Steps for follow-up when submitting the CMS-855. Want to save yourself a considerable amount of money during the development process? Follow up with fiscal intermediaries to ensure they have your Medicare enrollment application after submission.

"This happened to us twice, and we were told to simply resubmit," says Fred W. Ortmann III, the CEO and president of Ortmann Healthcare Solutions. "While this sounds like a good answer, it actually means you may re-submit and go to the back of the processing line. Since it is likely that you submitted your 855 at least two months previously, this could mean that you have delayed your approval date for the 855 by one to four months."

To avoid this problem, says Mr. Ortmann, ASCs should send the CMS-855 to the fiscal intermediary via registered or certified mail with the return receipt required. Then, approximately two weeks after sending, call the fiscal intermediary and ask for the application status. The fiscal intermediary should then give you a tracking number for your application.

"If they say they lost your application, then give them the tracking information and tell them you will send them a copy, but their tracking dates should start on the day they first received your initial package," says Mr. Ortmann. "If they don't agree to do this, then write a letter to the president of the fiscal intermediary, present the information discussed above, and ask that your approval be expedited and started on the date they received your initial application. If they decline, we suggest you write another letter to CMS."

Monitor GPO arrangements closely to ensure entire savings. Many ASCs join group purchasing organizations as a way to better manage supply costs. However to maximize the benefits, ASCs must continually monitor these arrangements.

"While GPOs are an incredibly effective way to save money at your ASC, you should never rely on the GPO and the vendors to get the pricing correct the first time. There are many steps that must be completed between your signing up with a GPO and the vendor loading the contracted price," says Rick Pence, the chief operating officer of National Surgical Care. "We have worked with many ASCs that have lost a lot of money by not closely evaluating the contracts, invoices and correspondence from the GPOs and the vendors."

Mr. Pence suggests the following three tips to ensure your ASC obtains its GPO savings:

1. Assign a person at your ASC to scrutinize the vendor invoices and compare to the GPO contracts. "Often there will be a discrepancy in cost, that usually does not favor the ASC," explains Mr. Pence. If a discrepancy is found, that person should contact the GPO and the vendor immediately to correct the mistake.


2. Always open and read all mail from the GPO and the vendors. A GPO or vendor may periodically make brand or price changes on certain supplies for which an ASC is contracted. Often an ASC will only be notified of these changes by written correspondence through the mail.
   
   "I have seen ASCs lose up to twenty-five percent of its anticipated savings on supplies by failing to read mail from their GPO or vendor," says Mr. Pence.


3. When changing GPOs, always carefully track through all changes from your old contract to the proposed new one. "Don't simply assume all the contracts will be loaded in a timely fashion, as some will not be," warns Mr. Pence. In addition, do not assume that it is an inferior contract just because some supply costs have increased. "By carefully tracking the proposed new contract, you may find that while some supply costs have risen, others have dropped significantly enough to put you in an overall better position," he adds.

In partnership with physicians and hospitals, National Surgical Care develops, operates and invests in ASCs nationwide. In 2007, centers managed by National Surgical Care will perform more than 110,000 cases, support 325 physician partners and include five hospital partners.

Free McGuireWoods Webinar: "Sales and Marketing of Drugs and Medical Devices." On Wednesday, Nov. 7 from 11:30 a.m. to 12:45 p.m. Central time, McGuireWoods will host a free Webinar, "Current Developments Affecting Pharmaceutical & Medical Device Sales & Marketing Practices." The Webinar will focus on recent enforcement actions as well as practical ways to comply with the rapidly evolving laws and regulations that impact marketing practices by pharmaceutical and medical device companies. Topics to be covered include recent settlements related to off-label promotion and anti-kickback claims; state limitations on the use of prescriber data; and a discussion focused on the state false claims laws under the Federal Deficit Reduction Act. CLE credit is pending. To register, please e-mail Andrea Green. For more information about McGuireWoods' life sciences practice, please e-mail Candace Eastman.

Ask Scott Becker. If you have an ASC-related legal or business question, e-mail Scott, and we'll publish the answer in a future E-Weekly. Please indicate when asking whether you prefer to remain anonymous.

Call for proposals. We are seeking speaking proposals for the Orthopedics-, Spine-, and Pain Management-Driven ASC Conference, to be held in Chicago June 19 to 21. Should you have suggestions, please e-mail Scott Becker by early November.