and payers) seek care that offers the convenience and quality they want at a better price. However, to truly boost the bottom line, ASCs can leverage tools like prior authorization software to enhance efficiency, reduce errors, control costs, and ensure a robust revenue cycle.  

Find out how Myndshft can help.