Joe Zasa, managing partner of ASD Management, an operator of 26 ASCs throughout the United States, discusses five ways ASCs leave money on the table that contribute to their financial struggles.
1. Not collecting eligible co-pays and insurance prior to surgery. Estimate the amount of your patients will owe based on your contracts and train your staff to collect these amounts over the telephone via credit card, Mr. Zasa says. Make sure staff members know to address this issue again on the day of surgery if the amounts are not paid. Your management should track and measure the amount collected every month. "The old saying, 'What gets measured gets done' never gets old," he says.
2. Contracts not loaded into MIS. Typically, struggling ASCs do not have their contacts loaded into its management information system, he says. Thus, they do not have a handle on their true accounts receivable. You should send a claim within 48 hours of surgery, and follow up on the claim 30 days post surgery. The goal is to have your A/R days below 45. "Vigilant focus on collections is lacking is nearly every struggling ASC that performs a reasonable number of cases," Mr. Zasa says. "However, unless you have a true reckoning of your A/R, you cannot work the claims properly. Load your contracts and track your A/R."
3. Performing non-profitable cases. It's critical to understand your cost and expected reimbursement on each and every case. 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, he says. Remind them that if the case is done in the hospital, it will cost them much more.
4. Blindly accepting the physicians' coding is a problem. "Physician codes and ASC codes are similar, but not the same," says Mr. Zasa. "Your operating note is the legal record and the center should code off of this. Further, have a third-party coding company audit charts a couple of times per year and see if you are leaving money on the table or if you have a coding issue. This is a very good compliance measure."
5. Understand your contracts. The clinical director should work with the business manager and must understand the cost of the procedures and which payors reimburse for implants. "Watch implant costs since they have a huge impact on your bottom line, especially in musculoskeletal centers," Mr. Zasa says. "Make sure that you are billing implants properly. Some contracts will pay cost plus a markup for shipping and handling. Others will pay 50 percent of charges. Ensure that you are being reimbursed properly by understanding your contracts."
ASD Management was founded in 1986 is active in turning around struggling ASCs, establishing new ASCs and HOPD MSOs and hospital-physician joint ventures. Mr. Zasa can be reached at (214) 369-2996 or learn more at www.asdmanagement.com.
Read more insight from the leadership team of ASD Management:
- 4 Things to Know About HOPD Management Service Organization Arrangements
- Trends in ASC Valuation
- Growing Your ASC: Q&A With Robert Zasa of ASD Management
1. Not collecting eligible co-pays and insurance prior to surgery. Estimate the amount of your patients will owe based on your contracts and train your staff to collect these amounts over the telephone via credit card, Mr. Zasa says. Make sure staff members know to address this issue again on the day of surgery if the amounts are not paid. Your management should track and measure the amount collected every month. "The old saying, 'What gets measured gets done' never gets old," he says.
2. Contracts not loaded into MIS. Typically, struggling ASCs do not have their contacts loaded into its management information system, he says. Thus, they do not have a handle on their true accounts receivable. You should send a claim within 48 hours of surgery, and follow up on the claim 30 days post surgery. The goal is to have your A/R days below 45. "Vigilant focus on collections is lacking is nearly every struggling ASC that performs a reasonable number of cases," Mr. Zasa says. "However, unless you have a true reckoning of your A/R, you cannot work the claims properly. Load your contracts and track your A/R."
3. Performing non-profitable cases. It's critical to understand your cost and expected reimbursement on each and every case. 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, he says. Remind them that if the case is done in the hospital, it will cost them much more.
4. Blindly accepting the physicians' coding is a problem. "Physician codes and ASC codes are similar, but not the same," says Mr. Zasa. "Your operating note is the legal record and the center should code off of this. Further, have a third-party coding company audit charts a couple of times per year and see if you are leaving money on the table or if you have a coding issue. This is a very good compliance measure."
5. Understand your contracts. The clinical director should work with the business manager and must understand the cost of the procedures and which payors reimburse for implants. "Watch implant costs since they have a huge impact on your bottom line, especially in musculoskeletal centers," Mr. Zasa says. "Make sure that you are billing implants properly. Some contracts will pay cost plus a markup for shipping and handling. Others will pay 50 percent of charges. Ensure that you are being reimbursed properly by understanding your contracts."
ASD Management was founded in 1986 is active in turning around struggling ASCs, establishing new ASCs and HOPD MSOs and hospital-physician joint ventures. Mr. Zasa can be reached at (214) 369-2996 or learn more at www.asdmanagement.com.
Read more insight from the leadership team of ASD Management:
- 4 Things to Know About HOPD Management Service Organization Arrangements
- Trends in ASC Valuation
- Growing Your ASC: Q&A With Robert Zasa of ASD Management