How to minimize ASC cancellations and increase your bottom line

Norman L. Burnette, CPA, CASC, and Administrator at Baylor Surgicare of Fort Worth, Texas -

NormanCancellations have always been an area of concern for surgery centers.

In the past, it was generally assumed that patients whose surgery was cancelled would simply reschedule, and therefore, surgical volume would not be affected. More recently, however, high-deductible health plans have called this assumption into question. Many patients, faced with the high out-of-pocket cost of elective surgery, simply fail to reschedule as they reconsider their decision to incur the expense.

In an effort to maintain case volumes and avoid lost revenue, surgery centers are looking for effective ways to eliminate preventable cancellations. For Baylor Surgicare of Fort Worth, bringing the pre-admission process online has helped because it has eliminated gaps in critical information that previously may have caused a case to be cancelled.

In the past, Baylor Surgicare relied on its nursing staff to phone each patient before a scheduled procedure to conduct a pre-op interview. Medical histories, including medications, allergies and previous procedures, were written by the nurses onto several forms. Frequently, patients could not remember details of their past medical history, particularly their medications and dosages. Furthermore, the handwritten forms were often difficult to read. In addition, forms for repeat patients had to be completely re-written for each new visit. The biggest issue, however, was the large number of cancellations caused by day-of-surgery surprises.  

In April 2014, Baylor Surgicare implemented One Medical Passport and brought its pre-admission process online. The system allows patients to complete the pre-admission process from home at their convenience. This has created a more patient-friendly and efficient pre-admission process. In addition, the medical information that is obtained is typically more accurate because patients have access to resources like family members, personal documents and their actual medications which are often not available when they receive a phone call during the day. Because pre-admission phone calls are shorter, nurses have more time to spend on patient education and addressing patient concerns, and less time on data entry.

Since moving the pre-admission process online, nurses at Baylor Surgicare have uncovered several medical issues that in the past would have gone undiscovered. For example, one patient recently indicated on his Medical Passport that he had a stroke and cardiac event in the past — both of which were unknown to Baylor Surgicare despite the patient having been there previously; the physician was also unaware of these events. The ability to catch issues in advance allows Baylor Surgicare to proactively manage them, thus avoiding delays and cancellations.

Baylor Surgicare has found that the demographic and insurance information, just like the medical information contained within the system, is also more current and accurate. This has allowed Baylor Surgicare to avoid billing delays which helps the center's bottom line and cash flow.

According to Juanita Rhoades, RN, PreOp/PACU Manager at Baylor Surgicare, "Time is money and we are experiencing huge savings thanks to One Medical Passport. Information is well organized and in a consistent location making it easier to find, this allows us to focus more on patients and less on paperwork. The biggest savings, however, is frustration; processes are much smoother today than they were prior to deploying this system.”

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