Senior Content Marketing Manager
Ep. 6: Ken Bulow – Getting Your Claim Paid After the Bill Goes Out | This Week in Surgery Centers
Here’s what to expect on this week’s episode. 🎙️
The patient had a successful surgery, and they just walked out of your #ASC to head home. But they still have a remaining balance they owe you – so now what?
Kenneth Bulow, EVP of Operations at Surgical Notes, shares his tips and best practices for getting your claims paid after the bill goes out. Every day you’re unable to collect money, your chance of collecting that balance decreases, so here’s what you can do.
🔄 Implement workflows and triggers. No manual process can effectively keep up with patient follow-up. Instead, you can use technology to automatically nudge patients via email or text on a cadence of your choice (ex., every three days) and push patients into a call list so that your staff knows who to follow up with and when.
🤝 Lean into your payer relationships. Culturally, we need to get out of the mindset that payers are the enemy. #Payers want to pay you. You just have to oblige to their unique rules and requirements. The more closely you can align yourself with your payers and share your goals with them, the better off you will be.
❌ Analyze denials and setbacks as often as possible. By frequently performing root-cause analyses, you can identify patterns in your process that might be going awry, create a plan to fix them, and then track the success of your plan.
🤔 Identify intellectually curious staff. Some people love to problem-solve. Find the right person within your team to help identify collection opportunities, learn your contracts inside and out, and recognize new solutions.
Find the full episode on Apple Podcasts, Spotify, or YouTube to hear all the details!
In our news recap, we’ll cover CMS’ 2023 final payment rule, new innovation around tattoos and medical alert bracelets, the average consumers medical debts, and a nurse who helped care for a man after he collapsed during a Broadway show.
Episode Transcript
0:00
welcome to this week in surgery centers
0:03
if you’re in the ASC industry then
0:05
you’re in the right place every week
0:07
we’ll start the episode off by sharing
0:10
an interesting conversation we had with
0:11
our featured guests and then we’ll close
0:13
the episode by recapping the latest news
0:15
impacting surgery centers we’re excited
0:18
to share with you what we have so let’s
0:20
get started and see what the industry’s
0:22
been up to
0:23
[Music]
0:27
hi everyone here’s what you can expect
0:29
on today’s episode we are talking with
0:32
Ken Bulow who is the Executive Vice
0:34
President of Operations at surgical
0:36
notes now there are a lot of different
0:38
parts to the revenue cycle process but
0:40
today we are focusing on getting your
0:42
claims paid after the bill goes out and
0:45
some workflow tips for making this
0:46
simpler and more effective and
0:48
eliminating work
0:49
we’ll close the episode with a few news
0:51
stories we’ll start with cms’s 2023
0:54
final payment rule for ASCS talk about a
0:57
new innovation around tattoos and
0:59
medical alert bracelets look at the
1:01
average consumer’s medical debt and how
1:03
that impacts ASCS and of course and the
1:06
new segment with a positive story about
1:08
a nurse who helped care for a man after
1:10
he collapsed during a Broadway show hope
1:13
everyone enjoys the episode and here’s
1:15
what’s going on this week in surgery
1:17
centers
1:20
thank you
1:22
all right how’s it going guys welcome
1:24
back to another fantastic episode here
1:27
at this week in surgery centers I’m your
1:29
host Rafael akinsby and we have a
1:32
fantastic episode I’m super pumped about
1:34
this one this week we have Ken Bulow he
1:37
is the Executive Vice President of
1:39
Operations at surgical nodes fantastic
1:42
leader and we’re really excited to have
1:44
him on because we’re going to be talking
1:45
about something that I know a lot of our
1:47
listeners have asked about and want to
1:49
hear and you know today we’re going to
1:51
be covering getting your claim paid
1:53
faster after the bill goes out and this
1:56
is just one that I know impacts a ton of
1:59
different surgery centers and this is an
2:01
area that we really want to dive into
2:02
before I run through all the questions I
2:05
have for you today can I want to First
2:07
just kind of jump in and give you a
2:08
chance to talk a little bit about
2:09
yourself for anyone who doesn’t know you
2:12
um go ahead and kind of tell the people
2:13
about you and kind of what you do at
2:15
surgical notes
2:17
great yeah thanks for having me on I’m
2:19
thrilled to be here today I’m happy to
2:21
uh to to share a little bit of my
2:23
knowledge with your audience
2:25
um I have been working in healthcare
2:27
provider revenue cycle for about 25
2:29
years now it’s kind of all I’ve ever
2:31
done
2:32
um and then specifically working with
2:33
here with surgery centers since 2008.
2:38
um so I I’ve been in uh leadership roles
2:41
for revenue cycle firms or surgery
2:43
center management companies working
2:45
specifically with surgery center since
2:48
2008. awesome awesome today today it’s
2:51
at surgical notes so it you know I lead
2:53
uh one of my primary duties is leading a
2:55
revenue cycle team for our customers
2:57
who’ve given us the privilege of
2:59
handling their billing for them that’s
3:01
fantastic yeah and hearing how long
3:03
you’ve been in the space is one of the
3:05
reasons why we really wanted to have you
3:07
um on the podcast I think that that time
3:09
that you spent there and that wealth of
3:11
knowledge kind of gives so many great
3:13
points there in terms of ways that
3:15
you’ll be able to give some guidance so
3:16
we’re excited to dive in and you know
3:18
we’ll jump right in so you know when it
3:20
comes to revenue cycle management and
3:23
the revenue cycle process there are tons
3:25
of different steps in that process for
3:27
any surgery center
3:29
um but you know we really want to kind
3:30
of focus today on kind of that that last
3:32
piece there almost the last piece in
3:34
terms of following up with patients on
3:37
those unpaid claims and for people who
3:40
aren’t necessarily as familiar here can
3:42
you kind of give us a sense of you know
3:44
what percentage of patients typically
3:47
leave with an outstanding balance like
3:50
how common is that
3:52
so I would say
3:54
um in the perfect world
3:57
um you’re doing a full and complete
3:59
Insurance verification prior to the day
4:02
of surgery you are figuring out what the
4:05
patient’s benefits are you’re figuring
4:07
out what procedure is going to be
4:08
performed comparing that with your
4:10
contract so
4:12
um you know you take a
4:14
a knee arthroscopy you compare that with
4:17
your Cigna contract did you figure out
4:18
okay this is exactly how much I’m going
4:20
to uh have as an allowed amount for my
4:22
Cigna contract apply the patient
4:24
benefits and ideally you know a week or
4:28
so prior to surgery exactly what that
4:30
patient’s going to owe and um so in the
4:33
perfect world we call the patient ahead
4:34
of time we we tell them hey you’re
4:36
coming in on Tuesday this is how much
4:38
you owe we’ll take a credit card over
4:40
the phone today and in the perfect world
4:41
they pay you where you use one of the
4:43
modern tools out there to send them a
4:45
text message and say hey here’s how much
4:47
you owe just click this link and pay us
4:49
um so in the world that’s how it happens
4:51
in reality
4:54
um a a hesitant to give percentages
4:56
because it really varies yeah based on
4:59
based on how that Center is run based on
5:01
the technologies that they choose to
5:03
take advantage of
5:04
um but for those patients who don’t pay
5:05
up front then you have another
5:06
opportunity when they’re standing right
5:08
in front of you to say hey you owe me
5:10
you know prior to service and um
5:13
uh so again taking advantage of that
5:15
second opportunity to collect from them
5:16
they should have already known because
5:18
they should have already uh contacted
5:19
them ahead of time
5:21
um so industry-wide you know if I had to
5:23
say at that point by the time the
5:25
patient has come in yeah
5:27
um somewhere North of 60 of what we see
5:31
have collected something okay it’s not
5:33
always the entire ending balance because
5:35
some patients uh can’t uh can’t put it
5:38
all down at once but but somewhere North
5:40
of 60 have taken something I’ve had a
5:42
conversation everybody’s had a
5:43
conversation with a patient but 60 have
5:45
had a conversation with that patient
5:46
because some either all or some portion
5:49
of that video okay that that’s helpful
5:51
to to know then and I want to dive in a
5:54
little bit deeper on that you know and
5:56
we won’t hold you to an exact percentage
5:58
um on this you know maybe we’ll get
5:59
someone on the production team they’ll
6:01
go look up the stat or something but
6:03
that is helpful for us to get get some
6:05
sense of and in kind of thinking about
6:07
that based on what you’ve said there so
6:08
that 60 is there’s a certain amount
6:11
that’s been collected but not
6:13
necessarily all of the all of the the
6:16
amount that a patient owes and
6:17
especially thereafter once they’ve left
6:20
the surgery center
6:22
correct right so you have some patients
6:24
who have paid everything some patients
6:26
who’ve had nothing and some who have
6:27
paid uh abortion okay and there are
6:29
genuinely some cases where you’re just
6:31
not sure of exactly what that charge is
6:33
going to be and so that estimate could
6:35
result later on with either yelling them
6:37
a little bit back or the patient knowing
6:39
you a little bit more after the claim
6:40
because adjudicated through the
6:41
insurance company that makes sense that
6:43
makes sense well diving in there a bit I
6:46
want to kind of follow on to that same
6:47
note so what do you think are probably
6:50
the three biggest things ases get wrong
6:53
after a patient walks out the door and
6:56
they still owe them some owe them some
6:58
money for for that that case
7:02
um I think
7:04
um uh the thing that folks
7:06
get wrong or may not understand is every
7:09
day that goes by
7:12
um where you’re unable to collect those
7:14
dollars your chance of collecting that
7:16
dollar goes down yeah so
7:19
um if you wait 30 days if you wait 60
7:21
days if you wait 90 days every every
7:23
every every every day that goes by you
7:24
have a lesson you know statistically a
7:26
less lower and lower chance of
7:27
collecting that so what we like to do is
7:29
make sure that we’re communicating with
7:31
patients all along the way sometimes we
7:33
are legitimately waiting for a claim to
7:35
process before we know exactly what the
7:37
patient knows the great news is for most
7:40
third-party payers the patient’s getting
7:42
an explanation of benefits and elb from
7:44
their third party at the same time so
7:46
they know it’s coming so they’re helping
7:48
right so Blue Cross signal United
7:49
whoever’s helping keep in touch with
7:51
that patient to say we’re paying your
7:52
claim to your provider and you do owe
7:54
something and you should expect to hear
7:55
from them but it’s really important to
7:57
just have all that done done timely I
7:59
don’t think that was three but that’s
8:01
the problem that’s kind of what I would
8:03
say is most important no that makes
8:04
sense sometimes we you don’t have to
8:06
have all a full checklist of different
8:08
things sometimes it kind of you hit the
8:10
nail on the head there and I think that
8:11
that’s something that’s true and
8:12
resonates really well for a lot of a lot
8:15
of ASCS and um you know you think about
8:17
it and it goes beyond just the ASC
8:19
industry I think in general you know
8:22
from once you get service or a product
8:24
of any kind the further out you are from
8:27
that time of service just the less
8:29
incentivized you are to make that
8:31
payment at all or at least in some kind
8:33
of timely manner so it makes a lot of
8:35
logical sense there
8:37
especially if you’ve had a good
8:38
experience right you just you’ve walked
8:40
out of that place of service whatever it
8:42
is but in our example it’s a surgery
8:44
center you’ve walked out of that surgery
8:45
center they’ve fixed whatever problem or
8:47
they’ve you know uh have you on the path
8:50
to recovery
8:51
um you’re feeling really good about them
8:52
the more time that goes by
8:55
um the less inclined you are to remember
8:56
that nurse or that doctor or that front
8:58
desk person who who had a positive
9:00
experience with and and want to write a
9:02
check yeah yeah that makes a ton of
9:04
sense if I you know if I was someone
9:05
let’s just say getting uh getting a car
9:08
wash after the car after my car was
9:10
washed a couple weeks later I I’m
9:11
probably not thinking about how great a
9:13
job they did on my car anymore so if I
9:15
hadn’t already paid for it they’re
9:17
probably not going to get a payment
9:18
until I get that car washed again so
9:20
that that makes sense well
9:23
um let’s say I am a surgery center that
9:25
yeah I’m trying to trying to collect
9:27
that that payment you know that process
9:30
I imagine is probably not easy it’s
9:32
probably pretty tedious and time
9:34
consuming trying to go through the
9:36
process of collecting that payment what
9:38
are some of the you know the workflow
9:40
tips for making that process simpler and
9:43
maybe eliminating some of the work so
9:45
they can actually collect that payment
9:49
I think that um uh so again we’ll I know
9:52
we’ll talk about insurance a little bit
9:53
but from a patient standpoint
9:55
um ensuring that as soon as you know
9:58
there is some patient liability you’ve
10:01
um allocated that to a patient
10:04
responsibility bucket using whatever
10:06
technology you use and then get those
10:08
statements out so we um we tend to work
10:10
with vendors who automate the statement
10:11
process for us so there’s a statement
10:13
file that goes out every day and every
10:15
patient that’s ready for a statement
10:17
will get that statement
10:19
um and so as much as you can kind of
10:21
automate it put it on a plan that says
10:23
every X number of days and
10:25
um uh you know typically we’re looking
10:27
at a little bit less than a month we’re
10:29
dropping a statement to a patient every
10:30
month and making sure that there’s
10:32
messaging that’s escalating to say hey
10:33
look you you owe us this money let’s pay
10:35
us and and by the time you get to the
10:37
third one if they haven’t uh paid you
10:39
voluntarily they’re probably not going
10:40
to so at that point it’s probably worth
10:42
picking up the phone and saying hello
10:44
you know you should have seen three
10:45
statements from us have you received
10:47
those is there a reason you haven’t paid
10:48
us was it a service issue was it a
10:50
process issue or do you not have the
10:52
money let’s let’s talk about some ways
10:53
we can we can help you get there
10:56
um and then fundamentally I mean there
10:58
will be times when you have to take
10:59
advantage of the third party agencies
11:02
out there that uh uh basically will
11:05
represent themselves as a collection
11:06
agency and take over from that point
11:09
um the idea is to prevent that yeah that
11:11
makes a lot of sense and I think you
11:12
know for many surgery centers you want
11:15
to be able to get out ahead of it well
11:16
before you have to go with a third party
11:18
um collections agency to be able to make
11:21
that make that happen and I think the
11:23
point you mentioned there I want to I
11:25
want to dive in on those first two
11:26
points a little bit in terms of kind of
11:28
communicating that to the patient um
11:30
well in advance and then also taking
11:32
advantage of that additional step of
11:34
kind of calling and letting them know
11:35
that hey you might have received a few
11:37
different statements you know how
11:39
effective do you think that’s been for a
11:41
lot of surgery centers and do you think
11:42
that drives a lot of success for them in
11:45
terms of collecting those payments
11:49
um absolutely I mean I don’t know about
11:50
you but you know I get mail and
11:52
sometimes it piles up on my desk and
11:54
then I’ll get a day and I’ll sit down
11:55
and I’ll get to work on all of it and um
11:58
sometimes you just need that little
12:00
nudge from somebody to say hey remember
12:01
this is you know this is dude you got to
12:03
take care of this and uh and so it
12:05
prompts them to do it uh that makes
12:07
sense and and is that something that you
12:09
know in terms of kind of building some
12:11
workflows around do you think that’s
12:13
something where surgery centers can kind
12:15
of templatize that process for their
12:17
team so it’s maybe more efficient for
12:19
them
12:20
yeah so you know you can use those
12:23
statements as trigger so if you set up a
12:25
workflow that says let’s just say for
12:27
example every 25 days I want to send out
12:30
a statement
12:31
um uh you can then create a workflow
12:33
that says after statement one I’m
12:34
probably not going to do anything I’m
12:35
gonna hope they pay after that second
12:37
statement here’s what I want to do I
12:39
want to I want to put it on a call list
12:40
I want to have somebody call them after
12:41
the third statement I want to do the
12:43
same thing
12:44
um just so that it becomes kind of a a
12:47
process and it’s just you know by the
12:50
time you get to that third statement you
12:51
can say I know this has happened because
12:53
my process is I send a statement I send
12:55
a second one I make a phone call I send
12:57
a third one I make a second another
12:58
phone call and if it is a process and
13:01
it’s all documented you can you can be
13:03
sure that that’s done and that you’ve
13:04
done your part to try to collect those
13:05
dollars yep that makes sense I’m a huge
13:08
fan of anything I can put into a
13:09
workflow or process it makes my life
13:11
simpler and it’s easier to manage and I
13:13
imagine for a lot of our listeners it’s
13:15
probably the same
13:16
so yes jumping forward a bit there you
13:20
know one of the things I heard you say
13:21
before that I think is a stroke of
13:24
Genius is um you know things go wrong
13:26
and in patterns and I think that that
13:29
makes a ton of sense you know in terms
13:32
of you know running a surgery center if
13:34
you were running a surgery center today
13:36
you know how would you identify the
13:38
patterns
13:39
um learn and learn from them so that you
13:41
can avoid kind of some of these gaps and
13:43
problems around collections uh in the
13:45
future
13:47
I think I may have been referring to
13:49
more to Insurance follow-up at that
13:51
point
13:52
um where we see things go wrong in
13:54
patterns so
13:55
um the way the way that um I think about
13:58
insurance carriers here today in 2022 is
14:01
they want to pay us
14:03
um and this is a little bit
14:04
controversial in the provider Community
14:06
I think you know for the folks who’ve
14:08
been in the provider space as long as I
14:09
have we’ve always had this view of
14:10
they’re the enemy the payer is the enemy
14:13
they don’t want to pay us they want to
14:14
hold on to those dollars and earn
14:16
interest on them and um uh I I
14:19
fundamentally believe today that is not
14:21
the case and I believe that they set up
14:24
their claim shops and they want to pay
14:26
us because they have to pay an agent on
14:29
the other side as well if they don’t pay
14:31
us and um in order to do that they set
14:34
up rules yeah and um and they publish
14:36
those rules on their websites and
14:38
there’s a provider manual that tells you
14:39
how things work and um and so typically
14:42
what we find today is that when your
14:45
claims aren’t getting paid by a third
14:47
party it’s because you didn’t follow
14:49
some rule we can debate for hours about
14:51
whether those rules make any sense
14:53
whether we agree with those rules but
14:55
the fact is there are some fundamental
14:57
boundaries guard rails that they’ve set
14:59
up and it’s our job to follow them so
15:01
yeah we do see when things go wrong it
15:03
tends to be in patterns it could be that
15:05
there’s a new modifier requirement for a
15:08
certain payer it could be that a code
15:09
that used to be payable is no longer
15:11
longer payable it could be there’s a
15:13
contract rate change that we weren’t
15:15
aware of that we should have been aware
15:16
of but whatever it is it’s um it’s the
15:20
job of the surgery center or whoever’s
15:22
working in the revenue cycle for that
15:23
surgery center to try and understand
15:26
what is it that went wrong here yeah how
15:28
do I fix this thing this individual
15:30
claim that’s in front of me and then
15:32
what other claims or what other process
15:36
do I need to put in place to make sure
15:38
this thing never happens again and
15:41
um you know the more you do that over
15:43
time the cleaner you see uh your revenue
15:46
cycle get until something changes on the
15:48
payer side yeah that that makes sense
15:50
and I think you you call that a couple
15:52
really great points there one in terms
15:54
of that perception of the relationship
15:56
with payers and um I think that’s just a
15:59
common misconception so I think that
16:01
that makes a ton of sense there in terms
16:03
of rethinking or maybe realigning or
16:05
thinking around how we see the the
16:07
relationship with payers
16:09
um and then two I think the part one of
16:11
the parts I want to dive into a bit more
16:12
there
16:13
um is kind of talking about those steps
16:15
of actually going through what I would
16:17
say is almost kind of a root cause
16:18
analysis on why we’re seeing some of
16:21
those uh why you have some of those
16:23
errors or things don’t get don’t get
16:24
paid and you know in terms of kind of
16:26
diving in there a bit more what are some
16:28
of the ways that maybe surgery centers
16:30
can do some of that root cause analysis
16:31
more consistency consistently when they
16:34
have moments where things aren’t getting
16:36
paid and they’re not sure what code
16:37
might have changed what are some of the
16:39
things you think that can be more
16:41
effective for them there
16:44
um I think that it’s a little bit of a
16:45
culture shift of how we approach
16:47
collections yeah
16:49
um and so again historically collections
16:52
is I’m calling and saying pay my bill
16:54
pay my bill third party pay my bill and
16:56
it’s really fundamentally you know
16:58
getting curious and so it’s training
17:01
folks or hiring differently around
17:04
people who we like to use the phrase are
17:06
intellectually curious right people who
17:08
like Puzzles people who want to say okay
17:10
I have this thing in front of me and I
17:12
didn’t get the expected outcome where
17:15
and you used to use because analysis
17:16
where where did we go wrong and owning
17:19
it right saying it’s on me where did we
17:21
go wrong that we didn’t get the outcome
17:23
desired and so it’s
17:25
um where you find that could be in many
17:27
places it could be encoding it could be
17:29
in registration it could be that
17:31
um you know something went haywire with
17:33
the claim submission but you really have
17:35
to have that
17:37
um intellectual curiosity to kind of dig
17:39
and uncover and try to figure out where
17:40
did we go wrong here yeah that makes
17:42
sense and and I I think you kind of
17:44
nailed a couple good points there in
17:46
terms of that intellectual curiosity and
17:48
then being honest with yourself on kind
17:49
of you know where did we go wrong to be
17:51
able to get that get to that point
17:52
because I think it’s easy to want to
17:54
point a finger elsewhere but it
17:56
sometimes it’s a lot harder to say okay
17:58
maybe maybe we didn’t do do everything
18:00
up to par so that that makes a ton of
18:02
sense
18:03
we’re now moving into the life lessons
18:06
phase of the ASC podcast yeah that’s
18:08
that’s the next phase that’s the thing
18:10
we got to get we got to get you back on
18:11
the Pod just so we can do a whole thing
18:13
that’s um you know just the life lessons
18:15
from Ken Beulah things to things to live
18:17
by
18:19
well I I think we’re hitting a lot of
18:21
really good points here and you know
18:23
we’ve covered a ton of really great
18:25
nuggets for our listeners and as we kind
18:28
of think about some of the next steps uh
18:29
going forward here one of the things
18:31
that I want to just jump back on before
18:33
we end you know you had some really
18:36
great points there in terms of that
18:37
relationship with payers uh you know are
18:39
there any things that you would say are
18:41
just maybe some key tips for building
18:43
that relationship with payers so that
18:45
surgery centers can just be be more
18:47
effective and successful there
18:50
yeah I think there’s a couple things
18:52
um in terms of building relationships
18:54
helping them understand
18:56
what your goals as a business are yeah
19:00
and how your goals can align with uh you
19:04
know the pairs and you know so the
19:05
surgery center it’s pretty easy
19:06
historically we’ve always just said hey
19:08
we’re the lower cost of care
19:10
um you know let’s move cases out of the
19:12
hospital I think that is still today a
19:14
fantastic argument
19:15
um but it requires a bit more Nuance to
19:17
you know to organize those that thinking
19:20
around here’s our business plan here’s
19:22
how if we get X Y or Z in terms of rate
19:26
we’re looking for we’ll be able to
19:27
recruit a couple more docs and if we
19:29
recruit a couple more docs here’s what
19:31
it means to you so that’s kind of on The
19:32
Upfront kind of relationship piece and
19:35
then internally I think it’s really
19:37
important to know those contracts know
19:39
what’s in those so that again it’s all
19:42
part of how do I prevent problems before
19:44
they become problems knowing what the
19:46
requirements are within each contract
19:47
how do you have to build things do you
19:49
you know buy allow Federal is a good
19:51
example when something is done on the
19:52
left side and the right side there are a
19:54
couple different ways to build those and
19:55
understanding for each pair what their
19:57
requirements are because again if you do
20:00
that you can prevent problems up front
20:01
and every problem prevented up front
20:04
it’s just less work that you need to do
20:05
later on that makes sense that makes a
20:08
ton of sense well before I let you get
20:10
out of here today can you know one of
20:12
the things that we do every single week
20:14
with every single one of our guesses we
20:16
ask them one of the questions that that
20:18
we can kind of send all of our our
20:20
listeners off with so what is one thing
20:22
our listeners can do this week to
20:25
improve their surgery centers and it
20:27
could be related to anything it doesn’t
20:28
just have to be on the payment side
20:31
that’s a that’s a really good question
20:33
um and obviously that’s uh as a fan of
20:36
the Pod I I know that that’s how we we
20:37
end these segments
20:39
um so I think I would say it’s 2022
20:42
let’s Embrace technology there are a lot
20:45
of surgery centers out there who
20:48
um uh I see scheduling on spreadsheets I
20:51
see not taking advantage of you know I
20:54
we use our phones for everything today
20:56
and there are so many opportunities to
20:59
introduce technology again thinking
21:01
about revenue cycle
21:02
um that can help us be more efficient so
21:04
whether it’s adopting a way to text a
21:07
patient either clinical information or
21:09
financial information
21:10
adopting a method for them to
21:13
communicate with you electronically
21:14
including paying their bills
21:16
electronically
21:17
um I would look for those I would try to
21:19
take advantage of those it really exists
21:22
everywhere else in our life and I think
21:23
from my experience in visiting surgery
21:26
centers it seems to be a place where
21:27
there’s a there’s a nice opportunity for
21:29
us to take advantage of what’s out there
21:31
it’s awesome that’s some great advice
21:33
there I you know I think just to the
21:35
point that you mentioned in 2022 you
21:37
know we have a standard for technology
21:39
everywhere else in our lives so why
21:40
don’t why don’t we expect that in our in
21:42
our workplace and in our surgery centers
21:44
so that’s fantastic
21:46
um Ken this has been a fantastic episode
21:48
I’ve really appreciated having you on I
21:50
feel like there’s so many Great Clips
21:51
we’ll be able to take from this and be
21:53
able to share this out with all of our
21:54
listeners so thank you for for coming on
21:57
the Pod and uh we look forward to having
21:59
you back and we might have to take you
22:00
up on that offer of uh of an entire
22:02
episode of just life lessons with Ken
22:04
life lessons life lessons yes I
22:07
appreciate it uh thank you for inviting
22:09
me it’s been uh great to participate in
22:11
it and uh I’m happy to I’m happy to come
22:14
back and share life lessons from Canada
22:15
there’s probably a lot of people who who
22:17
wouldn’t want to listen thank you I I I
22:20
appreciate the time and and uh
22:23
uh well that’s awesome talk to you soon
22:26
[Music]
22:29
as always it has been a busy week in
22:32
healthcare so let’s jump right in our
22:35
first story this week comes from ASCA
22:37
ncms as you likely heard by now on
22:40
November 1st CMS released its 2023 final
22:44
payment rule for ASCS and hopdees now
22:47
the document they released is
22:50
1764 pages so we are working on a bigger
22:54
more detailed story on the final rule
22:56
for next week but I wanted to quickly
22:59
share
23:00
that CMS has only added four new
23:03
procedures to the ASC covered procedures
23:06
list for 2023.
23:08
and aska had actually proposed 47
23:12
procedures so to see only four make it
23:15
through is pretty disappointing
23:18
um the final rule has a few other
23:20
takeaways for ASCS though some that are
23:22
really positive so we’ll put a few links
23:25
in the episode notes so you can learn
23:27
more and again we’ll take a deeper dive
23:29
on next week’s episode
23:32
our second story comes from outpatient
23:34
surgery and they are looking into
23:36
tattoos replacing medical alert
23:39
bracelets researchers at the Georgia
23:41
Institute of Technology have developed a
23:44
low-cost painless tattoos that could
23:47
potentially be used in healthcare
23:49
the tattoos themselves are skin patches
23:52
that contain microscopic needles and
23:55
researchers suggest that they could be
23:58
used to cover up scars or guide cancer
24:00
radiation treatments but they could also
24:03
serve as an alternative to medical alert
24:05
bracelets that are often used for
24:07
diabetes epilepsy or allergies so one
24:11
example of how it could work is the
24:14
provider could actually design a tattoo
24:16
for a patient and it can include letters
24:19
numbers images or symbols then the mold
24:22
is filled with permanent or temporary
24:24
ink and then applied to the patient and
24:27
the difference is that there’s no blood
24:28
no pain and it can be applied within
24:31
minutes so it could also include black
24:34
link black light ink excuse me so it
24:37
won’t be visible all the time if the
24:39
patient prefers and I love that this
24:42
could be an option for patients and can
24:44
give them some control over their body
24:46
back and for patients who aren’t
24:48
comfortable with tradition all medical
24:50
tattoos whether for religious reasons or
24:53
personal preference this offers them an
24:55
alternative that might not feel so
24:57
intense so really cool stuff coming out
25:00
of the Georgia Institute of Technology
25:03
our third story today in an article
25:06
published by Healthcare dive over 45
25:09
percent of Americans say Health Care
25:11
bills have put them into debt in
25:14
addition to this alarming statistic they
25:17
also highlight how many Americans are
25:19
financially unprepared to deal with a
25:21
health emergency
25:23
60 said they do not maintain a dedicated
25:27
savings fund for health emergencies and
25:31
56 percent said they are struggling to
25:34
pay for any health maintenance costs
25:37
so these numbers are jarring for many
25:40
reasons obviously numbers like this will
25:43
prevent or delay care for many who
25:45
desperately need it but it also
25:47
highlights how important it is for ASCS
25:50
to begin Financial discussions with
25:52
patients as soon as possible and we
25:55
really have to do it in a way that is
25:57
fully transparent really compassionate
26:00
and easy for patients to understand and
26:03
as difficult as it can be we have to
26:06
meet patients where they are at so
26:08
offering customizable payment plans will
26:10
be key and also providing them with
26:13
educational resources in their native
26:15
languages as well so that they can
26:18
understand where the cost comes from and
26:21
just make them feel more comfortable
26:23
going through the process and also
26:25
committing to such
26:26
um making such a financial commitment
26:29
um and ultimately will also help ASCS
26:31
get paid as well so looking at kind of
26:34
inflation and where everybody or
26:36
culturally where we are at with with
26:38
health care medical bills super
26:41
important that we kind of lean in and
26:43
realize this is where we’re at and we
26:45
just need to make price transparency a
26:48
priority
26:50
and to end our new segment on a positive
26:52
note Nicole Horace who is a registered
26:55
nurse from Florida she was at a Broadway
26:58
musical for funny girl featuring Leah
27:00
Michelle when she noticed a man stand up
27:03
and collapse during the performance
27:05
after giving it a few seconds she went
27:08
over and introduced herself as a nurse
27:10
and was able to care for the man until
27:13
they were able to safely get him into an
27:15
ambulance maintaining the man’s safety
27:18
and dignity was of utmost importance to
27:20
Nicole and she was quoted afterwards
27:23
saying that’s what happens when you take
27:25
your nurse pledge and you get pinned and
27:27
you are always a nurse on the clock off
27:30
the clock Christmas day or any other
27:32
random day of the year you are always a
27:34
nurse and I’m sure many of you can
27:37
relate to that sentiment and also have
27:39
very similar stories you could share as
27:41
well so amazing job Nicole
27:44
and that news story officially wraps up
27:47
this week’s podcast thank you as always
27:49
for spending a few minutes of your week
27:51
with us make sure to subscribe or leave
27:53
a review on whichever platform you’re
27:55
listening from I hope you have a great
27:57
day and we’ll see you again next week
28:02
[Music]
welcome to this week in surgery centers
0:03
if you’re in the ASC industry then
0:05
you’re in the right place every week
0:07
we’ll start the episode off by sharing
0:10
an interesting conversation we had with
0:11
our featured guests and then we’ll close
0:13
the episode by recapping the latest news
0:15
impacting surgery centers we’re excited
0:18
to share with you what we have so let’s
0:20
get started and see what the industry’s
0:22
been up to
0:23
[Music]
0:27
hi everyone here’s what you can expect
0:29
on today’s episode we are talking with
0:32
Ken Bulow who is the Executive Vice
0:34
President of Operations at surgical
0:36
notes now there are a lot of different
0:38
parts to the revenue cycle process but
0:40
today we are focusing on getting your
0:42
claims paid after the bill goes out and
0:45
some workflow tips for making this
0:46
simpler and more effective and
0:48
eliminating work
0:49
we’ll close the episode with a few news
0:51
stories we’ll start with cms’s 2023
0:54
final payment rule for ASCS talk about a
0:57
new innovation around tattoos and
0:59
medical alert bracelets look at the
1:01
average consumer’s medical debt and how
1:03
that impacts ASCS and of course and the
1:06
new segment with a positive story about
1:08
a nurse who helped care for a man after
1:10
he collapsed during a Broadway show hope
1:13
everyone enjoys the episode and here’s
1:15
what’s going on this week in surgery
1:17
centers
1:20
thank you
1:22
all right how’s it going guys welcome
1:24
back to another fantastic episode here
1:27
at this week in surgery centers I’m your
1:29
host Rafael akinsby and we have a
1:32
fantastic episode I’m super pumped about
1:34
this one this week we have Ken Bulow he
1:37
is the Executive Vice President of
1:39
Operations at surgical nodes fantastic
1:42
leader and we’re really excited to have
1:44
him on because we’re going to be talking
1:45
about something that I know a lot of our
1:47
listeners have asked about and want to
1:49
hear and you know today we’re going to
1:51
be covering getting your claim paid
1:53
faster after the bill goes out and this
1:56
is just one that I know impacts a ton of
1:59
different surgery centers and this is an
2:01
area that we really want to dive into
2:02
before I run through all the questions I
2:05
have for you today can I want to First
2:07
just kind of jump in and give you a
2:08
chance to talk a little bit about
2:09
yourself for anyone who doesn’t know you
2:12
um go ahead and kind of tell the people
2:13
about you and kind of what you do at
2:15
surgical notes
2:17
great yeah thanks for having me on I’m
2:19
thrilled to be here today I’m happy to
2:21
uh to to share a little bit of my
2:23
knowledge with your audience
2:25
um I have been working in healthcare
2:27
provider revenue cycle for about 25
2:29
years now it’s kind of all I’ve ever
2:31
done
2:32
um and then specifically working with
2:33
here with surgery centers since 2008.
2:38
um so I I’ve been in uh leadership roles
2:41
for revenue cycle firms or surgery
2:43
center management companies working
2:45
specifically with surgery center since
2:48
2008. awesome awesome today today it’s
2:51
at surgical notes so it you know I lead
2:53
uh one of my primary duties is leading a
2:55
revenue cycle team for our customers
2:57
who’ve given us the privilege of
2:59
handling their billing for them that’s
3:01
fantastic yeah and hearing how long
3:03
you’ve been in the space is one of the
3:05
reasons why we really wanted to have you
3:07
um on the podcast I think that that time
3:09
that you spent there and that wealth of
3:11
knowledge kind of gives so many great
3:13
points there in terms of ways that
3:15
you’ll be able to give some guidance so
3:16
we’re excited to dive in and you know
3:18
we’ll jump right in so you know when it
3:20
comes to revenue cycle management and
3:23
the revenue cycle process there are tons
3:25
of different steps in that process for
3:27
any surgery center
3:29
um but you know we really want to kind
3:30
of focus today on kind of that that last
3:32
piece there almost the last piece in
3:34
terms of following up with patients on
3:37
those unpaid claims and for people who
3:40
aren’t necessarily as familiar here can
3:42
you kind of give us a sense of you know
3:44
what percentage of patients typically
3:47
leave with an outstanding balance like
3:50
how common is that
3:52
so I would say
3:54
um in the perfect world
3:57
um you’re doing a full and complete
3:59
Insurance verification prior to the day
4:02
of surgery you are figuring out what the
4:05
patient’s benefits are you’re figuring
4:07
out what procedure is going to be
4:08
performed comparing that with your
4:10
contract so
4:12
um you know you take a
4:14
a knee arthroscopy you compare that with
4:17
your Cigna contract did you figure out
4:18
okay this is exactly how much I’m going
4:20
to uh have as an allowed amount for my
4:22
Cigna contract apply the patient
4:24
benefits and ideally you know a week or
4:28
so prior to surgery exactly what that
4:30
patient’s going to owe and um so in the
4:33
perfect world we call the patient ahead
4:34
of time we we tell them hey you’re
4:36
coming in on Tuesday this is how much
4:38
you owe we’ll take a credit card over
4:40
the phone today and in the perfect world
4:41
they pay you where you use one of the
4:43
modern tools out there to send them a
4:45
text message and say hey here’s how much
4:47
you owe just click this link and pay us
4:49
um so in the world that’s how it happens
4:51
in reality
4:54
um a a hesitant to give percentages
4:56
because it really varies yeah based on
4:59
based on how that Center is run based on
5:01
the technologies that they choose to
5:03
take advantage of
5:04
um but for those patients who don’t pay
5:05
up front then you have another
5:06
opportunity when they’re standing right
5:08
in front of you to say hey you owe me
5:10
you know prior to service and um
5:13
uh so again taking advantage of that
5:15
second opportunity to collect from them
5:16
they should have already known because
5:18
they should have already uh contacted
5:19
them ahead of time
5:21
um so industry-wide you know if I had to
5:23
say at that point by the time the
5:25
patient has come in yeah
5:27
um somewhere North of 60 of what we see
5:31
have collected something okay it’s not
5:33
always the entire ending balance because
5:35
some patients uh can’t uh can’t put it
5:38
all down at once but but somewhere North
5:40
of 60 have taken something I’ve had a
5:42
conversation everybody’s had a
5:43
conversation with a patient but 60 have
5:45
had a conversation with that patient
5:46
because some either all or some portion
5:49
of that video okay that that’s helpful
5:51
to to know then and I want to dive in a
5:54
little bit deeper on that you know and
5:56
we won’t hold you to an exact percentage
5:58
um on this you know maybe we’ll get
5:59
someone on the production team they’ll
6:01
go look up the stat or something but
6:03
that is helpful for us to get get some
6:05
sense of and in kind of thinking about
6:07
that based on what you’ve said there so
6:08
that 60 is there’s a certain amount
6:11
that’s been collected but not
6:13
necessarily all of the all of the the
6:16
amount that a patient owes and
6:17
especially thereafter once they’ve left
6:20
the surgery center
6:22
correct right so you have some patients
6:24
who have paid everything some patients
6:26
who’ve had nothing and some who have
6:27
paid uh abortion okay and there are
6:29
genuinely some cases where you’re just
6:31
not sure of exactly what that charge is
6:33
going to be and so that estimate could
6:35
result later on with either yelling them
6:37
a little bit back or the patient knowing
6:39
you a little bit more after the claim
6:40
because adjudicated through the
6:41
insurance company that makes sense that
6:43
makes sense well diving in there a bit I
6:46
want to kind of follow on to that same
6:47
note so what do you think are probably
6:50
the three biggest things ases get wrong
6:53
after a patient walks out the door and
6:56
they still owe them some owe them some
6:58
money for for that that case
7:02
um I think
7:04
um uh the thing that folks
7:06
get wrong or may not understand is every
7:09
day that goes by
7:12
um where you’re unable to collect those
7:14
dollars your chance of collecting that
7:16
dollar goes down yeah so
7:19
um if you wait 30 days if you wait 60
7:21
days if you wait 90 days every every
7:23
every every every day that goes by you
7:24
have a lesson you know statistically a
7:26
less lower and lower chance of
7:27
collecting that so what we like to do is
7:29
make sure that we’re communicating with
7:31
patients all along the way sometimes we
7:33
are legitimately waiting for a claim to
7:35
process before we know exactly what the
7:37
patient knows the great news is for most
7:40
third-party payers the patient’s getting
7:42
an explanation of benefits and elb from
7:44
their third party at the same time so
7:46
they know it’s coming so they’re helping
7:48
right so Blue Cross signal United
7:49
whoever’s helping keep in touch with
7:51
that patient to say we’re paying your
7:52
claim to your provider and you do owe
7:54
something and you should expect to hear
7:55
from them but it’s really important to
7:57
just have all that done done timely I
7:59
don’t think that was three but that’s
8:01
the problem that’s kind of what I would
8:03
say is most important no that makes
8:04
sense sometimes we you don’t have to
8:06
have all a full checklist of different
8:08
things sometimes it kind of you hit the
8:10
nail on the head there and I think that
8:11
that’s something that’s true and
8:12
resonates really well for a lot of a lot
8:15
of ASCS and um you know you think about
8:17
it and it goes beyond just the ASC
8:19
industry I think in general you know
8:22
from once you get service or a product
8:24
of any kind the further out you are from
8:27
that time of service just the less
8:29
incentivized you are to make that
8:31
payment at all or at least in some kind
8:33
of timely manner so it makes a lot of
8:35
logical sense there
8:37
especially if you’ve had a good
8:38
experience right you just you’ve walked
8:40
out of that place of service whatever it
8:42
is but in our example it’s a surgery
8:44
center you’ve walked out of that surgery
8:45
center they’ve fixed whatever problem or
8:47
they’ve you know uh have you on the path
8:50
to recovery
8:51
um you’re feeling really good about them
8:52
the more time that goes by
8:55
um the less inclined you are to remember
8:56
that nurse or that doctor or that front
8:58
desk person who who had a positive
9:00
experience with and and want to write a
9:02
check yeah yeah that makes a ton of
9:04
sense if I you know if I was someone
9:05
let’s just say getting uh getting a car
9:08
wash after the car after my car was
9:10
washed a couple weeks later I I’m
9:11
probably not thinking about how great a
9:13
job they did on my car anymore so if I
9:15
hadn’t already paid for it they’re
9:17
probably not going to get a payment
9:18
until I get that car washed again so
9:20
that that makes sense well
9:23
um let’s say I am a surgery center that
9:25
yeah I’m trying to trying to collect
9:27
that that payment you know that process
9:30
I imagine is probably not easy it’s
9:32
probably pretty tedious and time
9:34
consuming trying to go through the
9:36
process of collecting that payment what
9:38
are some of the you know the workflow
9:40
tips for making that process simpler and
9:43
maybe eliminating some of the work so
9:45
they can actually collect that payment
9:49
I think that um uh so again we’ll I know
9:52
we’ll talk about insurance a little bit
9:53
but from a patient standpoint
9:55
um ensuring that as soon as you know
9:58
there is some patient liability you’ve
10:01
um allocated that to a patient
10:04
responsibility bucket using whatever
10:06
technology you use and then get those
10:08
statements out so we um we tend to work
10:10
with vendors who automate the statement
10:11
process for us so there’s a statement
10:13
file that goes out every day and every
10:15
patient that’s ready for a statement
10:17
will get that statement
10:19
um and so as much as you can kind of
10:21
automate it put it on a plan that says
10:23
every X number of days and
10:25
um uh you know typically we’re looking
10:27
at a little bit less than a month we’re
10:29
dropping a statement to a patient every
10:30
month and making sure that there’s
10:32
messaging that’s escalating to say hey
10:33
look you you owe us this money let’s pay
10:35
us and and by the time you get to the
10:37
third one if they haven’t uh paid you
10:39
voluntarily they’re probably not going
10:40
to so at that point it’s probably worth
10:42
picking up the phone and saying hello
10:44
you know you should have seen three
10:45
statements from us have you received
10:47
those is there a reason you haven’t paid
10:48
us was it a service issue was it a
10:50
process issue or do you not have the
10:52
money let’s let’s talk about some ways
10:53
we can we can help you get there
10:56
um and then fundamentally I mean there
10:58
will be times when you have to take
10:59
advantage of the third party agencies
11:02
out there that uh uh basically will
11:05
represent themselves as a collection
11:06
agency and take over from that point
11:09
um the idea is to prevent that yeah that
11:11
makes a lot of sense and I think you
11:12
know for many surgery centers you want
11:15
to be able to get out ahead of it well
11:16
before you have to go with a third party
11:18
um collections agency to be able to make
11:21
that make that happen and I think the
11:23
point you mentioned there I want to I
11:25
want to dive in on those first two
11:26
points a little bit in terms of kind of
11:28
communicating that to the patient um
11:30
well in advance and then also taking
11:32
advantage of that additional step of
11:34
kind of calling and letting them know
11:35
that hey you might have received a few
11:37
different statements you know how
11:39
effective do you think that’s been for a
11:41
lot of surgery centers and do you think
11:42
that drives a lot of success for them in
11:45
terms of collecting those payments
11:49
um absolutely I mean I don’t know about
11:50
you but you know I get mail and
11:52
sometimes it piles up on my desk and
11:54
then I’ll get a day and I’ll sit down
11:55
and I’ll get to work on all of it and um
11:58
sometimes you just need that little
12:00
nudge from somebody to say hey remember
12:01
this is you know this is dude you got to
12:03
take care of this and uh and so it
12:05
prompts them to do it uh that makes
12:07
sense and and is that something that you
12:09
know in terms of kind of building some
12:11
workflows around do you think that’s
12:13
something where surgery centers can kind
12:15
of templatize that process for their
12:17
team so it’s maybe more efficient for
12:19
them
12:20
yeah so you know you can use those
12:23
statements as trigger so if you set up a
12:25
workflow that says let’s just say for
12:27
example every 25 days I want to send out
12:30
a statement
12:31
um uh you can then create a workflow
12:33
that says after statement one I’m
12:34
probably not going to do anything I’m
12:35
gonna hope they pay after that second
12:37
statement here’s what I want to do I
12:39
want to I want to put it on a call list
12:40
I want to have somebody call them after
12:41
the third statement I want to do the
12:43
same thing
12:44
um just so that it becomes kind of a a
12:47
process and it’s just you know by the
12:50
time you get to that third statement you
12:51
can say I know this has happened because
12:53
my process is I send a statement I send
12:55
a second one I make a phone call I send
12:57
a third one I make a second another
12:58
phone call and if it is a process and
13:01
it’s all documented you can you can be
13:03
sure that that’s done and that you’ve
13:04
done your part to try to collect those
13:05
dollars yep that makes sense I’m a huge
13:08
fan of anything I can put into a
13:09
workflow or process it makes my life
13:11
simpler and it’s easier to manage and I
13:13
imagine for a lot of our listeners it’s
13:15
probably the same
13:16
so yes jumping forward a bit there you
13:20
know one of the things I heard you say
13:21
before that I think is a stroke of
13:24
Genius is um you know things go wrong
13:26
and in patterns and I think that that
13:29
makes a ton of sense you know in terms
13:32
of you know running a surgery center if
13:34
you were running a surgery center today
13:36
you know how would you identify the
13:38
patterns
13:39
um learn and learn from them so that you
13:41
can avoid kind of some of these gaps and
13:43
problems around collections uh in the
13:45
future
13:47
I think I may have been referring to
13:49
more to Insurance follow-up at that
13:51
point
13:52
um where we see things go wrong in
13:54
patterns so
13:55
um the way the way that um I think about
13:58
insurance carriers here today in 2022 is
14:01
they want to pay us
14:03
um and this is a little bit
14:04
controversial in the provider Community
14:06
I think you know for the folks who’ve
14:08
been in the provider space as long as I
14:09
have we’ve always had this view of
14:10
they’re the enemy the payer is the enemy
14:13
they don’t want to pay us they want to
14:14
hold on to those dollars and earn
14:16
interest on them and um uh I I
14:19
fundamentally believe today that is not
14:21
the case and I believe that they set up
14:24
their claim shops and they want to pay
14:26
us because they have to pay an agent on
14:29
the other side as well if they don’t pay
14:31
us and um in order to do that they set
14:34
up rules yeah and um and they publish
14:36
those rules on their websites and
14:38
there’s a provider manual that tells you
14:39
how things work and um and so typically
14:42
what we find today is that when your
14:45
claims aren’t getting paid by a third
14:47
party it’s because you didn’t follow
14:49
some rule we can debate for hours about
14:51
whether those rules make any sense
14:53
whether we agree with those rules but
14:55
the fact is there are some fundamental
14:57
boundaries guard rails that they’ve set
14:59
up and it’s our job to follow them so
15:01
yeah we do see when things go wrong it
15:03
tends to be in patterns it could be that
15:05
there’s a new modifier requirement for a
15:08
certain payer it could be that a code
15:09
that used to be payable is no longer
15:11
longer payable it could be there’s a
15:13
contract rate change that we weren’t
15:15
aware of that we should have been aware
15:16
of but whatever it is it’s um it’s the
15:20
job of the surgery center or whoever’s
15:22
working in the revenue cycle for that
15:23
surgery center to try and understand
15:26
what is it that went wrong here yeah how
15:28
do I fix this thing this individual
15:30
claim that’s in front of me and then
15:32
what other claims or what other process
15:36
do I need to put in place to make sure
15:38
this thing never happens again and
15:41
um you know the more you do that over
15:43
time the cleaner you see uh your revenue
15:46
cycle get until something changes on the
15:48
payer side yeah that that makes sense
15:50
and I think you you call that a couple
15:52
really great points there one in terms
15:54
of that perception of the relationship
15:56
with payers and um I think that’s just a
15:59
common misconception so I think that
16:01
that makes a ton of sense there in terms
16:03
of rethinking or maybe realigning or
16:05
thinking around how we see the the
16:07
relationship with payers
16:09
um and then two I think the part one of
16:11
the parts I want to dive into a bit more
16:12
there
16:13
um is kind of talking about those steps
16:15
of actually going through what I would
16:17
say is almost kind of a root cause
16:18
analysis on why we’re seeing some of
16:21
those uh why you have some of those
16:23
errors or things don’t get don’t get
16:24
paid and you know in terms of kind of
16:26
diving in there a bit more what are some
16:28
of the ways that maybe surgery centers
16:30
can do some of that root cause analysis
16:31
more consistency consistently when they
16:34
have moments where things aren’t getting
16:36
paid and they’re not sure what code
16:37
might have changed what are some of the
16:39
things you think that can be more
16:41
effective for them there
16:44
um I think that it’s a little bit of a
16:45
culture shift of how we approach
16:47
collections yeah
16:49
um and so again historically collections
16:52
is I’m calling and saying pay my bill
16:54
pay my bill third party pay my bill and
16:56
it’s really fundamentally you know
16:58
getting curious and so it’s training
17:01
folks or hiring differently around
17:04
people who we like to use the phrase are
17:06
intellectually curious right people who
17:08
like Puzzles people who want to say okay
17:10
I have this thing in front of me and I
17:12
didn’t get the expected outcome where
17:15
and you used to use because analysis
17:16
where where did we go wrong and owning
17:19
it right saying it’s on me where did we
17:21
go wrong that we didn’t get the outcome
17:23
desired and so it’s
17:25
um where you find that could be in many
17:27
places it could be encoding it could be
17:29
in registration it could be that
17:31
um you know something went haywire with
17:33
the claim submission but you really have
17:35
to have that
17:37
um intellectual curiosity to kind of dig
17:39
and uncover and try to figure out where
17:40
did we go wrong here yeah that makes
17:42
sense and and I I think you kind of
17:44
nailed a couple good points there in
17:46
terms of that intellectual curiosity and
17:48
then being honest with yourself on kind
17:49
of you know where did we go wrong to be
17:51
able to get that get to that point
17:52
because I think it’s easy to want to
17:54
point a finger elsewhere but it
17:56
sometimes it’s a lot harder to say okay
17:58
maybe maybe we didn’t do do everything
18:00
up to par so that that makes a ton of
18:02
sense
18:03
we’re now moving into the life lessons
18:06
phase of the ASC podcast yeah that’s
18:08
that’s the next phase that’s the thing
18:10
we got to get we got to get you back on
18:11
the Pod just so we can do a whole thing
18:13
that’s um you know just the life lessons
18:15
from Ken Beulah things to things to live
18:17
by
18:19
well I I think we’re hitting a lot of
18:21
really good points here and you know
18:23
we’ve covered a ton of really great
18:25
nuggets for our listeners and as we kind
18:28
of think about some of the next steps uh
18:29
going forward here one of the things
18:31
that I want to just jump back on before
18:33
we end you know you had some really
18:36
great points there in terms of that
18:37
relationship with payers uh you know are
18:39
there any things that you would say are
18:41
just maybe some key tips for building
18:43
that relationship with payers so that
18:45
surgery centers can just be be more
18:47
effective and successful there
18:50
yeah I think there’s a couple things
18:52
um in terms of building relationships
18:54
helping them understand
18:56
what your goals as a business are yeah
19:00
and how your goals can align with uh you
19:04
know the pairs and you know so the
19:05
surgery center it’s pretty easy
19:06
historically we’ve always just said hey
19:08
we’re the lower cost of care
19:10
um you know let’s move cases out of the
19:12
hospital I think that is still today a
19:14
fantastic argument
19:15
um but it requires a bit more Nuance to
19:17
you know to organize those that thinking
19:20
around here’s our business plan here’s
19:22
how if we get X Y or Z in terms of rate
19:26
we’re looking for we’ll be able to
19:27
recruit a couple more docs and if we
19:29
recruit a couple more docs here’s what
19:31
it means to you so that’s kind of on The
19:32
Upfront kind of relationship piece and
19:35
then internally I think it’s really
19:37
important to know those contracts know
19:39
what’s in those so that again it’s all
19:42
part of how do I prevent problems before
19:44
they become problems knowing what the
19:46
requirements are within each contract
19:47
how do you have to build things do you
19:49
you know buy allow Federal is a good
19:51
example when something is done on the
19:52
left side and the right side there are a
19:54
couple different ways to build those and
19:55
understanding for each pair what their
19:57
requirements are because again if you do
20:00
that you can prevent problems up front
20:01
and every problem prevented up front
20:04
it’s just less work that you need to do
20:05
later on that makes sense that makes a
20:08
ton of sense well before I let you get
20:10
out of here today can you know one of
20:12
the things that we do every single week
20:14
with every single one of our guesses we
20:16
ask them one of the questions that that
20:18
we can kind of send all of our our
20:20
listeners off with so what is one thing
20:22
our listeners can do this week to
20:25
improve their surgery centers and it
20:27
could be related to anything it doesn’t
20:28
just have to be on the payment side
20:31
that’s a that’s a really good question
20:33
um and obviously that’s uh as a fan of
20:36
the Pod I I know that that’s how we we
20:37
end these segments
20:39
um so I think I would say it’s 2022
20:42
let’s Embrace technology there are a lot
20:45
of surgery centers out there who
20:48
um uh I see scheduling on spreadsheets I
20:51
see not taking advantage of you know I
20:54
we use our phones for everything today
20:56
and there are so many opportunities to
20:59
introduce technology again thinking
21:01
about revenue cycle
21:02
um that can help us be more efficient so
21:04
whether it’s adopting a way to text a
21:07
patient either clinical information or
21:09
financial information
21:10
adopting a method for them to
21:13
communicate with you electronically
21:14
including paying their bills
21:16
electronically
21:17
um I would look for those I would try to
21:19
take advantage of those it really exists
21:22
everywhere else in our life and I think
21:23
from my experience in visiting surgery
21:26
centers it seems to be a place where
21:27
there’s a there’s a nice opportunity for
21:29
us to take advantage of what’s out there
21:31
it’s awesome that’s some great advice
21:33
there I you know I think just to the
21:35
point that you mentioned in 2022 you
21:37
know we have a standard for technology
21:39
everywhere else in our lives so why
21:40
don’t why don’t we expect that in our in
21:42
our workplace and in our surgery centers
21:44
so that’s fantastic
21:46
um Ken this has been a fantastic episode
21:48
I’ve really appreciated having you on I
21:50
feel like there’s so many Great Clips
21:51
we’ll be able to take from this and be
21:53
able to share this out with all of our
21:54
listeners so thank you for for coming on
21:57
the Pod and uh we look forward to having
21:59
you back and we might have to take you
22:00
up on that offer of uh of an entire
22:02
episode of just life lessons with Ken
22:04
life lessons life lessons yes I
22:07
appreciate it uh thank you for inviting
22:09
me it’s been uh great to participate in
22:11
it and uh I’m happy to I’m happy to come
22:14
back and share life lessons from Canada
22:15
there’s probably a lot of people who who
22:17
wouldn’t want to listen thank you I I I
22:20
appreciate the time and and uh
22:23
uh well that’s awesome talk to you soon
22:26
[Music]
22:29
as always it has been a busy week in
22:32
healthcare so let’s jump right in our
22:35
first story this week comes from ASCA
22:37
ncms as you likely heard by now on
22:40
November 1st CMS released its 2023 final
22:44
payment rule for ASCS and hopdees now
22:47
the document they released is
22:50
1764 pages so we are working on a bigger
22:54
more detailed story on the final rule
22:56
for next week but I wanted to quickly
22:59
share
23:00
that CMS has only added four new
23:03
procedures to the ASC covered procedures
23:06
list for 2023.
23:08
and aska had actually proposed 47
23:12
procedures so to see only four make it
23:15
through is pretty disappointing
23:18
um the final rule has a few other
23:20
takeaways for ASCS though some that are
23:22
really positive so we’ll put a few links
23:25
in the episode notes so you can learn
23:27
more and again we’ll take a deeper dive
23:29
on next week’s episode
23:32
our second story comes from outpatient
23:34
surgery and they are looking into
23:36
tattoos replacing medical alert
23:39
bracelets researchers at the Georgia
23:41
Institute of Technology have developed a
23:44
low-cost painless tattoos that could
23:47
potentially be used in healthcare
23:49
the tattoos themselves are skin patches
23:52
that contain microscopic needles and
23:55
researchers suggest that they could be
23:58
used to cover up scars or guide cancer
24:00
radiation treatments but they could also
24:03
serve as an alternative to medical alert
24:05
bracelets that are often used for
24:07
diabetes epilepsy or allergies so one
24:11
example of how it could work is the
24:14
provider could actually design a tattoo
24:16
for a patient and it can include letters
24:19
numbers images or symbols then the mold
24:22
is filled with permanent or temporary
24:24
ink and then applied to the patient and
24:27
the difference is that there’s no blood
24:28
no pain and it can be applied within
24:31
minutes so it could also include black
24:34
link black light ink excuse me so it
24:37
won’t be visible all the time if the
24:39
patient prefers and I love that this
24:42
could be an option for patients and can
24:44
give them some control over their body
24:46
back and for patients who aren’t
24:48
comfortable with tradition all medical
24:50
tattoos whether for religious reasons or
24:53
personal preference this offers them an
24:55
alternative that might not feel so
24:57
intense so really cool stuff coming out
25:00
of the Georgia Institute of Technology
25:03
our third story today in an article
25:06
published by Healthcare dive over 45
25:09
percent of Americans say Health Care
25:11
bills have put them into debt in
25:14
addition to this alarming statistic they
25:17
also highlight how many Americans are
25:19
financially unprepared to deal with a
25:21
health emergency
25:23
60 said they do not maintain a dedicated
25:27
savings fund for health emergencies and
25:31
56 percent said they are struggling to
25:34
pay for any health maintenance costs
25:37
so these numbers are jarring for many
25:40
reasons obviously numbers like this will
25:43
prevent or delay care for many who
25:45
desperately need it but it also
25:47
highlights how important it is for ASCS
25:50
to begin Financial discussions with
25:52
patients as soon as possible and we
25:55
really have to do it in a way that is
25:57
fully transparent really compassionate
26:00
and easy for patients to understand and
26:03
as difficult as it can be we have to
26:06
meet patients where they are at so
26:08
offering customizable payment plans will
26:10
be key and also providing them with
26:13
educational resources in their native
26:15
languages as well so that they can
26:18
understand where the cost comes from and
26:21
just make them feel more comfortable
26:23
going through the process and also
26:25
committing to such
26:26
um making such a financial commitment
26:29
um and ultimately will also help ASCS
26:31
get paid as well so looking at kind of
26:34
inflation and where everybody or
26:36
culturally where we are at with with
26:38
health care medical bills super
26:41
important that we kind of lean in and
26:43
realize this is where we’re at and we
26:45
just need to make price transparency a
26:48
priority
26:50
and to end our new segment on a positive
26:52
note Nicole Horace who is a registered
26:55
nurse from Florida she was at a Broadway
26:58
musical for funny girl featuring Leah
27:00
Michelle when she noticed a man stand up
27:03
and collapse during the performance
27:05
after giving it a few seconds she went
27:08
over and introduced herself as a nurse
27:10
and was able to care for the man until
27:13
they were able to safely get him into an
27:15
ambulance maintaining the man’s safety
27:18
and dignity was of utmost importance to
27:20
Nicole and she was quoted afterwards
27:23
saying that’s what happens when you take
27:25
your nurse pledge and you get pinned and
27:27
you are always a nurse on the clock off
27:30
the clock Christmas day or any other
27:32
random day of the year you are always a
27:34
nurse and I’m sure many of you can
27:37
relate to that sentiment and also have
27:39
very similar stories you could share as
27:41
well so amazing job Nicole
27:44
and that news story officially wraps up
27:47
this week’s podcast thank you as always
27:49
for spending a few minutes of your week
27:51
with us make sure to subscribe or leave
27:53
a review on whichever platform you’re
27:55
listening from I hope you have a great
27:57
day and we’ll see you again next week
28:02
[Music]
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