1. Negotiate with the future in mind. Set yourself up for the next contract during current negotiations, says Jim Odom of The C/N Group. Stay abreast of the ever-changing healthcare industry and know which types of procedures are profitable and how that may change. "If you position product lines you know are going to decline over the course of the current contract, establish a foundation now, so the pain is less when the contract kicks in down the road," says Tom Faith of The C/N Group. Additionally, ask payors about their timeline for switching to the APC reimbursement model. "We've been listening to what they say and how they answer to position ourselves better for the future," says Mr. Odom. "We ask the payor what they are talking about internally for one or two years down the road, such as which procedures are bring pushed into ASCs and which have pressure to be performed at hospitals."
2. Have a relationship with a healthcare lawyer. Physicians must be aware of Stark Law and referral issues to avoid accidentally breaking the law. They must also be aware of the potential for malpractice suits and be prepared for any action that could come their way. Select a competent "health lawyer" who can guide you through any issues that might arise. They will be helpful in assessing partnership contracts, as well as regulation issues. "The physicians have to understand how the wording in a contract could increase their liability," says Pedro Vergne-Marini, MD, managing member of Physicians Capital Investments.
3. Increase front-end training for submitting claims. If your data indicates a high or increasing number of denials, Bill Gilbert, vice president of marketing at AdvantEdge Healthcare Solutions, says the problem probably lies with your front-end staff. "That means a need for training, maybe some job aides and adjustments to how front end staff are using the system." He says problems with denials can be caused by a variety of errors, and not understand the billing system can cause problems easily. When your center implements new software, take a few days to coach your staff on the ins and outs of submitting claims. This will save you a lot of time re-submitting denials that arise from a lack of comfort with the system.
4. Only hire staff who will be "A" players. ASCs sometimes hire staff members who have great resumes only to find out, after they are hired, they are just not a good fit for the organization in spite of a seemingly perfect background and set of experiences for the job that needed to be filled, says Tom Jacobs, CEO of MedHQ. This scenario, which has played out thousands of times in good and bad organizations alike, is likely due to a mismatch in values. With a well-defined set of company values, what constitutes an A player can be clearly defined, and we have a much better chance of avoiding the above scenario.
Another important step is to properly teach staff members how to hire "A" players with respect to the values (and behaviors) now inherent to your company. This entails more than just a standard single-interviewer process; interviewers should try to steer potential team members to provide concrete examples of what they have done in the past to ensure that the values of the potential hire are in line with the entire company. We want candidates to talk about actual past experiences during the interview, rather than discuss platitudes and what they would do in the next position. Past performance is the best indicator of future performance.
5. Be familiar with disinfectant use. Pay attention to the label of your disinfectant because it should tell you if a product is compatible or not compatible with particular surfaces, says Jack Wagner, CEO of Mirco-Scientific, a producer and distributor of antimicorbial products. For example, there a chemical surface wipe that says in the small print on the bottom of the label, "Do not use this product on clear plastics." This means it isn't appropriate for clear plastics, which include domes (the covering on anesthesia machine ventilators), plastic lenses over operating lights and blood pressure cuffs. There are a number of materials in an ambulatory surgery center that are made of clear plastics. If this product cannot be used on clear plastics, then obviously this product is not compatible with an ASC's equipment and is not appropriate for use in a center.
It's also important to note that some disinfectants are approved as cleaners and disinfectants. Some are simply disinfectants, which would mean you would need to clean the surface with soap and water, rinsing and drying it before you apply the disinfectant. All of these details are listed on the label.
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