Becker's ASC Review

34 CODING & BILLING 10 ways ASCs can reduce denials, improve the appeals process By Rachel Popa A lpharetta, Ga.-based Surgical Infor- mation Systems' Senior Vice Presi- dent of Revenue Cycle Services Jho Outlaw shared 10 ways ASCs can improve appeals and reduce denials. Ten tips to know: 1. Keep a vigilant mindset. ASCs should tackle denials with the mindset that they deserve to get paid for services provided. e first step to reducing denials is staying vigilant. 2. Create and stick to processes. Centers should create and maintain processes for flagging and following up on denials. 3. Prioritize staff education. Continuously training staff on the appeals and denials process keeps ASC employees on the same page. 4. Track performance. Auditing team members' performance ensures staff is fol- lowing procedures correctly. 5. Start benchmarking. Comparing employees' success rates can help ASCs compare themselves to others nationwide. 6. Recognize success. Celebrate suc- cesses with the team when reimbursement increases. 7. Take a stand. Make sure to follow up on unfair denials. 8. Negotiate. Appeals successes may help ASCs negotiate future contracts. 9. Keep focused. Repeated denials are disappointing, but it's important to not get discouraged. 10. Pick your battles. Knowing when to pursue or move on from an appeal is key. n ORHub enters Arkansas market with ASC agreement – 3 notes By Angie Stewart ORHub signed an agreement with an ASC in Arkansas. Here's what you should know: 1. The agreement is the healthcare data analytics company's first in Arkansas. 2. ORHub's Surgical Spotlight platform is designed to improve surgery centers' financial management by linking operating room efficiency metrics to real-time cost data for materials and labor. 3. ORHub CEO Colt Melby said in a statement, "The early market orders discussed in 2018 are now converting into new billings. It is evident that the pay-per-use business model resonates with various healthcare facilities and provides ORHub with recurring revenue opportunities while generating a high level of return on investment for our clients." n How 3 ASC administrators deal with the rise in high deductible plans By Laura Dyrda A s more people become covered under high deductible health plans, patients are responsible for paying a larger portion of their medical bill. Here, three ASC administrators discuss how they meet the challenges of more patients with high deductible plans and handle patient responsibility. Jarett Landman. CEO of Orthopedic Surgical Center of the North Shore (Peabody, Mass.): Education, like all things, is paramount. We take ample time to review patient responsibility before arriving at the center and try our best to be transparent with costs. We remind patients, in an empathetic way, that the deductible is the patient's covenant with their insurer as a term of their coverage, not an inflated charge from the center. We also recommend medical consumerism, particularly asking patients to 'rate shop' local hospitals. Almost all of the patients return to us after seeing the impact on their deductible for the same procedure in the hospital setting! Kris Kilgore, RN. Administrative Director of Surgical Center of Michigan (Grand Rapids): We now have assigned one staff member from our accounts receivable department to send a letter two weeks prior to surgery to collect co-pays and deductibles, with a follow-up call three days before surgery if it is not collected after the letter. Alfonso del Granado. Administrator of Ashton Center for Day Surgery (Hoffman Estates, Ill.): We request payment upfront for the entire deduct- ible, though we do make limited exceptions and sometimes offer short-term payment plans — three to six months — if placed on auto-pay with the patient's credit card. We have also had to contract with most big payers because the out-of-network deductibles are impossible for patients to afford. n

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