The Hidden Costs of Poor Communication in ASCs: A $1.7 Billion Problem

Communication is central to everything your ASC does, from patient scheduling and insurance verification to surgical procedures and post-op follow-ups. But when communication falters, whether among departments, staff, or patients, the ripple effects can be costly — and even deadly.

A report by CRICO, a leader in medical professional liability (MPL) insurance, analyzed tens of thousands of malpractice cases and found that:

• Over a third (7,000+) involved a healthcare communication failure. 
• Nearly 50% of breakdowns happened in surgery settings like ASCs.
• Roughly 1,700 cases ended in preventable deaths. 

According to the report:

“Across all specialties and care delivery settings, miscommunication begets misinformation… then misinformation can lead to mismanaged care, unmet expectations, and patient harm.“

Beyond the clinical risks, communication failures also have serious financial consequences. A missed detail here, an unclear message there, and suddenly, a smooth claim submission turns into a denial, delay, or lost revenue. CRICO’s findings found that malpractice claims involving poor communication led to $1.7 billion in related annual healthcare losses, costing $84,000 more per case than claims without communication breakdowns.

Whether it’s incorrect procedure coding or failure to communicate patient financial responsibility, poor communication destabilizes your ASC’s revenue cycle. Let’s break down where these breakdowns happen and, more importantly, how to fix them before they cost you even more.

Top 10 Communication Challenges for ASCs

ASC communication breakdowns stem from gaps between clinical teams, billing departments, and administrative staff. After decades of working with ASCs, we’ve observed some of the most prevalent communication challenges and ranked them from most to least common. Understanding these challenges is the first step to improving processes and preventing costly mistakes.

Issue	Cause or Prevalence Level	Risks
1. Coding Errors	Cited in 30-40% of claim denials	Miscommunication between surgeons and coders leads to incorrect CPT/ICD codes
2. Incomplete, Inefficient, or Inaccurate Documentation	80% of US medical bills have errors; 75% of providers use paper billing processes	Missing details delay coding and billing, increasing denial risks
3. Internal Communication Siloes	Widespread disconnects between billing and clinical teams	Poor coordination causes missed deadlines and revenue leaks
4. Delayed Dictation	9.7-hour mean delay for surgeons to start dictation	Surgeons’ procrastination on documentation stalls billing cycles
5. Misaligned Expectations	Absence of clear turnaround guidelines	Unrealistic timelines for documentation/coding create bottlenecks
6. Training and Education Gaps	Lack of staff awareness of how their actions affect the revenue cycle	Physicians/staff inadvertently cause denials
7. Inconsistent Communication Methods	Overreliance on informal channels	Verbal/informal updates lead to missed critical information
8. Failure to Address Issues Proactively	Poor feedback loops industry-wide	Recurring issues like coding errors go unresolved
9. Inadequate Patient Follow-Up	Only 78% of ASCs follow up by phone within 24 hours of discharge	Poor response to billing inquiries delays payments
10. Ineffective Payer Contract Negotiations	61% increase in contract negotiation issues in 2024 than in years prior	Poorly negotiated contracts reduce reimbursement rates

So, where do these issues occur within the revenue cycle? Let’s look at some everyday scenarios at each stage and how each department plays a part in clear communication.

Where Communication Fails Across the Revenue Cycle

Without strong communication protocols, ASCs risk leaving significant money on the table; inefficient communication among care providers wastes over $12 billion per year in healthcare. CRICO’s report highlighted where communication falters most among healthcare staff:

• 57% of communication breakdowns happen between providers like surgeons and billing teams.
• 55% occur between providers and patients, such as when patients aren’t clearly informed about insurance coverage, financial responsibilities, or follow-up care.
• 12% involve both provider-provider and provider-patient errors.

This means each stage of the revenue cycle is vulnerable to communication breakdowns. Given the high patient volumes and complex billing processes ASCs face, it’s easy to see how these failures result in revenue leakage. 

Here’s how poor communication can play out across the revenue cycle and the impact it has on your surgery center’s bottom line.

Pre-Procedure Stage

Effective communication before surgery ensures all patient information and insurance details are accurate and complete. A breakdown here can snowball into bigger problems down the road. If staff doesn’t confirm insurance coverage or obtain the correct pre-authorization, claim rejections or long reimbursement delays result.

Let’s say the front office staff confirms a patient has insurance coverage for a needed surgery but fails to check for policy exclusions. The billing team submits the claim, but the insurance provider denies it due to an incorrect or incomplete coverage check. Now, the ASC has to re-verify the insurance, which delays payment and costs the center time and money.

Miscommunication Risks

• Revenue: Surgeons, clinical staff, and the front office must be on the same page about what insurance verification has been done and what’s still pending. If one department doesn’t communicate that an insurance verification was only partially completed or missed, there’s a high risk of reimbursement delay when the claim is eventually submitted.
• Operations: Incomplete or incorrect insurance verification can lead to last-minute surgery cancellations or rescheduling, disrupted schedules, and reduced surgical team efficiency. 
• Compliance: Failure to verify coverage properly can result in audits and potential violations of payer agreements.

Procedure Stage

Communication between surgical teams and the billing department ensures accurate coding and proper documentation. Without clear coordination, errors can directly impact ASC revenue. Surgical teams may fail to document all procedures performed or provide billing with enough detail for proper coding. This can lead to undercoding or even overcoding, which may reduce or complicate reimbursement.

If the surgical team performs a highly specialized procedure with an extra step to correct a complication — but doesn’t note all components of the surgery — the billing department might code it as a simpler, less reimbursable operation. As a result, the ASC misses out on full reimbursement for the case’s complexity.

Miscommunication Risks

• Revenue: Sometimes, surgical teams assume the billing department knows which codes to use, or billing teams might not reach out for clarification on procedure details. This can lead to missed opportunities for higher reimbursement.
• Operations: This breakdown increases administrative workloads and forces staff to chase down missing documentation instead of focusing on critical tasks.
• Compliance: Improper coding due to miscommunication can lead to penalties and legal repercussions if inaccuracies are deemed fraudulent.

Post-Procedure Stage

Clear patient communication after the procedure helps ASCs obtain timely, accurate payments. Patients don’t always understand the breakdown of their costs, especially when insurance is involved. Suppose they aren’t adequately informed about their deductible or out-of-pocket expenses before the procedure. In that case, they may be confused or frustrated when the bill arrives and delay payments, underpay, or avoid paying altogether, which hurts cash flow.

Miscommunication Risks

• Revenue: If the ASC doesn’t clearly communicate what’s covered, what’s not, and what the patient is expected to pay, the chances of a late or missed payment increase significantly.
• Operations: This compounds the operational burden on staff, who must make multiple follow-up calls and manually correct billing errors.
• Compliance: Failing to provide transparent cost estimates or accurate billing details can lead to patient disputes, regulatory complaints, and legal action.

Strategies for Improving ASC Communication

When the stakes are this high, you can’t afford not to invest in communication improvements. There’s no one secret to minimizing communication failures in healthcare, but implementing these tips can help you incrementally reduce the severity of future breakdowns and the frequency of these issues over time.

Integrate Technology and Automation

The right technology can simplify communication, cut down on errors, and save valuable time. For instance, automating eligibility and benefits verification can save ASCs an average of $3.60 per verification, reduce administrative work, and prevent claim denials before they happen.

• Electronic health records (EHRs) with built-in, cloud-based revenue cycle management (RCM) software:
• Keep patient data, documentation, and billing in one place so everyone works with the same accurate information. 
• Automate communication workflows like dictation deadline reminders and missing information notices. 
• Ensure real-time updates across teams to minimize human error and allow quicker follow-ups on outstanding claims.
• Artificial intelligence (AI) is an excellent tool for error detection. It can detect coding mistakes or missing details before claim submission, helping ASCs avoid costly denials and delays. 

As you take advantage of automation, your surgery center can boost efficiency, lower costs, and create a smoother experience for staff and patients.

Standardize Communication Protocols

One of the easiest ways to cut down on miscommunications is to standardize communication protocols and get everyone to speak the same language. Start by involving all stakeholders in creating a set of standardized guidelines for key processes like coding, documentation, dictation, and patient communication. For example:

• Use CPT/ICD-10 codes consistently across all teams.
• Develop templates for operative reports to ensure surgeons include all necessary details (e.g., anesthesia type, complications).
• Establish patient communication scripts for pre-op instructions, post-op care, and billing FAQs.

Then, you can integrate these standards into your EHR system to automate and streamline workflows. It’s important to hold training sessions to help everyone understand and adopt the new protocols. For example:

• Teach coders how to use standardized coding guidelines.
• Train surgeons on how to complete operative report templates accurately.
• Educate front-desk staff on delivering consistent patient communication.

As part of your protocols, reinforce the idea that staff communicating outside their departments should aim for specificity. In 2016, the ASCA Journal asserted that ASCs can keep expectations aligned across teams with precise communications. For example, revenue cycle teams telling a physician they need faster dictations should instead explain that dictation is currently taking six days when the organization’s goal is three.

Boost Cross-Department Collaboration

Improving collaboration across your ASC can be a game-changer for communication and revenue cycle management. Here’s how to make it happen:

• Establish structured communication channels among the revenue cycle team, physicians, and administrative staff.
• Meet regularly. Hold consistent check-ins to align on goals, solve problems, and celebrate wins.
• Define roles clearly. Make sure everyone knows their responsibilities and how they contribute to the operation’s success.
• Create feedback loops. Use dashboards and reports to give all stakeholders visibility into performance metrics. Allow staff to report issues, track progress, and adjust workflows as needed. 
• Track success with KPIs. Measure how your communication strategies and feedback loops work and where to improve. 
• Build a team-first culture. Encourage accountability, support, and positivity. Teams that work well together achieve better results.

Invest in Training and Education

Addressing knowledge gaps can immediately resolve communication breakdowns like coding errors, department siloes, and misaligned expectations. Well-trained teams collaborate better, make fewer mistakes, and adapt faster to changes. We recommend investing in education to build a culture of excellence and drive financial and operational success by:

• Hosting interdepartmental workshops. Bring surgeons, coders, and billing staff together to review coding standards and workflows. Make sure each staff member knows how their contributions affect financial performance. This breaks down silos and builds teamwork.
• Training on documentation accuracy. Regular sessions help everyone understand how to capture critical details, reducing claim denials and revenue loss.
• Updating on communication protocols. Keep teams on the same page with transparent, consistent information-sharing processes.
• Addressing regulatory changes. Ongoing training on regulatory changes helps avoid costly penalties and keeps your ASC ahead of risks.

Improve Patient Communication

Clear, proactive financial discussions with patients before, during, and after procedures are necessary for boosting communication and collections. 

Automation is an easy place to start with tools that send patients detailed cost breakdowns, payment reminders, and answers to common questions. A patient portal or text messaging system can provide real-time updates on upcoming payments to reduce confusion and prevent delays.

Take it a step further by embedding cost transparency into every interaction:

• Before a procedure, explain out-of-pocket costs and payment options. 
• During check-in, confirm financial arrangements. 
• After discharge, send automated reminders for any remaining balances.

Patients appreciate clarity and consistency, and as you address their concerns and confusion proactively, you can improve satisfaction while strengthening your revenue cycle.

Get an RCM Partner

When your team struggles to keep up with demands, reimbursements become unpredictable, and delays cut into your cash flow despite your best efforts, it may be time to find an RCM partner. The right RCM partner can reduce administrative burdens and solve problems proactively to increase revenue streams and free your team to focus on patient care. 

Here’s what to look for:

• Specialized ASC expertise. They should understand ASC-specific coding, billing, and compliance standards.
• Strong communication. A good partner acts as an extension of your team, keeping you informed and involved.
• Proven track record. Look for a partner with strong references and case studies.
• Transparent reporting. They should be willing and able to provide clear, real-time insights into your revenue cycle.
• Scalable solutions. Ensure they can grow with your ASC’s needs.
• Consultations, audits, and assessments. The best RCM partners are so confident in their abilities that they offer no-strings-attached consultations, audits, and assessments. They’re not afraid to show you exactly where gaps exist and what solutions they’d recommend — because they know their expertise will impress you enough to earn your trust and partnership.

We’ve got you covered if you’re not confident about finding the right partner. Download our “10 Questions to Ask Your RCM Partner About Communication Processes” to see how they can address your organizational gaps and pain points.

The Bottom Line: Clear Communication Drives Profitability

Poor communication in ASCs is a $1.7 billion operational headache that leads to claim denials, lost revenue, and patient dissatisfaction. Thankfully, small changes can yield big results. As you implement our strategies for improving communication at every level of your organization, you can reduce errors, recover lost revenue, and create a smoother experience for everyone involved.

And when internal efforts aren’t enough, partnering with a trusted RCM expert can give you the expertise and tools needed to close gaps and optimize your revenue cycle. AT&C Revenue Services stands ready with everything you need to take your revenue cycle to the next level. 

Request a consultation today to find out how we can help.