1. Practice staff providing incomplete information. Mr. Riemenschneider says ASCs often receive incomplete information when staff members at the physician practice are rushed. When the nurse at the practice receives the ASC’s scheduling sheet, he or she may leave off critical information without realizing it is necessary to perform the case. “She’ll fill out what she has, but she’s in a rush, and the practice just wants to get the case on the schedule,” Mr. Riemenschneider says. “They’ll make a best effort and throw it into the fax.”
He says ASC staff must thoroughly review information provided by the practice to make sure a case is not scheduled with missing details. For example, the physician must indicate which payor the patient uses to make sure the ASC will be reimbursed for the procedure.
2. One-way transmission of information between practice and ASC. One of the main problems with surgery center scheduling is that information is “thrown over the wall” from the practice to the ASC, Mr. Riemenschneider says. This means that once the ASC receives scheduling information from the practice, the practice doesn’t see how the and may not be able to check for errors.
“There’s no visibility into the schedule from the time it was originally scheduled to the day of the case,” Mr. Riemenschneider says. “If there’s a mistake, no one is going to pick up on it.” He says an online scheduling system can help surgery centers and practice catch mistakes, because both parties are able to access the schedule and check for errors after the information has been entered.
3. Wrong procedure or omission of a second procedure. Mr. Riemenschneider has seen schedulers enter the wrong procedure into the ASC schedule — a mistake that can often necessitate a case cancellation. “There are a lot of procedures, and they can be very similar within the same specialty,” he says. If a scheduler is entering many procedures every week, he or she is bound to slip up and enter the wrong procedure occasionally, he says. Procedures should be verified after they are scheduled to make sure the ASC or practice catches the error before the day of surgery.
4. Missed faxes. Missed faxes can easily cause scheduling errors in a surgery center if a staff member fails to notice a fax come in. If a case is moved or cancelled, the ASC may not realize until the day of surgery, when the physician doesn’t arrive at the facility for his or her case start. Mr. Riemenschneider recommends that ASCs try to replace fax machines with online scheduling to make sure faxes aren’t carried off or thrown away in a pile of other papers. “This also applies to the voicemail that was missed until it was too late,” he says.
5. Omission of necessary implants or special orders. Mr. Riemenschneider says one of the most common errors in ASC scheduling is the omission of implants or special orders for the case. If the surgery center needs to order an implant several days ahead of time to perform the case, the error might result in a costly case cancellation.
Mr. Riemenschneider says he recently worked with an ASC that did not receive the information necessary to order special lenses for the case. While the surgery center scheduling staff caught the error the day prior to surgery, the ASC had to overnight the lenses and therefore spend more money to avoid case cancellation. “If you look at incomplete information, you’ll often see that an implant or a special piece of equipment was omitted,” Mr. Riemenschneider says. “If this kind of information is missing up front, there’s no visibility and no one is going to pick up on it.”
6. Inaccurate payor information. Accurate payor information is essential to scheduling profitable cases. For example, the ASC staff may need payor information at the time of scheduling to make sure the center is in-network with the payor, Mr. Riemenschneider says. The center also needs to know whether the case involves a Medicare patient, in case the center is not certified to accept Medicare patients or the procedure is not covered by Medicare. Online scheduling systems can help ASCs improve payor information accuracy by creating “rules” that prevent the practice from scheduling a case with a Medicare patient if the ASC is not Medicare-certified.
7. Different schedules at the practice and ASC. Surgery centers and physician practices may not operate on the same schedule, Mr. Riemenschneider says. “Physician practices are often seeing patients past 5:00 p.m., and since many of the schedulers are nurses, their day may not slow down until the end of the day,” he says. If nurses feel rushed to enter information before the ASC closes for the day, they may make more mistakes and feel frustrated with the ASC’s scheduling process.
“It’s very important for the ASC scheduling process to be as convenient, effective and reliable as possible,” Mr. Riemenschneider says. “ASCs want scheduling with their facility to be the path of least resistance. They want it to be the [physician] office’s first choice.”
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