For productivity, Durian recommends looking at the number of employees you are utilizing based on your case volume. “You want to make sure that you have the right mix of employees measured against the volume of cases,” he says. “That number will fluctuate month to month. Also look at the number of hours per case that you provide. You may have a benchmark of 12 hours to take care of a patient, including everything—reg- istration, preop, surgery and postop— and you would want to stay within that benchmark if possible.” For

quality, Durian recommends

tracking your ASC’s infection rates, which is the number of patients devel- oping infections after surgery. That number, he adds, needs to be as low as possible. “Manage your prophylactic IV antibiotic timing carefully,” he says. “Most patients get an antibiotic through an IV before the surgery, and you want to make sure that you are doing that and not forgetting to provide it on time.”

times,” he says. “Proper compliance will help bring down infection rates.”

Eye Center of Columbus LLC Shawn M. Herman, RN, clinical direc- tor of Eye Center of Columbus LLC in Columbus, Ohio, looks at three bench- marks at the end of the month: days in AR, denial rate and cash collection at time of surgery. For days in AR, he says, “some ASCs

Another measure Durian recom-

mends tracking is transfer rate. “How many of your patients are being taken to the hospital due to complications?” he asks. “You want that number to be as low as possible and within benchmarking. We use data from ASCA and compare it with data from other centers around us.” Hand hygiene compliance, Durian adds, is another important quality mea- sure for an ASC. “Make sure that your staff are washing their hands with soap/ water or alcohol rubs at the appropriate

like to keep their AR between 20–35 days, but to me this is a high figure. The billing department for the Eye Center of Columbus is two individuals. We have seven operating rooms (OR) and last year we did over 10,500 cases. The fact that we are a single-specialty ASC (oph- thalmology) gives us the advantage of being able to narrow down our focus on the errors our billers make when sending claims to the insurance company.” For denial rate, “1-2 percent denial rate is a good standard to follow,” Her- man says. “A couple of years ago, the Eye Center of Columbus was between 3-4 percent. We initiated a quality assurance and performance improvement (QAPI) study focusing on the factors causing these denials. After reviewing a couple of months’ data, we were able to pinpoint two factors. After re-educating the billing staff, scheduling and insurance verifica- tion personnel, we brought the denial rate to 1.5 percent within a couple of months.” On cash collection at time of surgery, “this topic really needs to be addressed in all ASCs,” he says. “Medical insurance is changing drastically due to Obamacare and high deductible insurance,” he explains. “Train your insurance verifica- tion staff to talk with your patients and explain to them how much money will be needed at the time of surgery. You also need to train your front desk staff on ways of assisting patients who come into the center and are having difficulty coming up with the cash. Depending on the month, our staff is able to capture between 85 and 93 percent of all pay- ments due prior to surgery.”


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