|
March/April 2007
In this month's issue:
Developing a Center? The Pros and
Cons of Using a Consultant
Opening an ambulatory surgery center is a complex,
long-term undertaking requiring a unique set of skills, knowledge,
and experience in areas as diverse as legal regulations, accreditation,
and insurance billing. Often physicians turn to consultants as
a cost-effective way to obtain the expertise required to get their
center up and running.
Consultants in fact may be able to provide reasonably priced
services for facility planning and set up. Based on their
years of experience developing surgery centers, they can be a
good source of information and guidance about such issues as
facility requirements, accreditation, and the sources and pricing
of equipment and supplies. A good consultant should be able to
provide a detailed roadmap for building a state-of-the-art center.
However, the need for expert assistance doesn't end when your
center opens for business. In fact, successfully managing
your facility's day-to-day operations probably will be the most
challenging aspect of owning a center. Unfortunately, once the
center is open and the consultant is gone, the responsibilities
of managing the center usually fall upon an already over-worked
physician. It's a complex, thankless job that requires expertise
in many areas outside a physician's training. Moreover, this
work is not the best use of your time and talent. The hours you
spend managing a center are not spent seeing more patients - and
generating more income. After all, the reason for opening your
own center was to increase the income you receive on the services
you already perform, not to add to your workload.
Another issue to consider is that the continuing success of consultants
often requires them to simultaneously attend to the needs of multiple
current and prospective clients. If any member of the consultant's
team is unavailable due to illness or commitments on other projects, your center's needs can be ignored
for days or even weeks at a time. In contrast, a management team
can draw upon a larger pool of experienced personnel to quickly
resolve urgent matters.
When weighing the costs of teaming with a management partner versus
using a consultant, it's good to keep in mind that a partner will
be very interested in the success of your surgery center one, five,
or ten years after it opens. As a result, the partner may be more
motivated than the consultant to consider both the short- and long-term
needs of your center.
You also should consider whether or not a consultant has the bargaining
power to obtain favorable pricing through contract negotiations
and bulk purchasing discounts. Be sure to also determine whether
your consultant has a solid record of successfully negotiating
fee schedules with payers to obtain the highest reimbursement rates
for their clients' centers. If not, higher operating costs and
lower fees may impact your center's profitability.
Opening your own surgery center is a wise financial decision if it
increases your income stream without adding to your workload. To
realize the benefit of increased passive income, you must make
strategic business decisions that provide long-term solutions to
the complex challenges of operating your own facility. Otherwise,
your center will become a source of additional demands on your
time and energy, which is the last thing that any busy physician
needs. Be sure to make decisions today that will meet your needs
now - and far into the future.
Surgery Center Partners can help you own a profitable, state-of-the-art
surgery center where you can deliver high quality care to all
of your patients. As our partner, you can rely on our expert
staff to handle all aspects of developing and managing your center.
It's the hassle-free solution to center ownership.
Back to Top
Tips for Avoiding Billing Woes
Maximizing reimbursement from insurance plans requires
both an efficient system for collections and experience in resolving
the daily problems that arise with payers. Late billing and delayed
payments can have a dramatic impact on profits, so the timely
resolution of problems is critical to maintaining a healthy and
predictable cash flow for your center.
Optimal system and staffing
Maximizing your center's profitability from reimbursements requires
a well-organized system, the best billing software, and a knowledgeable
staff dedicated to productivity, service quality, and patient satisfaction.
Such qualified personnel can identify and quickly resolve problems
as they arise.
Outsourced or in-house
Since a bill may pass through many hands, including the physician's
office staff, a unit coordinator, a billing agent, a collector,
or an outside collection agency, it's important to decide whether
to maintain a qualified billing and collection specialist onsite,
or to outsource these functions to a company that specializes in
providing these services. While you will have direct control over
in-house staff, you must have sufficient work to justify the effort
and costs associated with recruiting and retaining qualified personnel.
Effective communication
Your surgery center's billing system should work independently
yet in cooperation with your office. In most cases, billing will
be initiated by your office because all procedures will need to
be pre-authorized and the patient informed about possible co-payments.
Good communication and a positive working relationship between
the office and billing staff, as well as thoroughness and efficiency,
are essential to keeping the billing cycle moving and prevent holdups
in payments.
Selection of billing software
Another major decision involves
choosing the most appropriate billing software for your center.
The best software can remove much of the guesswork in the billing
process and even track staff productivity. To choose wisely, you
need to know the most critical areas to track and what you want
the software to achieve. For example, does it have a contract module
that can load contracts into the system? Does it do billing electronically?
Does it have a collection module? Does it indicate exactly how
much to expect as reimbursement? For
the best fit, assess your needs before you start shopping for software.
Staff training
Ideally, the payment schedule will run without a hitch. But there
are many areas where things can go awry, such as late payments,
billing errors, and failure to make co-payments. Your staff must
be trained to:
- verify the accuracy of all patient data
- interpret information on insurance cards
- double-check billing and claims before they are sent out
- call patients and talk about payment options, when necessary
- send bills to collection agencies when they are not paid after
90 days
- understand the intricacies of i nsurance contracts
- negotiate with insurance carriers.
Joining forces with a management partner that has its
own billing department can offer the best of both worlds - a
high level of control, along with the assurance of knowing you
can leave all problems to them.
Back to Top
|
