1. Improve workflow by focusing on specific procedures. Successful orthopedic and spine practices should consider focusing on specific types of procedures, rather than try to offer everything, to eliminate distractions and make sure the institution runs effectively, says ohn Grossmith, MD, a board certified neurosurgeon at The Bonati Spine Institute in Hudson, Fla.. A focused facility has a specific workflow to keep the patients moving through the pre-, intra-, and postoperative process. At The Bonati Spine Institute, the spine surgeons only perform minimally invasive endoscopic laser spine surgery involving the thoracic, lumbar and cervical spine. The surgeons and medical staff have extensive experience treating patients undergoing these specific procedures, therefore the process is able to run smoothly, says Dr. Grossmith.
2. Compare your performance against industry benchmarks. There needs to be an understanding of how well you are performing against industry accepted best practices, says Jim Freund, senior vice president of Genascis. Compare these to how well you are performing in each specific business office function — from transcription and coding and feed through the billing, claim follow-up, patient statements, collections, payment processing and reporting. This will enable you to focus on areas that need improvement and then create a plan that will address this. This can include staff training, on-going education, implement the appropriate rules and processes along service lines, and continually track your performance. The challenge for any ASC, whether independent or managed, is to truly understand their business and make the appropriate changes.
From “The Evolution of the ASC Market: Q&A With Genascis Senior Vice President Jim Freund.”
3. Standardize operating procedures. It is critical to develop standard operating procedures for all aspects of spine surgery, including preoperative evaluation, intraoperative case management and postoperative care, says Nicola Hawkinson, MA, NP, CEO and Founder of SpineSearch. Create a manual detailing the manner in which your ASC intends to manage these complex patients. Such policies guarantee a consistent approach to patient care and provide a reference for staff to consult when necessary. Furthermore, the use of standard operating procedures ensures that different employees will complete the same task in the same manner.
From “5 Best Practices to Improve Spine Efficiency in ASCs.”
4. Simultaneous reporting of procedures. Physicians should document each procedure immediately after the procedure. When a physician waits until the end of the week to document their procedures, they risk forgetting the details of the procedure or writing an insufficient report for the coders to create a claim. Detailed reporting is crucial for the coders to accurately bill for correct reimbursement. “Coding is an art, it’s not an exact science,” says Jay Nussbaum, CEO of Healthcare Watchdog, a medical billing and advocacy group with offices in New Jersey and California. “A lot of times, what you’re going to code depends on what the doctors write in the documentation”
Additionally, if a claim is denied because the payor found a procedure unnecessary, detailed notes help physicians defend their choice to follow through with the procedure. “If the physician has taken good notes, they can make a good claim as to why the procedure was necessary to the insurance companies. Making that strong case really can turn a lot of denials into approvals,” says Mr. Nussbaum.
From “7 Best Practices to Improve Efficiency in Physician-Owned Orthopedic Practices.”
5. Reassign staff responsibilities to maximize productivity. We reviewed front office job duties in both our physical therapy department and our clinic, says Penny Forbes, practice administrator at Sierra Regional Spine Institute in Reno. We noticed the support staff in PT had several hours during the day that were “down time” hours. This position requires the employee to be present throughout the day to handle calls, scheduling and billing, but this employee is efficient and was often left with little to do for various periods throughout the day.
In contrast, on the clinic side our front office supervisor often runs out of time because her duties include editing dictation, daily scanning, helping with phones, check out and supervising five other staff members. She also covers each member of the staff when one is out on vacation or sick leave. During this coverage period the dictation and scanning duties are often delayed.
So we assigned the daily scanning to the PT front office staff member to fill her down time, and freed up the clinic supervisor who could then continue to cover not only in the front office but we were able to extend her reach to the x-ray desk and even to the clinic. We have thus enabled our employees to multi-task at a greater level without hiring additional staff.
