Becker's ASC Review

21 ASC Turnarounds Ambulatory Surgery Center of Stevens Point (Wis.). The ASC's average days in A/R have been between 45 and 55, says Becky Ziegler-Otis, RHIA, CPHQ, CHC, CASC, administrator of the center. This has been the surgery center's average for several years. Approximately, 5 percent of our cases are worker's compensation cases which can take months to facilitate payment. "This affects overall A/R days and it all has to be factored into the overall number," she says. The key to keeping A/R low is constant attention, according to Ms. Zeigler- Otis. The ASC uses an outsourced billing company, SourceMedical's Revenue Cycle Services, which provides constant attention to the A/R. "I also work closely with the billing company and when needed we have conference calls with insurance company provider representatives to ad- dress outstanding denials or appeals status. There are times in which we coordinate regular monthly meetings which are very helpful in address- ing outstanding issues," she says. "The meetings help identify trends or patterns you may be having with a specific payer and allows you to coop- eratively work with the payer on ways to avoid having the denials in the future." There are also constant changes in regulation and billing agreements, notes Ms. Zeigler-Otis. Keeping on top of these changes and getting ready for code changes is essential. "If you don't pay attention to the details you could be losing important rev- enue," she says. The surgery center offers a number of treatments, including carpal tunnel release, shoulder procedures, trigger finger, bunion correction, cataract re- moval and pain management. The Ambulatory Surgical Pavilion at Robert Wood Johnson (New Bruns- wick, N.J.). The ASC's average number of A/R days is 26. It has maintained this for the last two-and-a-half years. "The revenue cycle specialist is very consistent – she works every account with an outstanding balance at least twice every month," says Michael Orseno, director of Regent Revenue Cycle Management. "In addition the facility staff work hard at obtaining pre-au- thorizations and capturing correct insurance and demographic information to minimize denials." The surgery center encompasses 13,000 square feet and it includes four oper- ating rooms, one procedure room, a 10-bed post-anesthesia care unit as well as a 13-bed pre- and postoperative area. The center offers surgical services in a wide array of specialties, such as general surgery, gynecology, vascular sur- gery, plastic surgery, podiatry, orthopedics and pain management. The center is managed by Regent Surgical Health. The Colonoscopy Center (Omaha). Average days in accounts receivable have been running under 20 days for the past year, according to Susan Kingslan, business office manager at the center. Ms. Kingslan attributes their success a number of reasons, including good communication between the reception desk staff and the business office staff as well as charges be- ing entered and claims filed the next business day after the procedure is performed. "We also conduct benefit verification prior to the procedure and request pre- payment of deductible and coinsurance," she says. The Colonoscopy Center is dedicated to performing common anorectal pro- cedures as well as diagnostic and therapeutic colonoscopies. The center was opened by Colon and Rectal Surgery, a physician group that is comprised of seven surgeons. Lakes Surgery Center (West Bloomfield, Mich.). The surgery center's av- erage number of days in gross A/R are 28, says Jennifer Butterfield, MBA, RN, CNOR, CASC, administrator of the center. The center has main- tained that average for the last five years and its benchmark is set at less than 45 days. "I believe the key for successfully keeping days in A/R low is monitoring a 30/60/90 report weekly and continually following up with insurance companies on claims over 14 days," she says. "Also, being enrolled in elec- tronic fund transfers with insurance companies allows faster payment to your facility." The center is fully accredited by the Joint Commission for Accreditation of Healthcare Organizations. It includes four operating rooms, two procedure rooms, examination rooms, preoperative/recovery areas and a reception area. The center's physicians provide care in a number of specialties, including ENT, gastroenterology, general surgery, ophthalmology, orthopedic/sports medicine, spine surgery, pain management and podiatry. Midland Surgical Center (Sycamore, Ill.). The ASC's average number of days in A/R is 29, and it has maintained this number for the last one-and- a-half years. There are a high number of state employees that come to the center, which affects A/R. "We have to wait to be paid because the state is broke. Claims are adjudicated quickly but our wait to get paid is averag- ing 12 months," says Michael Orseno, director of Regent Revenue Cycle Management. "It is a testament to both the facility staff and Regent staff that the center's A/R is so low with such a high state employee percentage in the payer mix." The surgery center is a joint venture between Regent Surgical Health, lo- cal physicians and Kishwaukee Community Hospital in DeKalb, Ill. The center includes two operating rooms and pre- and postoperative areas. It offers surgical services in a wide-array of specialties, such as orthopedics, podiatry, neurosurgery, pain management, plastic surgery and ophthal- mology. Robert Wood Johnson Endosurgical Center (East Brunswick, N.J.). The surgery center's average days in A/R have been 21 days for the past year-and- a-half. The center's case mix is primarily endoscopy procedures. "Physician dictations are very timely and charges are entered quickly," says Michael Orseno, director of Regent Revenue Cycle Management. "The facil- ity staff work hand-in-glove with Regent billing staff to ensure follows up on claims and patient balances are worked in a timely manner." The 6,800-square-foot center is a joint venture between Regent Surgical Health, local physicians and the Robert Wood Johnson University Hospital. It includes fully-equipped operating rooms, a recovery room, a post recovery room and a spacious waiting room. Surgery Center of Mount Dora (Fla.). The surgery center has maintained average days in A/R at 21 days for the last one-and-a-half years. "The surgery center has a great team led by a great business office manager," says Michael Orseno, director of Regent Revenue Cycle Management. "The center has a high percentage of Medicare patients, which helps, but the team follows up on all claims efficiently." The surgery center encompasses 12,000-square-feet, and it features three op- erating rooms and one procedure room. It is a joint venture between Regent Surgical Health, nine local physicians and Leesburg (Fla.) Regional Medical Center. The center offers surgical services in orthopedics, spine, general sur- gery, urology, podiatry and gastroenterology. n 7 ASCs With Quick A/R Turnaround By Anuja Vaidya

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