Becker's ASC Review

17 ASC Turnarounds RA: Not shopping around enough for supplies and products is a common mistake. There are a lot of suppliers and great products that are refur- bished and can be bought at good prices. It pays to be educated and to do your homework. AC: Balanced comparison shopping. Too few comparisons risks inadvertent selection of the most expensive and least practical, while too many comparisons leads to analysis paralysis, wasted time, prolonged decision-making and greater like- lihood of buyer's remorse. AM: Don't go with the bells and whistles if it is not necessary. You want to meet your needs for pres- ent and future, but some may only be options and will dissipate your savings. JT: The need to research the item you are looking at. In most instances there is more than one company carrying this item and of course they want you to buy theirs. You need to look at what best suits your needs. In our instance, we needed a machine that not only worked, but also did so efficiently and in a small time footprint and thus the Xenex UV light. Time is money in an operating room. Q: Are there any other investments/up- grades you're considering for the future? RA: Getting an EMR is our next big goal and we hope to have it in place within 24 months. AC: We are investigating non-orthopedic sub- specialist equipment. We will have to manage the utilization of operating rooms with anticipated financial and storage constraints. AM: Hoping to pilot an electronic health record for our management company, USPI, which will improve other areas for us. Hopefully this time next year, we can have this same interview regard- ing how an EHR has affected our ASC! We were given the opportunity to pilot the One Medical Passport and never looked back. JT: We have moved ahead with two robotic systems for our total joint replacements. We have the Blue Belt Navio robotic for partial knee replacement, and we have the MAKOplasty robotic arm for par- tial knee resurfacing and hip replacement. n 1. The warning signs. Revenue cycle man- agement is a complex process that touches every aspect of an ASC's operations, but there are num- ber of apparent red flags that indicate the current strategy needs to be reevaluated. "A few warning signs that warrant further investigation include: a decrease in your revenue, increase in A/R days, an increase in upfront denials and contract vari- ances," says April Sackos, vice president of revenue cycle management with Meridian Surgical Part- ners. High staff turnover can also indicate man- agement issues. 2. Common stumbling blocks. ASCs do not have the resources of a hospital or health system; controlling all revenue cycle management process- es with limited staff and resources is much akin to a delicate juggling act. Many surgery centers struggle with similar issues. Common stumbling blocks, according to Michael Orseno, director of Regent Revenue Cycle Management, include: • Lack of necessary or quality IT • Inappropriate management information system • Shortage of useful reporting • Dearth of knowledgeable staff 3. Key ways to improve. Despite these ob- stacles, surgery centers can improve and master revenue cycle management. "Make sure you have internal monitoring and benchmark key perfor- mance indicators," says Ms. Sackos. "[Consider] automating benefit verification, payment posting, insurance follow-up and payment plan monitor- ing, to name a few." New processes and consistent monitoring can go a long way to revamp an ASC's approach, but any of these changes are difficult to achieve with the wrong staff. Regent RCM has developed as- sessments for both staff- and management-level business office candidates. These assessments are designed to test practical knowledge and identify candidates who will excel in an ASC environment. Consider integrating such an assessment into your surgery center's business office hiring process. "If your ASC's area has a shallow talent pool, out- sourcing is always an option," says Mr. Orseno. 4. In-house vs. outsourcing. In-house and outsourced revenue cycle strategies come with a set of unique challenges. "In-house challenges typically stem from finding and retaining the right staff with the knowledge, and expertise required to successfully manage the revenue cycle functions," says Ms. Sackos. On the other hand, completely outsourcing pres- ents a communication challenge. If there is a sim- ple question or a larger issue, it isn't simply an is- sue of walking down the hall to the business office. Outsourcing also makes it easier to lose touch with financial data and revenue cycle processes. "ASC leaders may not invest time to find a problem; they may just blame the vendor," says Mr. Orseno. "The consequence of which they unfamiliar with their own data." "Regardless of whether you outsource or perform all functions in-house, it is a team approach," says Ms. Sackos. n The Financial Pulse of Your ASC: 4 Key Notes on Revenue Cycle (continued from cover) Michael Orseno April Sackos SAVE THE DATE October 22 - 24, 2015 • Swissôtel - Chicago, Illinois learn more & register at https://www.regonline.com/22ndAnnualASC Becker's ASC 22nd Annual Meeting The Business and Operations of ASCs

• Cover