Here are five tips for effective GI/Endoscopy centers.
1. Disinfect instruments appropriately. Shaun Sweeney, vice president of sales and marketing for Cygnus Medical, explains ASCs should follow manufacturer recommendations, which may include using approximately 500 mL of enzymatic detergent and water to suction and flush out channels. Skipping the first step of suctioning enzymatic detergent through the suction channels will not only affect the efficacy of the channels being properly reprocessed but will also release high volumes of gross contamination into the soaking stage. "High-level disinfection is dependent on every stage being performed properly. A breakdown early on can affect the efficacy of the process later," he says.
2. Make sure disinfectants are legal. There are products out there which are sold but do not comply with the state and national requirements of regulatory agencies, says Jack Wagner, president of Micro-Scientific. You need to look at the label and if it's legal, it will give you an EPA registration number. That number is like a driver's license. It lets regulatory people and you know the product has been tested, evaluated and it has been approved by the U.S. EPA.
If there's no registration number on the label, it's not a legal product to use.
3. Perform case-costing to obtain data. Many ASCs do not have cost data because they typically don't need it when sending out claims, says Ron Brank, a group vice president for Symbion in Nashville, Tenn. For example, Symbion ASCs are mostly paid through a set fee schedule or a grouper methodology. To capture cost information, ASC staff members need to perform case-costing, which involves reviewing the chart for each case, determining what supplies, such as implants, were used. Then they add up the supply and labor costs for each case and enter the data into the patient accounting system. "This will require extra staff time, but the cost is well worth it," Mr. Brank says. Symbion's IT department captures this information into its data warehouse, adds indirect and fixed costs and provides reports on case-profitability in a number of views, such as by CPT code, specialty, financial class and physician.
The data can be used during managed care negotiations. In managed care contract negotiations, "an ASC needs meaningful data about the costs of each particular type of case to know whether it can make a profit on the rates the payor is offering," Mr. Brank says. Ambulatory surgery centers that cannot do this often end up accepting a money-losing rate. Alternatively, the data-poor ASC may compare the payor's offer to estimates of costs or a small sample of cases. This is risky because it may not accurately reflect the true average cost per case.
4. Conduct smart payor negotiations. If possible, meet payor representatives in person for the negotiations. "We get so much better results when we meet together," says Jim Odom of The C/N Group. "We can read their body language and see where they are coming from. If they are saying 'no' to something, you can read their body language to see if there might still be an opportunity there." Additionally, take the time to let them know who you are and what your facility does. You can invite the representative to your facility so they can see where you operate every day. This forms a deeper relationship and can help the representative connect the finances to the actual healthcare provided.
Additionally, create a calendar with dates of expected outcomes or milestones and inform the payor of these dates in advance. Delays in scheduling a meeting or receiving a response to your counter proposal can be hazardous for the center. Always let the payor know the date you expect to conclude negotiations, says Mr. Odom. This date should be at least one month before the expiration of your current contract.
5. Look at warranty offers on equipment. Certainly you want to consider the warranty period and ensure it is adequate, says Ray Midlam, product manager, certified pre-owned equipment for Olympus America. However, even a warranty with the most favorable terms is only as good as the supplier behind it. You need to be fairly confident they are going to stay in business while you own the equipment and that they can deliver on their promise in a timely fashion. Most sellers in the secondary market have no ready or reliable access to parts.
Related Articles on GI:
Celiac Disease Treatment Differs Between Physicians and Academics
Dr. Douglas Rex Discusses Future of Screening Colonoscopy
New Jersey Srugeons Perform State's First Robot-Assisted Bariatric Surgery
1. Disinfect instruments appropriately. Shaun Sweeney, vice president of sales and marketing for Cygnus Medical, explains ASCs should follow manufacturer recommendations, which may include using approximately 500 mL of enzymatic detergent and water to suction and flush out channels. Skipping the first step of suctioning enzymatic detergent through the suction channels will not only affect the efficacy of the channels being properly reprocessed but will also release high volumes of gross contamination into the soaking stage. "High-level disinfection is dependent on every stage being performed properly. A breakdown early on can affect the efficacy of the process later," he says.
2. Make sure disinfectants are legal. There are products out there which are sold but do not comply with the state and national requirements of regulatory agencies, says Jack Wagner, president of Micro-Scientific. You need to look at the label and if it's legal, it will give you an EPA registration number. That number is like a driver's license. It lets regulatory people and you know the product has been tested, evaluated and it has been approved by the U.S. EPA.
If there's no registration number on the label, it's not a legal product to use.
3. Perform case-costing to obtain data. Many ASCs do not have cost data because they typically don't need it when sending out claims, says Ron Brank, a group vice president for Symbion in Nashville, Tenn. For example, Symbion ASCs are mostly paid through a set fee schedule or a grouper methodology. To capture cost information, ASC staff members need to perform case-costing, which involves reviewing the chart for each case, determining what supplies, such as implants, were used. Then they add up the supply and labor costs for each case and enter the data into the patient accounting system. "This will require extra staff time, but the cost is well worth it," Mr. Brank says. Symbion's IT department captures this information into its data warehouse, adds indirect and fixed costs and provides reports on case-profitability in a number of views, such as by CPT code, specialty, financial class and physician.
The data can be used during managed care negotiations. In managed care contract negotiations, "an ASC needs meaningful data about the costs of each particular type of case to know whether it can make a profit on the rates the payor is offering," Mr. Brank says. Ambulatory surgery centers that cannot do this often end up accepting a money-losing rate. Alternatively, the data-poor ASC may compare the payor's offer to estimates of costs or a small sample of cases. This is risky because it may not accurately reflect the true average cost per case.
4. Conduct smart payor negotiations. If possible, meet payor representatives in person for the negotiations. "We get so much better results when we meet together," says Jim Odom of The C/N Group. "We can read their body language and see where they are coming from. If they are saying 'no' to something, you can read their body language to see if there might still be an opportunity there." Additionally, take the time to let them know who you are and what your facility does. You can invite the representative to your facility so they can see where you operate every day. This forms a deeper relationship and can help the representative connect the finances to the actual healthcare provided.
Additionally, create a calendar with dates of expected outcomes or milestones and inform the payor of these dates in advance. Delays in scheduling a meeting or receiving a response to your counter proposal can be hazardous for the center. Always let the payor know the date you expect to conclude negotiations, says Mr. Odom. This date should be at least one month before the expiration of your current contract.
5. Look at warranty offers on equipment. Certainly you want to consider the warranty period and ensure it is adequate, says Ray Midlam, product manager, certified pre-owned equipment for Olympus America. However, even a warranty with the most favorable terms is only as good as the supplier behind it. You need to be fairly confident they are going to stay in business while you own the equipment and that they can deliver on their promise in a timely fashion. Most sellers in the secondary market have no ready or reliable access to parts.
Related Articles on GI:
Celiac Disease Treatment Differs Between Physicians and Academics
Dr. Douglas Rex Discusses Future of Screening Colonoscopy
New Jersey Srugeons Perform State's First Robot-Assisted Bariatric Surgery