How an Improved Operative Report Can Mean More $$$ for Your ASC

ambulatory surgery center reportingBecker's ASC review recently ran a post on "11 Ways to Make More Money Per Procedure." The post goes into detail on the various ways that Ambulatory Surgery Center administrators can maximize the profits on each procedure their surgeons perform. Within that list, there are two particular areas that tie into operative reporting and will benefit greatly from synoptic operative reports.

Increase staffing efficiencies. ASCs can increase the amount of work accomplished each day by cross-training staff members in at least two areas. Having flexible, proficient staffers can also free up clinical personnel to focus on their tasks in the operating room, thus increasing OR throughput and daily case volume, Ms Sackos says.

One of the staffing efficiencies overlooked by the Becker's post is the time it takes to create, revise, approve and submit operative reports. The current process for creating an operative report after surgery is usually, incorrectly, framed as just the time to dictate the report. When surgeons think about "reporting" on their procedures, usually they're only thinking about the time spent speaking into the phone for the dictation service - which tends to be only a couple of minutes at most. Unfortunately, that's not accurate and really only focuses on the briefest element of operative reporting.

For most facilities, once surgeons emerge from the operating room after a procedure, they record their dictation. Again, this can be as short as a matter of seconds. But dictation is not the entirety of the reporting process. Next - the transcription company has to write down everything said - or make changes to the indicated template if your surgeons use those - before sending the transcription back to the surgeon. Transcription itself can take anywhere from 12 hours to 3 days in some places. At that point, the surgeon then has to review everything written about the procedure that happened a few days ago (oh and there have been other procedures in the interim, so hopefully surgeons remember everything about THAT particular surgery and patient accurately). Often there are typos or blanks left when a transcriptionist can't make out what the doctor says. The doctor then has to make those corrections and submit it back to be transcribed again, which takes another 1-3 days. Then the surgeon reviews, approves and signs out the operative report. Then the report is sent to coding and, once properly coded with diagnosis and procedure codes, copies are sent onward to billing department and to the HIM department (medical record), as well as sent to the physician's office for professional billing. This means the entire reporting process - from the moment the surgeon picks up the phone to dictate to the moment the report is sent out for billing for reimbursement of the procedure - is not a matter of minutes, but days that involves many staff members' time and effort.

Instead, there are ways of streamlining the operative reporting process that can eliminate costs associated with transcription while making efficient use of your ASC's staff's time.

surgical dictation transcription vs synoptic report

Instead of wrapping up your surgeon with days of review documents and delaying reimbursement, electronic operative reporting (like mTuitive's OpNote) enables surgeons to build reports quickly, concentrate on the deviations from the norm, and sign out immediately. This jumpstarts the billing process and therefore ASCs (and surgeons) are getting reimbursed faster.

 Another item in the Becker's post is about optimizing coding for improved reimbursement:

Optimize coding. Coders are the last line of defense before a claim is submitted for payment, and these staff members have to be able to deal with challenges such as incomplete physician documentation, multiple procedures, compliance issues, modifiers and unclear operative notes, Ms. Sackos says.
The best people to handle such challenges are certified coders with surgery center experience who have access to current information about coding and regulatory changes. Well-trained coders will submit accurate claims and get their surgery centers paid promptly.

 While certified coders are certainly important and helpful, electronic reporting is greatly assisting their efforts to ensure that your facility is coding for as much as you can. A post on KevinMD recently revealed that with the rise of EHRs, there is an uptick in coding and in reimbursement rates. surgeon dictating reportsOne of the many reasons for this increase is that it is easier for doctors to be more comprehensive and complete with their documentation when it is automated and electronic. Furthermore, electronic health documentation tends to be more comprehensive and complete - physicians remember more when presented with a list of possibilities, required fields have to be filled out or addressed in order to submit the report, and seeing something written out is easier to incite recall than simply trying to remember when speaking into a phone. This means that these expert coders are now presented with more information from which they can now qualify and code for more aspects of the procedure - thereby leading to greater reimbursement from Medicare and insurance companies.

And many of the electronic reporting solutions - again, like mTuitive's OpNote - come packaged with diagnosis and procedure codes which - even if not used for the final billing - at least assist the coders in coding the reports faster and submitting these reports for reimbursement that much quicker. In ASCs, cashflow is king, and cutting down turnaround time for reimbursement means that cash is in hand for the ASC faster.

There are many changes in the healthcare industry - moreso in the ASC arena where new regulations and initiatives are affecting how procedures are billed and how much staffers can be paid. In times of great change, it's more important than ever that ASCs are doing all that they can to ensure they are reaping the utmost benefits from their hard work. Improving your surgeons' operative reports by streamlining the process and enticing more completeness in the content means freeing up time for your ASC staff and getting more money to your ASC faster.




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