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14 ASC Turnarounds: Ideas to Improve Performance • ASCs Inc. can help you sell your ASC/MOB real estate • The market for selling ASC/MOB real estate is excellent • Prices are high due to a shortage of good properties • Low selling costs maximize your profits • We will help you increase the value of your real estate Sell and leaseback your ASC/MOB real estate A sale–leaseback of your ASC/MOB real estate will enable you to unlock cash and make more productive use of your capital. Call today to get a free valuation of your ASC/MOB real estate! Contact Jon Vick at JonVick@ASCs-Inc.com 760-751-0250 or visit us online at ASCs-Inc.com P innacle III, an ambulatory surgery center development and management company conducts facility reviews of clinical and business office operations. Their reviews evalu- ate the overall health of an ASC, ensure full reim- bursement is being captured, and provide recom- mendations on improving performance. "We conduct a review of the business office, man- aged care contracts, and overall facility operations to determine if the center is doing everything nec- essary to perform at the highest level," says Rob- ert J. Carrera, president and CEO of Pinnacle III. "The reviews can be global or specific, depending on what the ASC wants. Some centers choose to have an accounting firm perform a formal finan- cial audit as well." Here are 10 areas they focus on during their per- formance reviews: 1. Patient information gathering. One of the primary business office aspects reviewed is how the front desk handles patient information intake. "Having the most accurate patient demograph- ics makes for clean claims and timely reimburse- ment," notes Carol Ciluffo, vice president of rev- enue cycle management. "When demographic information is inaccurate, significant challenges are created. Pre-authorizations, verifications and eligibility are also key aspects of properly collect- ing patient information." 2. Billing compliance. The reviewers look for a formal billing compliance program that addresses components recommended by the OIG. They also look for evidence of best practices for collections. "We review the components of the program and staff adherence," says Kim Woodruff, vice presi- dent of corporate finance and compliance at Pin- nacle III. "It's important to ascertain whether the center's policies and procedures are carried out in practice or if they are just documents in a binder sitting on the shelf." 3. Separation of duties. ASCs — especially smaller facilities — may not have appropriate separation of duties, which is especially impor- tant when dealing with cash or financial transac- tions. "We try to help people identify how they can implement checks and balances in their pro- cesses that will reassure the administrator and board members the facility hasn't been left open to fraud or embezzlement," says Ms. Woodruff. 4. Payer contract review. Doing the cross walk from the clinical reimbursement perspective to see whether payer contracts meet reimbursement standards and cover costs is crucial to financial suc- cess. "There are some facilities that haven't renego- tiated their contracts for three or four years," says Mr. Carrera. "We typically review the top five payer contracts to determine when the last negotiation occurred, identify the average reimbursement per case for each contract and ascertain whether there are any opportunities for improvement. Even in the best run centers, we often find that at least one or two of their contracts yield some potential for greater returns." 5. Fee schedule reviews. Centers that don't regularly review their fee schedule will miss out Audit ASC Profitability: 10 Opportunities for Improvement By Laura Dyrda