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As the year wraps up, many ASC leaders are taking stock of the year in a familiar way. Care continues to shift toward the ambulatory setting, bringing higher volumes and greater case complexity. At the same time, reimbursement is tightening and operating costs are rising—raising an important question: is cash acceleration and margin performance keeping pace with growth?
Beneath that question sits an even more fundamental one: are we actually being paid for the care we’re delivering?
This isn’t a reflection of pessimism. It’s a recognition of how rapidly the ASC landscape has evolved—and how closely clinical execution and financial outcomes are now linked. As complexity rises, even small gaps in revenue integrity can have an outsized impact on margins.
Revenue integrity today is not a back-office function or a billing initiative. It’s an enterprise discipline focused on ensuring that what happens clinically is fully, accurately and compliantly reflected in reimbursement.
At its core, revenue integrity connects every step of the patient journey—scheduling, authorization, documentation, coding, and charge capture—so they work as one coordinated system instead of a series of handoffs. When these elements are aligned, ASCs can reduce risk, improve predictability and protect margins without slowing operations or burdening clinicians.
In an environment where payer requirements change quickly and case complexity continues to rise, revenue integrity has become the mechanism that keeps financial performance in step with clinical reality.
Over the past year, ASCs have continued to absorb procedures that once belonged exclusively in hospital settings. Payers have responded with tighter authorization requirements, narrower reimbursement policies, and increased scrutiny around medical necessity.
At the same time, labor costs remain elevated, supply chain pressures persist, and administrative teams are being asked to do more with fewer resources. In this environment, even small breakdowns—an authorization that doesn’t fully match the procedure performed, documentation that lacks specificity or a charge that underrepresents case complexity—can have an outsized financial impact.
What 2025 has made clear is this: strong volume alone is no longer enough to ensure financial stability.
Revenue integrity has emerged as a response to this new reality. Not as an added layer of process, but as a way to eliminate friction across teams.
When revenue integrity is in place:
The result is fewer preventable denials, less revenue leakage and greater predictability in cash flow—outcomes that matter as margins tighten and expectations rise.
Looking ahead to 2026, the risks of maintaining fragmented workflows will only increase. Case complexity will continue to rise. Payer policies will continue to evolve. Regulatory scrutiny is unlikely to ease.
ASCs that rely primarily on reactive denial management and post-bill fixes might find themselves spending more time correcting issues than preventing them. Over time, this approach can erode margins, slow growth initiatives and strain relationships between clinical, operational and financial teams.
Revenue integrity offers a path forward—not by chasing perfection, but by creating alignment where it matters most.
As ASCs plan for the year ahead, revenue integrity is becoming less of a tactical initiative and more of an operational foundation. It enables leaders to:
nimble works with ASCs navigating this transition, helping organizations connect clinical activity with financial outcomes in a way that reflects the realities of modern outpatient care.
As we move from 2025 to 2026, revenue integrity has become essential not because ASCs are underperforming but because they are doing more, faster and with greater complexity than ever before.
In the coming year, success will belong to centers that ensure their financial systems keep pace with their clinical capabilities. Revenue integrity closes the gap between care delivered and care reimbursed, creating a more stable and transparent foundation for whatever growth lies ahead.
As ASCs plan for 2026, now is the time to assess whether revenue integrity is keeping pace with clinical growth. A focused revenue cycle management (RCM) assessment can uncover gaps across authorization, documentation, coding and charge capture before they impact margins. nimble partners with ASC leaders to deliver clear, actionable insights that strengthen revenue integrity and support sustainable, long-term growth.
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