An Illinois ASC helps patients in need access care
INTERVIEWED BY SAHELY MUKERJI | JUNE-JULY 2023
The Orthopaedic Institute Surgery Center in Metropolis, Illinois, helps its community by never sending a child who needs surgery back home without that surgery if the ASC can safely provide it. This is irrespective of the child’s insurance status. Melanie Russell, RN, the administrator of the ASC, is a pivotal part of this effort.
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Barriers to moving complex procedures from HOPDs to your ASC
BY CRISTINA BENTIN | APRIL 2021
CY 2021 brought policy and reimbursement changes that would seem to position ASCs favorably for an obvious migration of cases from the hospital outpatient department (HOPD) to the ASC.
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Use correct modifiers
BY STEPHANIE ELLIS, RN | APRIL 2021
In the coding world, modifiers are two-digit symbols added to CPT procedure codes to signify the procedure has been altered in some way.
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Follow these steps
BY KEN BULOW | JUNE-JULY 2022
Noncompliant coding and billing can lead to increased denials, missed reimbursement opportunities and unnecessary refunds. Additionally, poor compliance outcomes harm surgeon and patient satisfaction and could lead to more serious consequences, including loss of payer contracts and legal ramifications.
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What ASCs can do to keep their data safe
BY MAIA KUNKEL | MAY 2023
Healthcare organizations across the country posted 333 breaches of protected health information (PHI) affecting 500 or more individuals in the last half of 2022, the latest data available on the matter. Consistent with previous time periods, the vast majority of the breaches—95 percent—were caused by unauthorized access or hacking.
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Review state laws and AHRQ materials before creating your policy
BY NESKO RADOVIC AND SANDRA JONES, CASC | NOVEMBER-DECEMBER 2019
In rare situations, the duration of the informed consent could present an issue. Some state laws presume that a written authorization signed by the patient is valid. Some states might specify the time frame in which consent remains valid; others require that consent be obtained no more than 30 days from the procedure. Therefore, checking state regulations is essential.
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Foster relationships by eliminating the guesswork
BY ROBIN NTOH | OCTOBER 2019
Relying on word-of-mouth to cultivate awareness is not enough to establish and build reputation among potential patients in today’s competitive healthcare marketplace. Patients are using various means to shop for and select their care providers, and it is helpful to have a marketing program that connects with people as they consider options.
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Risks that are uninsurable or prohibitively expensive to insure might call for alternative risk transfer
BY BENJAMIN S. TERNER | SEPTEMBER 2016
In an ever-changing world, it is no secret that risks associated with ASCs also are evolving. Trends in medical risk transfer, however, are generally not related to ordinary risks but rather nontraditional—low frequency/high severity—risks. If these risks occur, they have the ability to bring a practice to a screeching halt. Examples of such risks include: loss or suspension of professional license, legislative and regulatory changes, cyber risk (breach of customer data and detrimental code) and related Health Insurance Portability and Accountability Act of 1996 (HIPAA) violations.
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If passed, the Outpatient Surgery Quality and Access Act will better align Medicare’s ASC and HOPD payment systems
MARCH 2023
As this issue of ASC Focus goes to press, Congressman John Larson (D-CT) and Congressman Brad Wenstrup, DPM (R-OH), are planning to introduce the Outpatient Surgery Quality and Access Act of 2023 in the House side of the 118th Congress, and Senator Richard Blumenthal (D-CT) and Senator William Cassidy, MD (R-LA), are planning to introduce the legislation in the Senate.
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Consider these new strategies
BY MICHAEL RIVERS, MD | JUNE-JULY 2021
During the last 27 years, as an ophthalmic surgeon, I also was part owner of an ASC in Washington, DC. While I was able to transition successfully, I wish I had had many of the tools and features available today that would have made my life easier and my business more profitable.
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