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Improving the Patient Experience: Clinic and ASC Communication
59 Plays4 days ago
In this episode, Grant Duncan sits down with Katie Sypher, a registered dietitian and healthcare operations leader, and Michael McClain, founder of LeftCoast Healthcare Advisors, to tackle one of the most overlooked challenges in the ASC space: communication. They share practical strategies for aligning messaging between clinics, surgery centers, and patients — covering everything from mapping touchpoints to creating a single source of truth to reduce duplication, avoid confusion, and build patient trust.
After that, tune into our Data & Insights segment, where we explore why ASCs saw claim denial rates drop from 8% to 4% in 2024 — a 50% improvement — and what your center can do to replicate that success.
Resources Mentioned: 2024 State of the Industry Report by HST Pathways
Brought to you by HST Pathways.
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Transcript
Introduction and Episode Overview
00:00:00
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, and then we'll close the episode by recapping the latest news impacting surgery centers.
00:00:16
Speaker
We're excited to share with you what we have. So let's get started and see what the industry's been up
Meet the Guests: Communication Challenges in ASCs
00:00:21
Speaker
to. Hi, everyone. Here's what you can expect on today's episode. In this week's conversation, my colleague Grant Duncan sits down with Katie Seifer, a registered dietitian and healthcare operations leader, and Michael McClain, founder of Left Coast Healthcare Advisors.
00:00:36
Speaker
Together, they dig into one of the most important but often overlooked challenges for ASCs, communication. Katie and Michael share practical strategies for aligning messaging between clinics, surgery centers, and patients. Everything from mapping out touch points to documenting workflows so that you can reduce duplication, avoid confusion, and ultimately build trust with your patients and staff.
00:00:57
Speaker
You'll even hear real-world examples of how simple process changes can ease patient anxiety and improve efficiency across the board. After that, we'll switch over to our data and insights segment, where this week we're going to be talking about claimed denial rates.
Aligning Communication Across Stakeholders
00:01:09
Speaker
The big news, ASCs saw their denial rates drop from 8% to 4% in 2024, a 50% improvement. So in that segment, we'll talk about what's going on there and how your center can benefit.
00:01:21
Speaker
I hope everyone enjoys today's episode and hears what's going on this week in surgery centers.
00:01:35
Speaker
Hey, Michael and Kate, thanks so much for joining us on the podcast today. I'm excited to be speaking with both of you around improving the patient experience with clinic and ASC communication.
00:01:48
Speaker
Before we jump in, can you give quick intros for our audience?
00:01:55
Speaker
Well, my name is Katie Seifer and I'm a dietitian. I also have my MBA. And throughout my career, I've spent a ton of time opening clinics, streamlining operations, standardizing the process across multiple locations, as well as within surgery centers, integrating the clinic work and communication with the surgery center, all with the goal of to improve the experience for the patients, for the staff, and for the physicians. So I'm really passionate about this conversation and the the again, trying to focus on not creating more work, but creating work that is going to really aid in the process and the experience.
Guest Backgrounds: Improving Patient Experiences
00:02:36
Speaker
And so for me, I'm Michael McLean. I'm the founder of Left Coast Healthcare care Advisors. We're a ambulatory surgery consulting firm. In short, I'm the kid who didn't know what he wanted to do when he grew up.
00:02:48
Speaker
But before, you know, all this history of ambulatory surgery where I've run large clinics, I've run ASCs, surgery hospitals, was the CEO for a large health system over all of their ambulatory surgery assets. But before that, I was a hospitalist in critical care PA and spent a lot of time in integrated leadership roles.
00:03:13
Speaker
One in particular, working with Ascension where I oversaw yeah er development. for integrated clinical teams trying to improve the throughput and really limit overlap for patients and providers as they go through inpatient stays. So ED to floor to discharges, hospitalists. So lot of experience in this sort of patient communication space.
00:03:41
Speaker
Yeah, well, I'm grateful that we get to talk with both of you about that. So let's start with the information sharing between ah clinic, the ASC and patients.
Avoiding Conflicting Information in ASCs
00:03:53
Speaker
As you mentioned, it can be complex, but how can everyone stay aligned avoid sharing conflicting info and confusing the patient? Maybe I'll start. That's such a great question. And there's a lot to unpack there.
00:04:08
Speaker
Anytime that I'm asked to optimize the communication process, I always like to start with identifying who are the key stakeholders. So in this situation for a surgical journey, that's going to be the clinic, including the surgeon. It's going to be the surgery center.
00:04:24
Speaker
It's going to be the patient. It's going to be the payer. And those are four different stakeholders that have four very different roles within this process. And each one of those stakeholders is going to need information. And they're also going to be sharing information.
00:04:39
Speaker
And so part of the frustration or some of the confusion that we see is occurs when there's duplication, multiple people saying the same thing or saying different things. If there's unanswered questions, I don't know where to go to get this answer to question or get my question answered.
00:04:55
Speaker
um And really a lack of understanding of the entire journey from decision to have surgery all the way to the surgery, all the way to that post-op visit. And so when we identify those key stakeholders, the next step is the documentation. and I'll say it starts with the three W's. So what information does everybody need?
00:05:16
Speaker
Who is that information being shared with? And what time Is that, what's the timing or when does that information get shared?
Impact of Streamlined Communication
00:05:25
Speaker
And so when you take a few moments and you actually document it from everybody's lens or everybody's view or what their role is, it really highlights the areas of opportunity where you can streamline communication and then where can you minimize conflicting information and where can you share information?
00:05:43
Speaker
Yeah. And I think that's what, what it's really all about is because when it comes down to it, sort of figuring out and agreeing to what's going to be if the single source of information or what we call the single source of truth for the entire care team, whether it's the clinic or the ASC and the patient and making sure it's in a single place or an area, whether it's technology or not, having it that's easy easily accessible for the care teams, for the patient and making sure that everybody knows how to access it and be able to share that information with the patient.
00:06:21
Speaker
So you're not making the information up But that means there's a lot effort to go in but before you deploy a technology solution, which is putting in that effort.
00:06:32
Speaker
What information do you need? What's going to be shared? Do both the clinics and the ASCs understand what information is shared with patients in what order and have that work done before?
00:06:46
Speaker
Have the process really dialed in? Because the last thing you want to do is have patients get conflicting information, you know, a show up at seven, show up at nine, a show up at two hours before, it's three hours before.
00:06:59
Speaker
Because you want to improve that trust and clarity, not disturb it at a time when a patient is maybe the most concerned or most confused, which is right before surgery.
00:07:12
Speaker
Yeah, really resonated with both of what you were saying. And especially for the ASCs where they're coordinating with multiple physician offices, that becomes even more complex.
00:07:24
Speaker
You know, some ASCs, they've just got one or two feeders, but if you have a lot, well, Michael, you have to do that process with maybe dozens. So that becomes even more valuable. It's not just, okay, how do we figure out the scheduling? It's that communication piece. So important too.
00:07:42
Speaker
liked how you were talking about ah questions to ask. I feel like you could even throw in other common questions like where, why, you know, the other common these types of things. So those are great frameworks for people to think through.
00:08:01
Speaker
You also talked about how there are multiple stakeholders that have to be involved. And that means there's a lot of touch points between all those stakeholders from pre-op to post-op.
00:08:14
Speaker
How can ASCs go about mapping those out and proactively preparing that thoughtfully communication across all of those physician offices they
Coordinating Communication Across Multiple Offices
00:08:26
Speaker
may be working with?
00:08:28
Speaker
Well, think this is where it can't be done in a vacuum, right? Because what's really interesting and the more work that we've done with ASCs, whether it's a single ASC that's owned by a single practice or they have, like my very first ASC had six different surgeon practices in a multi-specialty ASC.
00:08:47
Speaker
It really starts out understanding who needs what. Because as you're looking at the processes, we, you know, we're talking about everything from, you know, benefit verification, surgery authorization, you know, in some states, it's not prior authorizing the case, but some states there are payers that require separate facility prior authorization. So you've got two competing prior authorizations going on.
00:09:13
Speaker
You have the clearance needs, the cardiac clearance. So you have pre anesthesia, you know, have you had dental work? And then it comes down to surgery schedule, surgery staffing, capacity in the ASC.
00:09:27
Speaker
And a lot of times these teams need the same information, but for different reasons and at different times in the process. And so really getting these teams together and understanding What do you need at what point during your scheduling process, preoperatively, intraoperatively, postoperatively?
00:09:47
Speaker
and know, when does the patient typically return to the office? What's the information that needs to be shared? Getting those teams together, it's not enough just to send up a copy of the discharge plan.
00:09:58
Speaker
It's really understanding and and working with getting those individual teams together, have that conversation, lay out a process for that office that works and document it, get those parties on the same page and say, this is who's going to have that conversation when.
Resources and Strategies for Streamlining
00:10:19
Speaker
and where and here's where the patient should go for answers and having that almost scripted process because that can really eliminate that multiple phone calls multiple emails you know i i recently had surgery in myself uh the repairer of biceps down it And there's nothing more frustrating than my my office is telling me to go to the surgery center. Well, I know the surgery center wants you to be there three hours early, but that's silly because you'll just sit there.
00:10:48
Speaker
So show up 90 minutes ahead. You don't need to be there three hours early. So I'm on my way and they're calling me saying, we're going to cancel your case because you're not here three hours early.
00:10:58
Speaker
And so I rushed to get there and I sit around for an hour and a half to doing nothing. You know, so both parties were right, but there's nothing more frustrating as that they should be stuck in that.
00:11:11
Speaker
Oh man, what a tough personal experience, but it totally highlights the conflicts that can arise when there isn't this alignment. And I'm sure everybody on the phone that's listening has examples of either duplicative information or conflicting information. And so really, how do we, what do we do with that? How do we minimize that? And that's where it comes back to getting people together and documenting exactly. If you lay it all out and you take the whole journey and you map every app with every stakeholder, you can easily see the
00:11:46
Speaker
There is duplication where there's opportunity, and then we don't have to ask the patient seven times. Let's ask it once, and we'll make sure the right people getting the information that they need, that decreases. We're all trying to be more efficient. That also helps with our efficiency.
00:12:03
Speaker
But I think Michael and as we were preparing for this, like, what does this sound like? Because this is a lot of work. It's a lot of effort. And I'm going to take this time and get people together to map this out.
00:12:15
Speaker
what would How would this look in real life, and a real life example? And so, Grant, let's just pretend for a moment that you're having surgery or you need surgery. And I'm on the MA from the clinic, so I'm going to call you.
00:12:27
Speaker
before any of this work has been done. So a typical call, right? Hey Grant, this is Katie from Dr. McLean's office. Just wanted to let you know you have a surgery. We have it scheduled here for August 7th.
00:12:38
Speaker
Just so keep in mind, the surgery center is going to be calling you with some additional details. They'll tell you when to show up, all that stuff, but just look for that call. Not sure when it's going to be, but they'll be calling you.
00:12:49
Speaker
Then we'll see you here for post-op. So I think that's what we needed to tell you. I hope you have a great day and we'll see you after... You may have a lot of other questions like, wait a second, wait, what am I supposed to go? Where is this location?
00:13:02
Speaker
What does my caregiver do while I'm waiting? And unfortunately, I may not be able to answer those questions and just say, they'll go in, they'll let you know. Versus, Michael, what made it sound like if you implemented this whole process and you've streamlined the communication?
00:13:20
Speaker
Yeah. and And while there's still sometimes a gap in the information because they're two different businesses, that gap can end up looking a lot more like, you know, Hey, Grant, I'm Michael.
00:13:30
Speaker
I'm a Dr. Seifers office and you're going to have surgery on August seven And the the way that the process goes is that the surgery center makes the final decision because they are the one who are going to be working with you And they know your medical care and your needs for the surgery best. So you're going be getting a call in the next seven days.
00:13:52
Speaker
That call is going to come and they're going to review with you the time to arrive for surgery. They're going to review with you any medications you should take the morning of. They're going to talk to you about where to park.
00:14:03
Speaker
They're going to talk to you about anything you should bring with you to the surgery center. You should get that call within this time period between 7 a.m. and 4 p.m.
00:14:14
Speaker
If you haven't heard from them in the next three days, here's the phone number to call where you can feel free to call me back. And I'll make sure that connects. But this is normal.
00:14:25
Speaker
And that's because they're setting up this care just for you. We work with them every day. We've already worked with them to schedule what your follow-up appointment is, but they will confirm with you on that day of surgery when you'll return because it'll be based on what the surgeon sees in the office or sees in the surgery.
00:14:45
Speaker
And then we will see you back here. Do you have any questions that I can answer for you or can I help make this any easier for Even though it's, it's a few more words, it's a little more scripted.
00:14:59
Speaker
It puts the patient at ease to expect a level of uncertainty, but it gives them as much information as possible. And that's because there's this level of communication and that sort of forces a level of commitment on both sides.
00:15:15
Speaker
I think what it also does is it really builds that confidence within the patient that each of these people are here for me. This is often a scary, overwhelming time, and we want to ease their way. Everyone's busy, right? You're on the phone. We talk to the patient.
00:15:29
Speaker
We're in clinics. We do this every day. But this is not what the patient does every day. This is a very new experience for them. And we want to build that confidence. throughout that entire journey from clinic to surgery center back to clinic. So it seems like everybody is on the same page and they've got my back and they're here to make this as successful as possible.
00:15:51
Speaker
But it does take time, as we said, and it does take effort. And so some of the ways to make sure to work through this is find an internal person. Maybe you assign an internal person. This is something that you really want to tackle.
00:16:04
Speaker
Who can help you and give that person that role? Because this is not something that you do on the side in combination of all the other probably seven hats that somebody is wearing.
00:16:15
Speaker
Having an internal person to really map that out or bringing in an external expert that can really see from each of the different key stakeholders and help map that out and help identify where those opportunities and those gaps are another way to see the entire picture, especially if you're having It's going to hopefully build that confidence in the clinician and the surgeon that say, I want to go to this surgery center because my patients have a great experience there.
00:16:43
Speaker
And they come back to me and they're talking about how awesome it is. And that's what they're telling their friends.
Technology's Role in Enhancing Communication
00:16:48
Speaker
So it's about the patient, but it's also about how do we continue to make this experience great during and then after. And then hopefully that also helps build business.
00:17:00
Speaker
And I would definitely be much more comforted hearing the second scripted talk track compared to the first there. You know, I was still might ask, do I really have to get there as early as, as they say, but ideally they would be on the same page and not say, yeah, cut the time in half. Don't do three hours, do 90 minutes.
00:17:22
Speaker
Katie, who... Who do you typically see as the people being willing to volunteer to take on this internal project if they're going to just do it internally?
00:17:33
Speaker
And then second question would be if someone like Left Coast Healthcare Advisors came in and was going to be helping with this, who would you typically be partnering most closely with to do that?
00:17:47
Speaker
That's a really great question. And i it's hard to just pick out a specific role because there are, and really I would say looking at your team, some people like to do this and some people are like, this is not what I like to do. So I, when I, as a manager, if I was asking someone to step up, it really was finding someone that's passionate about this. So someone that's going to be able to sink their teeth in and say, yes, I understand and recognize that this is something that we could do better and this is something I want to work on.
00:18:18
Speaker
And then coupling that with, do you have the bandwidth? Do you have the time? Because you don't want to start a project and start something like this and then get in over your skis and go, wait a second, we don't have time. And then it just falls through the cracks. And so i would say really it's looking at it a team member that is passionate and that has the time, a little bit of extra time to spend. And so that could be maybe a surgery scheduler. It could be a COO. I mean, probably not the CEO, but it could be a quality improvement person. It could, it really depends on who is at your center and what role, but I would definitely start with, are they interested and passionate about it?
00:18:55
Speaker
And do they have the bandwidth to take this on? And Michael, don't know if you have anything extra to add. Yeah, know I would, I would add that it helps if it's someone who's in a, in a either pre-op or perioperative role, because so much of the communication involves what happens before and after surgery.
00:19:13
Speaker
Um, and so understanding what's the pre-op screening process, someone who has a regular conversation and with a business office team with anesthesia, because so much of this is about information that's happening before the patient ever gets there.
00:19:29
Speaker
That doesn't mean that it has to be a perioperative's RN or it has to be anesthesia. You know, it can be very effectively run by a business office person. But again, there's so much information back and forth.
00:19:42
Speaker
And I'm always a big fan of volun-telling people, meaning asking for volunteers in a very narrow focus of people who have the right skillset. But Katie's comment in about bandwidth.
00:19:54
Speaker
Sometimes you have to make the bandwidth for feet. And so free them up from other services. The quick news is in an ASC setting, this is a great QAPI project. So you can designate this as a QAPI project and get credit for it on your surveys. And you know, this is important to us.
00:20:12
Speaker
We've chosen to put time and energy into this. Just document it. Just document
00:20:18
Speaker
Yeah, and my goal to help listeners connect that further, what could be an example of and before versus after quantitative items to track for that kind of QAPI study?
00:20:31
Speaker
Sure. Good data doesn't have to be complicated data. So sometimes the easiest way to do it is to, maybe it's doing a quick survey of your patients.
00:20:42
Speaker
And starting with questions about, and it's something that's very easy is query your patients. Start with 20 patients. What are the two things that you like the most or you like the least about your communication process?
00:20:56
Speaker
Do the same thing with your schedulers at your clinic office, and then the same thing with your own staff and compare notes. And then ah from those buying, you know, what are the common themes that we could address?
00:21:12
Speaker
Put together a very simple sort of plan, do check, act process. So what are you going to plan to fix? Fix something, measure the results, you know, what did we change?
00:21:26
Speaker
And then come back and do that same set of survey again afterwards and see if you've made an improvement in those. Granted, it's small, nobody's looking for a statistically significant reportable data, but start small and start just sort of chunking away at that.
00:21:42
Speaker
And if you have an EHR, great, you can use the tools within the EHR start getting more data. If you don't, you can still do this on paper.
00:21:54
Speaker
But the idea being start somewhere, make it improvement, check it, do it again, just continue to do it again.
00:22:02
Speaker
And Grant, our second question is how would Left Coast approach this or how would we approach it? And I'll give a current example is we're setting up a surgery center and there are, in the beginning, five different clinics that are going to be utilizing it. And so it's going into that clinic and actually working with every key member that inter- acts with the patient and saying, what questions do you ask?
00:22:23
Speaker
What information do you provide? What do you tell the patient? And doing that for every key stakeholder and then actually putting that entire map together and then pulling the folks and saying, okay, they're saying X, Y, and Z. You also need that information.
00:22:39
Speaker
What is the best way to get you that information in a timely manner? So that when you call the patient, you can say, oh, I see you talk so-and-so on this day. This is correct. We're going to have you be NPO for for three ever three hours or seven hours or 24 hours, whatever it is.
Aligning Technology with Processes
00:22:56
Speaker
And so really, we we go in and we have those conversations. And what I'll say is fascinating is oftentimes we assume things are happening. And then when we actually go in and verify what we have right now and what is actually happening doesn't always because we get busy or we have workarounds or we recognize That doesn't actually work. And my patient has 20 other questions. So I'm filling in the gaps for them.
00:23:18
Speaker
And so we really are that interview person that I will say that can really gather that information, map it all out, and then begin to highlight the areas of opportunity to say, this is where you could streamline and this is where you could communicate. And these are some tools and resources, whether you have internally or what it is is out and available that can really aid you in this conversation.
00:23:42
Speaker
And I would add that, that in that scenario, and some of the work that in that example where we we're doing, and this could be with any organization that either we or a third party is working with, then we are also sort of pressure testing the EHR itself.
00:24:00
Speaker
What does the documentation look like? Does everybody know how to get to the right dropdown menu to access this information? The assumption being, oh, well, you just pull this down and it's not there.
00:24:13
Speaker
Well, thought that's how you got to it. Well, it's not really. Oh, well, let's quick get on the phone, send an email, whatever we need to do to make sure that we have our process now. Does our technology match the process that we want to flow so that so that we're not creating now workaround because the technology isn't matching the process that we want?
00:24:35
Speaker
And so it's doing that hand in hand. So we're not what I call paving the cow path. Which is we just sort of use whatever tool is in front of us and we figure it out.
00:24:48
Speaker
Just having this conversation that it was another body of work that we did is we actually mapped out the post-op calls. And everybody wants to make sure they're doing their role and they're looking at it from their lens. So as a surgery center and anesthesia, I want to make sure that they're okay when they get home.
00:25:06
Speaker
The surgeon may also say, I want to make sure that they're okay when they get home. And sometimes the payer also wants to make sure in certain situations. And so as an example, as we mapped it out, this patient could be getting four different calls from four different stakeholders post-surgery, which can be really confusing. and it's all asking the same questions. And so it's just another highlighted example to say, wait a second, you're doing this because it it makes a difference. And it's where you're, it's your lens. It's what's really important.
00:25:36
Speaker
But we have to take a step back and look at the entire process and the entire journey and how does my job and my role fit within this larger experience? Because that's when we can really optimize it for efficiencies and confidence for the patient.
00:25:54
Speaker
Yeah, that's right. And when it's coordinated calls rather than four separate, then you're also going to avoid differing information being shared. What, what other roles do you see EHRs or AI or patient texting tools or automation playing and making this easier for everyone?
00:26:17
Speaker
Well, I think that we think that both ETRs and AI play a huge role, but and they have to be deployed with intent. And what we mean by that is that.
00:26:29
Speaker
Tools should complement your process and complement your sort of the the human workforce and not be a sole reliance on the right way to do something.
00:26:41
Speaker
Because when you rely only on the technology and not the process underneath, you have the but potential to create gaps or further create division between siloed organizations. And they're that's nowhere is that more obvious in the sort of the pre-op world where you have outside organizations with information, no matter how well seamlessly organized we think we are, there's always gaps. There's always things that are missing.
00:27:12
Speaker
And so we don't want to have that kind of just single, you know, nobody here is advocating for Epic where everything is one thing where, you know, it's all one massive data that, that doesn't work either. That's look got it all sorts of problems.
00:27:29
Speaker
It is really important to do it with intent. And I think that the challenge is, is that too often, i believe that a lot of clients get wrapped up in the tech piece and not the process piece.
00:27:43
Speaker
And they get working on their tables, they get working on creating, oh, let's get all the data in. We've got to get all our preference cards built and, oh, we got to, and they forget that you need to have your process dialed in first.
00:27:58
Speaker
And most of the time, good tech follows good process. And so there are, there are obviously really high quality that EHRs and the ASC space. We happen to be talking to one of the best here on the phone. So thanks again for having us.
00:28:15
Speaker
But I mean, there's also no shortage of, I get a call a week from somebody who has an AI driven tool and a new EHR, just give us a chance and we'll show you.
00:28:29
Speaker
So you have to be really mindful of where you're getting your technology or resources from just because somebody says they have the new best solution.
00:28:40
Speaker
Really, really do your homework. Talk to your colleagues, talk to the tree organizations, go to your state and local conferences and find out what they're using because it should be surfacing information for you.
00:28:54
Speaker
It should be taking away the projects and the time burning efforts. It should be removing those barriers. It should not be creating new challenges.
00:29:06
Speaker
Not that it's perfect, but it should be reasonably following good process that you already have in place and making things simpler.
Building Team Coordination and Trust
00:29:15
Speaker
It should not be tearing everything out and now you have to learn everything new. If it is, or if the first question is, okay, you tell us what you do and we'll just map it out to match whatever you're doing, that should be a red flag.
00:29:31
Speaker
I would follow up with that is build a framework. There are so used to joke in diabetes is there's a new diabetes drug that came out every single week. And it was like, how do I keep up with that?
00:29:42
Speaker
And it's the same with AI and technology, right? There is so much that is coming out every single day and they can be shiny and they can be fun and they can be promising. But build your framework. And always like to start with what problem are we trying to solve?
00:29:55
Speaker
Because if you can go in and go, what problem are we trying to solve? And go in with the framework to ask the questions is going to help you make smarter decisions and not get excited. It's exciting to caught up in the shininess of something.
00:30:09
Speaker
But if it's not going to actually aid in your process, as Michael said, end up getting dusty on a shelf. So develop a framework and start with the question, what problem am I trying to solve for? Usually that gets you look farther down the road.
00:30:24
Speaker
I agree there. There's an acronym referred CISP solution in search of a problem that is kind of the opposite of what you're saying. It's like, here's this shiny thing.
00:30:36
Speaker
What can we solve? And in reality, as you're saying, starting with the problem is often a much better approach if you want to actually be effective there. A framework that's come to mind is very similar to what you're saying is thinking about people, process, technology, and data.
00:30:54
Speaker
As you were saying, don't just start with the technology and jump in think about those other components there too. Absolutely. What other tips do you have for better coordination?
00:31:06
Speaker
I like to think about better coordination really starts with keeping things simple. So number one, assume positive intent rarely is, and this happens, I've worked both in the clinic setting and the AAC setting, you know, run practices and run AACs.
00:31:23
Speaker
Rarely is the other side doing things wrong on purpose. You know, they're not doing it to be mean. So a assume positive of intent on the other side. I also think it matters to, if you're not sure, that's okay. Just don't tell the patient.
00:31:40
Speaker
If you're not sure, don't tell the patient. Confirm information and get back to the patient. I know that can be chaos in the middle of a busy day. how am I going to confirm this?
00:31:51
Speaker
I got to get through 25 things. How am I going to get back to the patient? Don't guess because when you guess and tell the patient something that's not right, chances are you're going to lose them in terms of trust.
00:32:05
Speaker
And that's the worst thing that you can do. And I think the other takeaway is that whenever you're starting a process, I used to have regularly scheduled staff meetings between clinics and ASCs, schedulers meetings.
00:32:24
Speaker
food beverages, sometimes in the morning, sometimes the evening coffee or donuts, or I know Katie's a clinical dietitian. She'll just be like, no food rewards. Okay. No food rewards.
00:32:36
Speaker
Look at Katie's size versus mine. i love food rewards, but get people together, break a little bit of bread and talk about things. both work-related and not because high-functioning teams also get along. so give us some opportunity to work together and solve problems together on a regular basis.
00:32:57
Speaker
And that really just coupling up with Michael and there's no problem with food. We just want to have balanced food and have lots of different options in all the food groups. But so a gospel gathering, right? We hate we are we are busy.
00:33:10
Speaker
We're in our job. We're focused. and sometimes you don't want to pick up the phone if you don't know the person on the other line. Because what if they're busy? I don't want to interrupt them. What if they don't answer? So find some time outside of work, whether that's a social happy hour or ah ball game, I don't know, something where you can relate and get to know someone. What are their interests? What do they like to do?
00:33:32
Speaker
So that when have a question, oh, I can call Sally. i just spoke with her. This is awesome. You're going to feel much more comfortable and it really is going to create that team environment. I think when we all became isolated with COVID and worked from home, it really highlighted to me that how helpful it was to have relationships that you knew and you could pick up the phone and call.
Practical Advice for ASC Improvement
00:33:54
Speaker
And we've got to find ways when we work in different clinics and in different areas to recreate that camaraderie, as Michael said, so that we really are realizing the good intent and that we all here to make this experience as positive as possible.
00:34:10
Speaker
Good insights. Last question for you here. We do this every week with our guests. What is one thing our listeners can do this week to improve their surgery centers?
00:34:21
Speaker
Besides everything we've talked about. Okay, well, I will go first. I actually was at book club last night and I asked the girls in my book club. I said, okay, who's had surgery? Who's had day surgery? And i brought up an idea of something that anybody could do this week is go in the waiting room, talk to the caregiver, talk to five caregivers that are waiting for their loved one to come out of surgery and ask them two specific questions.
00:34:46
Speaker
What went well from a communication standpoint? What did you feel went really well? And what were the most frustrating things? You can talk to five people and you could clearly quickly identify there may be some opportunities to make some really quick changes that could aid in doing what you're doing. So celebrate those wins and then change the communication, how it's communicated or what's communicated to really improve that experience for the And I'm going to go the other way. I'm going to go very anti-technology here to today.
00:35:19
Speaker
You know, usually I talk about patient communication and patient satisfaction, but you know, survey season is upon us. It seems like lots of places are getting surveyed through the summer and fall.
00:35:31
Speaker
Go in your ASC, grab your camera on a clipboard, go look at every single certificate you have on every single wall. Make sure they all are current.
00:35:44
Speaker
You would be surprised how many boiler certificates, AAAHC or Quad ASF or Medicare license is not up to date. You have the right one, probably sitting in your desk, ah file file, it's scanned, it's in your EHR, it's in your quality software, but it's not on the wall.
00:36:05
Speaker
Just take the time, check everyone, take pictures of the ones that are, and replace them. It just saves you a little bit of headache with the next survey where the patient that's bored and walking around or the caregiver that notices, the place is not licensed.
Reducing Claim Denials with Better Documentation
00:36:22
Speaker
It's worth the five, 10 minutes to do the walk around.
00:36:27
Speaker
Thank you very much, Michael and Katie. Great speaking to you.
00:36:38
Speaker
This week's data spotlight comes from the 2024 State of the Industry Report from HST Pathways, and it's a metric that directly impacts your bottom line, and that is claim denial rates.
00:36:50
Speaker
So here's the headline. In the past year, ASC saw their average claim denial rate drop from 8% to just 4%. That's 50% improvement. So why does matter? so why does this matter Claimed denials are one of the most frustrating operational challenges for any surgery center.
00:37:06
Speaker
They slow down your revenue cycle, tie up your billing staff and rework, delay payments, and sometimes lead to lost revenue entirely if the denial isn't caught and resolved in time. So when the industry cuts the average denial rate in half, that's a signal.
00:37:21
Speaker
Something's working. And it's worth digging in to understand what's happening so that your center can take advantage of the same trends. So what do we think is actually going on? The report points to a few likely factors, better documentation, improved coding practices, and in many centers, the early use of ai and automation to validate claims before they even go out the door.
00:37:42
Speaker
All of this means that ASEs are getting smarter about revenue cycle workflows, and the payoff is significant. Fewer delays, faster reimbursements, and less administrative overhead spent chasing dollars that you've already earned.
00:37:57
Speaker
Now, if your center isn't seeing this improvement yet, don't worry, but do take it as a sign to dig deeper. Here are a few actionable steps that you can take to help close the gap. First, start tracking your denial reasons monthly.
00:38:12
Speaker
Don't just look at the percentage, get into the why. Are they coming from eligibility issues, missing pre-authorizations, incorrect modifiers? Knowing the top causes will help you target improvements where they're going to make the most impact.
00:38:26
Speaker
Second, make sure you've got the right coding support. Whether it's in-house or outsourced, accurate and up-to-date coding is key in reducing claim denials, especially as payer rules get more complex and more specific.
00:38:40
Speaker
Third, lean into tech tools that validate claims before submissions. This includes EHRs or billing platforms that can flag missing fields, authorization gaps, and any mismatches in payer policies before the claim ever leaves your center.
00:38:56
Speaker
And finally, tighten communication with your referring clinics. The podcast conversation earlier touched on this, but when clinic and ASC teams are aligned, especially on eligibility and prior auth, the downstream impact on billing is huge.
00:39:09
Speaker
So to wrap it up, the data point. ASCs have seen their claim denial rates drop from 8% to 4% in the last year. And the centers that are improving in this area are doing so by leveraging smarter workflows, better tech, and stronger collaboration.
Conclusion and Listener Engagement
00:39:25
Speaker
So if you would like to join them, be sure that you're tracking your denials, invest in great coders, validate claims before they're submitted, and communicate tightly with your clinical partners.
00:39:36
Speaker
This is one metric that absolutely deserves a spot on your leadership dashboard because small improvements here can have a major ripple effect across your entire organization. That wraps up this week's episode of This Week in Surgery Centers.
00:39:49
Speaker
A big thank you to Michael McLean and Katie Seifer of Left Coast Healthcare Advisors and of course my colleague Grant Duncan for joining us this week to discuss practical strategies around improving communication between clinics, ASCs, and patients.
00:40:02
Speaker
As always, we'll be back next week with more conversations, insights, and tools to help your ASC thrive. And if you enjoyed the episode, please take some time to leave us a rating or review on your favorite podcast platform.
00:40:14
Speaker
It does help others find our show. Thanks again for tuning in, and we'll see you again next time on This Week in Surgery Centers.