Revenue Cycle Management Best Practices for Cardiovascular ASCs

Running a cardiovascular ambulatory surgery center (ASC) requires balancing clinical excellence with financial strength. While labor and supply costs drive much of the expense side, revenue cycle management (RCM) is the heartbeat of financial performance. Strong RCM practices ensure that every procedure translates into timely, accurate reimbursement - and ultimately, sustainable margins for growth.

Below are best practices that cardiovascular ASCs can implement to improve collections, reduce denials, and strengthen cash flow.

1. Map the Entire Revenue Cycle

The revenue cycle begins long before a procedure is performed. It includes scheduling, insurance verification, pre-authorization, coding, billing, collections, and reporting. For cardiovascular ASCs - where procedures are often high-cost and highly regulated - gaps at any stage can lead to significant revenue leakage.

Best practice: Develop a clear end-to-end process map, assign ownership at each step, and create visibility for administrators and physicians into where claims stand.

2. Prioritize Pre-Authorization and Eligibility Verification

Cardiovascular procedures such as ablations, angioplasties, and device implants are frequently subject to payer pre-authorization. Missing or incomplete approvals can result in outright claim denials.

Best practice: Automate eligibility verification and pre-authorization tracking. Use trackers at scheduling to confirm payer requirements are met before the patient arrives.

3. Invest in Accurate Coding and Documentation

Cardiovascular billing codes are complex, and payer rules often change. Errors in coding or incomplete physician notes are a leading cause of denials.

Best practice:

• Train staff in the nuances of CPT and ICD-10 coding for cardiovascular cases.
• Conduct routine coding audits to catch errors early.
• Encourage physicians to document in real time and utilize templates when possible to avoid discrepancies.

4. Track and Reduce Denials Proactively

The denial rate for specialty ASCs can reach double digits if left unmanaged. Each denial delays payment, requires rework, and increases days in accounts receivable.

Best practice:

• Establish a denial management dashboard showing denial rate by payer and procedure.
• Identify root causes (authorization, coding, medical necessity) and implement corrective actions.
• Appeal promptly and escalate patterns to payer representatives when necessary.

5. Leverage Key Performance Indicators (KPIs)

Financial visibility drives better decision-making. Every cardiovascular ASC should monitor key revenue cycle metrics consistently.

Core KPIs include:

• Days in A/R – target under 40 days.
• Days to bill – target under 3 days
• Clean Claim Rate – aim for 95%+ submission accuracy.
• Denial Rate – benchmark against ASC industry average (5–10%).
• Net Revenue per Case – critical for evaluating case mix profitability.

For how physicians can use KPIs to drive returns, see How Physician Partners Can Maximize ROI in a Cardiovascular ASC.

6. Align Incentives and Accountability

Revenue cycle success depends on collaboration between administrative, clinical, and financial teams. Staff need to understand how their roles directly affect reimbursement.

Best practice:

• Tie staff performance bonuses to RCM KPIs such as clean claim rate or denial reduction.
• Create accountability through regular revenue cycle review meetings involving administrators, billers, and physicians.

7. Adopt Technology for Scale

Manual processes can’t keep pace with the growing complexity of payer rules. ASCs that implement specialized revenue cycle technology can significantly reduce errors and accelerate payment cycles.

Best practice:

• Use ASC-focused RCM platforms that integrate with your EHR.
• Automate eligibility checks, claims scrubbing, and denial tracking.
• Incorporate analytics to spot trends in real time.

Conclusion

For cardiovascular ASCs, excellence in the operating room must be matched with excellence in revenue cycle management. By tightening processes, embracing technology, and aligning teams around financial goals, centers can ensure strong cash flow while maintaining the highest standards of patient care.

At Cardiovascular Centers of America (CCA), we help our partners implement these best practices across our ASC network. The result is improved reimbursement, lower denial rates, and financial stability that enables physicians to focus on what matters most: patient outcomes.

Looking to improve your ASC’s revenue cycle performance? Contact CCA to learn more about how we can help optimize your center’s financial health.