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Newsletters

January 3, 2014

Optimizing Surgery Scheduling in Alignment with the Revenue Cycle

Tips to Make Surgery Scheduling Processes More Efficient

A key challenge of healthcare in today’s financial environment is aligning perioperative services with the revenue cycle to achieve financial stability. With the paradigm shift in healthcare from quantity to quality, the challenge for most organizations regardless of size is one of optimizing clinical outcomes and maximizing reimbursement. To that end, the department of perioperative services through the use of best practice modalities often realizes more than 65% of an organization’s revenue.

The implementation of best practice modalities provides the infrastructure necessary for an organization to successfully capture efficiencies and optimize performance from an operational and financial perspective.

Benefits to the Facility

Capturing patient information early in the scheduling process provides an opportunity to identify clinical and financial issues which could delay or result in the cancellation of an elective, non-emergent surgical procedure.

Early Clinical Review

Early clinical review not only optimizes operating room utilization and efficiency as well as reduces the possibility of cancelled or delayed cases but also provides an opportunity for financial screening and clearance.

Early Financial Review

There are a variety of reasons for obtaining financial clearance in advance:

  • A decrease in the total percentage of bad debt for the organization by identifying funding sources for eligible self-pay patients
  • Reductions in insurance denials due to incorrect information or lack of authorization
  • A decrease in accounts receivable (A/R) days

Benefits to the Patient

The opportunity to provide financial screening and medical clearance prior to surgery ensures that the patient is optimized from a medical and financial perspective. When there is not sufficient time to optimize the patient prior to surgery, there is an increased risk that the patient will incur a greater length of stay, subpar clinical outcomes, and decreased levels of satisfaction with the patient experience in general.

How Much Time to Allot for Optimization

Patient optimization prior to surgery typically requires a minimum of 72 hours (3 business days) prior to surgery. When non-emergent, elective cases are scheduled with less than 72 hours’ notice, there is not sufficient time for optimization from a clinical or financial perspective. For example, preoperative testing performed within 72 hours cannot be compensated separately under CMS payment policy.

Implementing key strategies for optimization within the surgical schedule and the revenue cycle will allow these processes to integrate and the organization to achieve its clinical and financial goals. A focal point should be developing collaborative processes between perioperative services and finance to achieve successful outcomes and future sustainability.

More Tips to Improve Efficiency

In addition to optimizing scheduling, consider optimizing the layout of your OR suites. Download the free white paper -- Right-sizing the Surgical Suite: Build for the Future -- to learn:

  • Why perioperative design needs are changing
  • Four ways to avoid clutter and bottlenecks
  • Latest trends in OR suite design
  • How to ensure all departments are properly represented

Download now »

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Featured Resource:

FREE WHITE PAPER

Managing Bottlenecks to Increase Perioperative Efficiency