Transcript
Speaker: Welcome to This Week in Surgery Centers. If you're in the ASC industry, then you're in the right place. Every week, we'll start the episode off by sharing an interesting conversation we had with our featured guest.
Speaker: And then we'll close the episode by recapping the latest news impacting surgery centers. We're excited to share with you what we have. So let's get started and see what the industry's been up to.
Speaker: Hi everyone, here's what you can expect on today's episode. Today is one of my favorite shows that we put together. There will be no guest interview and no news or data segment, but instead a highlight reel of all the great advice our most recent guests have shared.
Speaker: Over the last few months, we have had so many amazing ASC leaders on our podcast. And at the end of every discussion, we always ask them, what is one thing our listeners can do this week to improve their surgery centers?
Speaker: So I took 16 of the most recent answers and turned them into this week's recap episode. The advice they share covers everything from managing contracts to leadership tips to advice on becoming more profitable and so much more.
Speaker: So a huge thank you to all of these guests for sharing such great advice. And without further ado, I hope everyone enjoys the episode and hears what's going on this week in surgery centers.
Speaker: I think this week you can probably go in and print out your current insurance payer profile list. So this is every insurance that you have loaded into your software system, right?
Speaker: Print that out and go through it and organize it to make sure that you have a good naming convention, meaning you want to make sure that you know you know that the front desk is always naming the payer of the same way. You're you know productizing the payer, meaning that you're distinguishing between HMO, PPO,
Speaker: Medicare Advantage, because I see a lot of issue with that, right? you know We have a situation where you know i pulled one last week and we may i may have had 200 different insurance profiles and in this system.
Speaker: Half of them were inactive, half of them were double. And you know the other thing is, if you're not properly understanding the frequency of insurance product type, what if you're sending an offer from a payer and they're offering you different rates for HMO or PPO? How are you understanding that frequency difference, right? So I think What I would do is, you know, print out that insurance list of all of your active insurances and go through and organize it, clean it up. And and that's and also a recommended annual practice as well, um because I think that front desk is really so important to not only operation of the ASC RCM, but considering managed care contracting, you know, our data is only as good as what's in the system. So, you know, that management at that front end is key to make sure that that I can look at your data on the back end properly and understand different
Speaker: different things. So hope that was helpful. What I would say is one thing you can do is try to carve out time this week. And the reason I say carve out is because I know as an administrator, your week is already prepared.
Speaker: So I'm saying if you can try to just carve out maybe an hour of time, might be a lot of time to commit to this, to just do some rounds, go around, talk with your staff.
Speaker: talk with your surgeons, talk with your patients. And with the question saying, was there anything you think we can improve upon? Because I think if you did that, you would also have a plethora of information that could help you as you're looking forward to what you need to do for your QAPI studies for the next year.
Speaker: I think empowering Team participation, i think that as administrators and with as busy as everything seems to be these days with staffing and surgeries picking up and things like that.
Speaker: Really considering empowering your team and and delegating out things evenly along the way. it does twofold. It helps ah your administrator not be so overburdened as to doing all of it on his or her own, but it also empowers the team to buy in more. So really targeting the team to help.
Speaker: with different things that interest them, infection control or quality or risk or safety. So I really think empowering the team to participate will really help your ASC in its improvements and then also help just in an overall teamwork aspect of everything.
Speaker: Take credit for the improvements that you make because you make them every day. You do something, you tweak a process, you make something better for a patient. Take credit for it, whether it's a study or not, but celebrate and communicate that to staff. It makes them feel good about the work they're doing and about the surgery center.
Speaker: I think to really challenge the status quo of what you've seen in surgery centers, there's not a one-size-fits-all approach. And I think if you're designing a surgery center, it can be a once-in-a-lifetime and chance to really put your mark on your practice and do things the way that you want.
Speaker: Of course, within the stipulations of the building code and all those different things, but there's so much innovation and creativity that goes on in ASCs these days. Challenge yourself, challenge your design team, and hopefully you have a design team that that is up to that challenge. And we can really work hard and and develop that new model of practice that that you're excited about and make your dream a reality.
Speaker: Yeah, myself, I'm not involved on the operational side of ASCs, but more on the transactional side. So I'll say this, I'll speak more to kind of those centers that I was just talking about that the centers that may be in the market that are independent, that may be looking at a strategic partner or potentially selling some ownership.
Speaker: I would say first, decide what you want out of a partnership. Do you want help? yeah is Is your center currently being managed by physicians and those physicians just want to be physicians and they don't want to manage the business anymore? So do you want a strategic partner to help with managing the day to day operations? Do you want help with managed care contracting? do you want help with staffing or billing and collection? So would say first and foremost, decide what you want to get out of a partnership before you start going down the path of getting a partner.
Speaker: Now, secondly, I would say most important, you know get your house in order. So get your financials cleaned up, get a really good grasp on the economics of the center. Look at your cap table. Does your cap table need to be cleaned up? Do you have a bunch of positions that have ownership that have retired or have relocated or may be violating one third from a violation perspective?
Speaker: clean up your cap table, basically get all your financials together and and really be able to tell your story or the story of your center to potential suitors. And so i think those are the two biggest things is just first decide what you want from a potential partner and then just having everything in order and ready to go to where once you start moving towards potential she partnership, everything's ready to go in TDOT.
Speaker: That's a tough one. I have two answers. I don't know. I'm trying to decide. Okay. I'll take one. Okay. I will say, while we are not a mine not a mind reader, we're not a mind reader.
Speaker: If you recognize that you're going to have an exceptional amount of surgeries in the coming weeks, try to be prepared. Because you cannot guarantee that one of your staff will not, you cannot guarantee that there would not be an emergency, right?
Speaker: So it's better for me to be overly prepared. at the same time that I don't over promise, but you know changes can be made beforehand versus being not prepared. And then all of a sudden, everything is a fire, right? um Understanding at the end of the day, the right agency partner is here to help you.
Speaker: We're not here to say, oh, you need to have someone for 13 weeks. Now, the right partner will say, listen, you only have a high census for four weeks. You don't need to hire someone for four weeks and incur that cost.
Speaker: Let the agency take care of it. It's four weeks. That person is guaranteed to be there. That's why they're signing that contract. So I guess, you know, be prepared and really rely on your agency.
Speaker: Really rely, not even agency because it's such an ugly word, rely on your partner because that's what they're there for. They're there to work for you and with you. thought about this one a lot. This is the hardest leadership skill that people will develop and learn to tell the truth.
Speaker: this is This is one of the hardest things you'll do when you see somebody who you've checked out on or you think is checked out on, but to really hold yourself accountable as a leader, to be in integrity with that person is below the bar.
Speaker: And I am no longer telling them, I'm no longer giving them feedback. I am walking a wide berth around them and essentially endorsing their bad behavior.
Speaker: Everybody in the organization deserves deserves to know where they stand and give them that feedback to help them be better and give them the dignity and empower them to respond to that.
Speaker: It's not your job to help them get there necessarily. You can help them, but you don't need to force them to do the right thing. You can treat them as adults, give them the feedback, positive and negative.
Speaker: But make sure you're telling the truth, whatever that truth is, whether they're doing well, they're not doing well, they could be better. And make sure you're in integrity and and it don't endorse non-confrontation.
Speaker: Don't and endorse or encourage that bad behavior. Yes. So I'm going to come at this more from a business standpoint because that's the side that I'm on in that I think a lot of people i hear are afraid to spend money to make money, whether it be hiring the right provider for more money,
Speaker: You really need to think about it like this, that you need to outsource things that you cannot do yourself or that cost you too much of your time. And if you are an ASC, whether you're a de novo ASC or you've been around forever, you can't get too stuck in your own ways that you're afraid to spend money on things that will ultimately lead to ah ROI, but it might take time. And that really boils down to recruiting in a whole sense and big picture is that you're never going to make back what you pay somebody, maybe even in the first couple of years when you're thinking about, you know, surgeons.
Speaker: But eventually you will. And you have to have that long-term mindset rather than just the upfront cost of things.
Speaker: Well, I think being intentional, this really wasn't talking about disaster readiness so much, but that's another area I see ASCs struggle with is disaster preparedness.
Speaker: And so it's all connected because a fire in an ASC would be a disaster, but polishing off those disaster plans. or Your fire response plan, i think, is pretty unique in an ASC.
Speaker: So take those ideas I mentioned earlier in mind, where you've got a fire drill and you've got a fire exit drill. And so when we talk about a fire response plan for an ASC, the responses are going to be different for those two types of fires.
Speaker: So if you've got a fire in your waiting room, that RACE acronym I talked about is the perfect application for how you respond to that. But RACE doesn't make as much sense in the OR.
Speaker: So look up another good resource for this is with AORN. They talk a lot about fires in operating rooms and that triangle of you've got the the source of ignition, the oxygen and the fuel, and how each person in that environment controls their part of it.
Speaker: So make sure that your fire response plan really addresses both instead of just to an all-encompassing plan.
Speaker: Ultimately, a concentrated effort on maintaining a low claim submission timeframe, your days to bill, and analyzing those chick claim adjudication bottlenecks within claim rejections and payer adjudication lags.
Speaker: It'll give you a solid starting point to identify potential areas for improvement, or if everything is going great, celebrate the success success of your staff. Fantastic. I like the celebration piece. And if we double click on days to bill, you have one or two tips for centers on how to get out of bill faster.
Speaker: On how to bill faster, your documentation being in line as quickly as possible. Ultimately you want to be looking at your mid days to be at two to three from the data surface.
Speaker: Documentation's done, coding's done, charge entry's done by day three. Yeah, I think an actionable step that an ASC could take as a project is go in and audit their top 10 unpaid claims over the last 90 days.
Speaker: Try to identify some common trends across those top 10. And I bet you're going to find a very core foundational issue, whether it be approvals, sort authorizations that were missed, or is it a certain payer that's just constantly asking for medical records, or is it a certain payer that's not paying on time or just, is it coding errors? Just really drill down and see why they're not paid.
Speaker: Cause I guarantee you'll find a core foundational issue that can be addressed on the front end. that can fix that problem. So i think probably the but one thing that I would, that keeps our surgery center and continues to be as successful starting as it has been was the complete buy-in from the physicians.
Speaker: So all of the physicians have ownership in the surgery center. so they're all a hook for the money and so that makes them all very adept at trying to make it work even if they're not happy with the software or instrument or whatnot everybody's in the same boat on trying to make it profitable and start getting back to even and so it's a it's got everybody focused on one mission and so that that has been one of the biggest advantages I think our practice, our surgery center has over most is just the complete buy-in from all of the physicians because they're all investors.
Speaker: Love your nurses that take care of you. Bring in something to your surgery center after you had surgery and you don't remember what happened.
Speaker: Just know that they took really good care of you. So go say thank you to the nurses and the team that took care of you.
Speaker: And I would say, youre y'all ain't gonna like my answer. I would say to do a random audit on your credentialing file. Amen, sister. Okay, I'll double that one.
Speaker: And do a random audit on your monitoring program. and I know that seems crazy and I know it's like, what? Who wants to do extra work? But when you're really looking at it from an auditor perspective and from wanting to keep, ensure that your compliance is up to date and that you're on point, that is the best thing that you could do for your surgery center is to ensure that there are no credentialing issues and that if anybody comes in there to look over your items, that they see that you take care of this department as well as you're taking care of the surgery and all the things that are done in the OR.
Speaker: So sticking with the data analysis and communicating data results to your board, my recommendation would be where you can, where it's possible.
Speaker: Anytime you're displaying data, try to show a trend if you have historical data for it and try to compare that against your plan. A lot of the times when you're trying to communicate with data,
Speaker: giving someone the so what behind a data point can be tough. And it's tough to always cover that in voiceover. And so if you can show them a data point versus a plan or a data point versus a trend, it helps to build in a little bit of that so what so that literally you're looking at just a chart and your audience will start to figure out like, oh, I don't know all the details behind this data point, but I know that trend's going down.
Speaker: And that's either good or bad, depending on the context. And especially if you include your plan against that trend, that's going to do, you're going to do yourself a lot of their a lot of favors by just helping your communications be very concise.
