In a presentation at the 9th Annual Orthopedic, Spine and Pain Management-Driven ASC Conference in Chicago on June 9, Brian Brown, regional vice president, operations, Meridian Surgical Partners, shared a number of areas of performance ASCs should review daily, weekly and monthly. Here are 10 of the areas highlighted by Mr. Brown as well as recommendations to improve performance in each of these areas.
Daily
On a daily basis the ASC should examine:
1. Scheduling. Identify any holes in the schedule and, if needed, consolidate cases and release staff early. Additionally, are the cases scheduled going to make the center money? To ensure this, centers should aim to schedule cases that are profitable based on the case and payor. ASC staff should also verify patient insurance before the day of surgery to ensure coverage has not lapsed.
2. Supply costs. Check pricing of supplies to ensure they match contracted rates and monitor supplies being opened in the OR vs. those actually being used.
3. Collections. Verify which billing went "clean" each day and track accounts rolling into 90 days past due. Implement a system to contact patients at various points along the past-due spectrum to reduce the number of claims reaching 90 days past-due.
Weekly
On a weekly basis, ASCs should examine:
4. Performance against collections goals. Set specific collections goals. To set the goal, Mr. Brown recommends adding the last two months net revenue and divide by two and then multiply by 98 percent (allowing for 2 percent bad debt.) Additionally, if a center fails to meet its goal from last month, that deficit should be added back in to the goal. As part of tracking collections performance, ASC staff should track denials and seek to identify any possible trends.
5. Hours per case. Determine productive vs. non-productive hours and make efforts to reduce non-productive hours per case.
Monthly
On a monthly basis, ASCs should examine:
6. Net revenue. Identify reasons behind any variance in volume and rates. For example, was one payor or specialty stronger or weaker than in previous months?
7. Days in A/R. Set a baseline goal for days in accounts receivable. Mr. Brown says this can range from 15 to 45 days, depending on whether the center is in-network or out-of-network and whether cases are implant-heavy, as implants often require paper claims that take longer to process.
8. Cost per case. Determine the cost of supplies and labor per case and share results by provider with ASC leadership.
9. Cash flow from operations. Determine cash flow for the month, plan capital expenditures and evaluate debt service.
10. Satisfaction. Review patient satisfaction ratings monthly and address any patient complaints immediately. Additionally, physician and staff satisfaction surveys should be performed annually.
Daily
On a daily basis the ASC should examine:
1. Scheduling. Identify any holes in the schedule and, if needed, consolidate cases and release staff early. Additionally, are the cases scheduled going to make the center money? To ensure this, centers should aim to schedule cases that are profitable based on the case and payor. ASC staff should also verify patient insurance before the day of surgery to ensure coverage has not lapsed.
2. Supply costs. Check pricing of supplies to ensure they match contracted rates and monitor supplies being opened in the OR vs. those actually being used.
3. Collections. Verify which billing went "clean" each day and track accounts rolling into 90 days past due. Implement a system to contact patients at various points along the past-due spectrum to reduce the number of claims reaching 90 days past-due.
Weekly
On a weekly basis, ASCs should examine:
4. Performance against collections goals. Set specific collections goals. To set the goal, Mr. Brown recommends adding the last two months net revenue and divide by two and then multiply by 98 percent (allowing for 2 percent bad debt.) Additionally, if a center fails to meet its goal from last month, that deficit should be added back in to the goal. As part of tracking collections performance, ASC staff should track denials and seek to identify any possible trends.
5. Hours per case. Determine productive vs. non-productive hours and make efforts to reduce non-productive hours per case.
Monthly
On a monthly basis, ASCs should examine:
6. Net revenue. Identify reasons behind any variance in volume and rates. For example, was one payor or specialty stronger or weaker than in previous months?
7. Days in A/R. Set a baseline goal for days in accounts receivable. Mr. Brown says this can range from 15 to 45 days, depending on whether the center is in-network or out-of-network and whether cases are implant-heavy, as implants often require paper claims that take longer to process.
8. Cost per case. Determine the cost of supplies and labor per case and share results by provider with ASC leadership.
9. Cash flow from operations. Determine cash flow for the month, plan capital expenditures and evaluate debt service.
10. Satisfaction. Review patient satisfaction ratings monthly and address any patient complaints immediately. Additionally, physician and staff satisfaction surveys should be performed annually.