Presented by: Ami Grube, CFO CPR Anesthesia, Inc.

Transcription

1 Presented by: Ami Grube, CFO CPR Anesthesia, Inc. 154

2 About Me Accomplishments with CPR Anesthesia, Inc. since 2002 Revenue generation Anesthesia specific billing expertise Managed care contracting Practice management Client accounts management Financial analysis Forensic and practice auditing Workflow design Payroll and Marketing strategies Personal hobbies Skiing, golf, tennis and travel with my family 155

3 Today s Agenda Top 7 struggles in Anesthesia staffing at an ASC Surgeon satisfaction Anesthesia department model OR utilization Financial support Flexibility of providers Unestablished back up plan Business related items 156

4 Quick Assessment OR suties/procedure rooms utilizing anesthesia Providers MDA only CRNA only Care team approach Coverage provided by Employed providers Contracted group Exclusive contract Open model Independently contracted providers Surgeon brings own provider Stipend or subsidy offered Who does billing Facility In-house / outsource Group 157

5 Surgeon Satisfaction Want anesthesia available at all times Primary customers Partners in ASC Anesthesia preferences vary by surgeon Sedation levels Blocks Personality conflicts Catering to block time Under utilize Over utilize Consistency it s what they deserve! 158

6 Anesthesia Department Model Contracted group vs. employed provider vs. independent contractor Provider type MDA CRNA Care team approach Additional coverage sought by Group Facility 159

7 OR Utilization Vertical stacking vs horizontal stacking Vertical Reduces staffing expenses Utilize vacant block time by other surgeons Conflict of adding cases by surgeon at last minute If they can t add they will take their cases elsewhere Horizontal Increases staffing expenses Block time under performance equals down time Exceptions vs norms Flexible for attracting new surgeons 160

8 Financial Support Stipend vs. subsidy Who monitors revenues Anesthesia billing Anesthesia specific billers, coders, software Proper documentation In or out of network providers Properly negotiated payor contracts Timely submissions of claims Accurate / clean claim submissions Denial and appeals management Patient payment options Revenue generated support accurate staffing model requirements 161

9 Flexibility of Providers Patient outcomes driven or monetarily driven In or on the phone handling business or watching the patient? Good cases with the bad Available at last minute Surgeon satisfaction Group have adequate back up plan 162

10 Unestablished Back Up Plan Vacation or emergency contingent plans Facility handles Taxing on administration time Incur additional expenses for coverage LT / incidentals Emergency credentialing Group handles Adequate number of providers in group Seamless transition of scheduling Facility input and/or approval of new providers Streamline credentialing process No back up plan Cancelled cases Delayed starts Frustrated surgeons and patients Provider s commitment to the facility in question 163

11 Business Related Items Credentialing provided as complete, timely and accurate files Facility credentials and billing credentials Instability in staffing How far in advance are schedules completed Do you know who is scheduled on what day HR / conflict related matters Facility have to approach provider Group handles conflict resolution and coaching Provider pay Providers complain about pay to facility low, untimely, inaccurate, etc. Malpractice coverage Provider responsibility or group coverage Financial audits 164

12 Why Use A Management Company Runs department like a business Streamlines all aspects Recruitment Credentialing Scheduling Billing Payment to providers Malpractice coverage Conflict resolution Reduces burden from facility staff and/or group Proves stability and consistency 165

13 Conclusions Assess anesthesia department functionality Financially supporting staffing requirements Are cases delayed or cancelled due to anesthesia Do you or your group have a back up plan Are your surgeons satisfied with current model and providers 166

14 Stay In Touch Ami Grube, CFO CPR Anesthesia, Inc x14 office cell 167