1. Start or convert to a monthly profit-distribution plan. ASCs that do not already have a monthly profit-distribution plan should use this approach, writes Brent Lambert, MD, president and owner of ASCOA. Distributing profits on a monthly basis is a powerful tool in getting investor physicians to focus on the financial performance of the center. Investors receiving monthly profit checks and financial performance reports are often more willing to eliminate wasteful practices and actively seek out additional, perhaps innovative, ways to reduce costs. A monthly profit distribution plan could include distribution of a moderate monthly amount to investors — just enough to reflect the cash flow improvement of the ASC. Even small distributions — as low as even $500-$1000 per month — can be effective in cultivating a financially responsible mindset among investors.
From: 10 Steps to Improving ASC Profitability With Dr. Brent Lambert of ASCOA
2. Give potential new partners a test run of your ASC. For potential recruits in an existing specialty at the surgery center, invite them to use the facility and see if they are comfortable with it, says Larry Taylor, president and CEO of Practice Partners in Healthcare. "This could be for a protracted period of time."
From: 10 Best Practices for Recruiting New Partners to Your ASC
3. Extend hours to increase capacity. A very busy center should not be limited by the usual hours of operation, says Chris Bishop, senior vice president for acquisitions and business development at Blue Chip Surgical Center Partners. Physician-owners may be reluctant to extend hours but they will appreciate how it can improve finances. It does not have to be very onerous – maybe two Saturdays or a few evenings a month. Such time slots would be a great draw to patients who have a hard time getting time off from work. Younger surgeons who are just starting their practices would be interested in off-hours to build up volume.
From: 12 Ways to Maximize Profits at Your ASC
4. Get clean claims out the door. Whether this step is done by the coder or by a separate person, don't underestimate the time required to perform this task accurately, writes Caryl A. Serbin, RN, BSN, LHRM, president and founder of Serbin Surgery Center Billing. Electronic claim submission is just as complex as submitting paper claims. All required information must be inserted accurately and must meet payor requirements. Remember, different states, different payors and different Medicare carriers may all have different requirements.
In order to submit a "clean claim" and avoid delays, use your software's "scrubbing" program to points out errors. Clearinghouses also have "scrubbing" software that checks for errors and returns for correction. Once corrections are made, the clearinghouse should advise you that the claim has been sent to the payor.
From: 10 Steps for ASCs to Collect Full Payment After the Procedure is Performed
5. Keep up-to-date collection tools. An updated insurance matrix outlining each contract is an important tool for collectors, says April Sackos, director of business office operations for Meridian Surgical Partners. Also, verify that all contracts are loaded in your system correctly. Loading all payor contracts enables collectors to evaluate if you received payment at the contracted rate. Also, if you receive your payor news bulletin electronically, make sure you keep them in an accessible shared e-folder and that everyone knows how to access them. If you receive updates in hardcopy, place in a binder and ensure that your staff is reviewing them in a timely manner.
From: 6 Common Collections Mistakes and How to Avoid Them
6. Do not perform non-profitable cases. It's critical to understand your cost and expected reimbursement on each and every case, says Joe Zasa, managing partner of ASD Management. Educate your surgeons on cases that are losers for the center so you can keep them out. In turn, work with third-party payors to negotiate carve outs for procedures for these losers for your center. Remind them that if the case is done in the hospital, it will cost them much more.
From: 5 Ways Struggling ASCs Leave Money on the Table
7. Add spine, but do so wisely. Naya Kehayes, CEO of Eveia Health Consulting & Management, sees a great deal of promise for spine in ASCs. "Spine is probably the newest, biggest most costly surgery done in the hospital that can be done outpatient," she says, but she cautions that ASCs should contact payors before deciding to add any specialty. "The biggest mistake an ASC can make is to buy all the equipment and then talk to the insurer," she says. Ms. Kehayes also sees great potential for ASCs that add cochlear implants, vaginal hysterectomies and some of the larger urology cases to their list of procedures.
From: 5 Best Specialties for ASCs Now
8. Offer ownership to high-volume physicians. "One decision that an ASC failed to make [which hindered profitability] was to offer ownership to a high-volume producer," says Kenny Spitler, senior vice president – development for HealthMark Partners. "He eventually took his business away from the practice and to another surgery center where ownership was offered. Additionally, they did not reduce their staff which was covering the departing doctor's case volume, which consequently put them in a negative cash flow situation."
From: Improve ASC Profitability: Case Studies With Kenny Spitler of HealthMark Partners
9. Perform thorough insurance verification on every patient. Better performing centers maximize their reimbursement by performing a thorough insurance verification on every scheduled patient, writes Michael Orseno, revenue cycle director for Regent Surgical Health. This enables them to determine if a patient has benefits, both in-network and out, and make payment arrangements for patients who don't have coverage. Particular attention must be paid to out-of-network and self-pay patients. Many payors have implemented caps on out-of-network procedures that rarely cover costs. Neglecting to perform complete insurance verification may result in a center performing a procedure for little reimbursement or, in extreme cases, for free.
From: Maximize Reimbursement: 4 Strategies for Success
10. Be aggressive in dealing with supply costs. Focusing on supplies can bring significant savings, says Ross Alexander, MBA, the administrator of The Surgery Center of Fort Collins (Colo.), a multi-specialty ASC owned and managed by a group of surgeons, Poudre Valley Health System and Surgical Care Affiliates. This is especially true of a center like the Fort Collins ASC, which performs neurospine procedures and can have large implant costs. Developing relationships with a group purchasing organization and with vendors is a must, as is monitoring GPO contracts to ensure you continue to receive the best prices.
Remaining vigilant about supply costs also means staying open to alternative products and services and maintaining a willingness to push back against vendors who impose price increases even in a low-inflation environment, Mr. Alexander says. "You really have to stand up and explain to vendors ASCs receive fixed case rates and say we really can't take this kind of price increase."
From: 5 Ways Surgery Centers Can Rein in Costs and Build Physician Relationships