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Winter 2012 ICD-10 Impact & Preparation: 5 Tips for ASCs IT Talk: Why Cloud Computing Makes Sense for ASCs Case Study: How One ASC Improved Reimbursement Rates, Reduced Expenses, While Saving Time Achieving Connectivity Through Automation Brought to you by Inside Source What ASC Professionals Know Follow us on:

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What ASC Professionals Know, ICD-10 Impact and Preparation: 5 Tips for ASCs, Why Cloud Computing Makes sense for ASCs, How one ASC Improved reimbursement rates, reduced expenses, while saving time, Achieving Connectivity through automation

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Page 1: Inside Source Winter 2012

Winter 2012

ICD-10 Impact & Preparation: 5 Tips for ASCs

IT Talk: Why Cloud Computing Makes Sense for ASCs

Case Study: How One ASC Improved Reimbursement Rates, Reduced Expenses, While Saving Time

Achieving Connectivity Through Automation

Brought to you by

Inside SourceWhat ASC Professionals Know

Follow us on:

Page 2: Inside Source Winter 2012

An ASC Perspective

In the healthcare technology world, the term “solutions” is tossed around rather casually. What

most vendors present as “solutions” the rest of the world simply sees as “software”. While it is true that good software can improve certain aspects

of facility operations, its effectiveness as a “solution” is limited by the design of its developers and the scope of its implementation. A true solution is one that is tailored to meet your operational goals and also fits within your operational budget.

For over 30 years, SourceMedical’s surgery center applications have helped facilities across the country better manage their accounts receivable, implement electronic health records, control inventory, get a handle on case costing, and stay compliant with industry regulations. However, our solutions offer centers more than software.

In today’s challenging payer environment, a growing number of centers are partnering with SourceMedical to better manage their patient accounting services as a supplement to their facility management software. The SourceMedical solution allows ASCs to manage the day-to-day clinical aspects of their facility and to focus on patient care with the added peace of mind that their accounts receivable are being managed by a team of dedicated ASC coders, billers, and collectors whose job it is to maximize facility revenue.

In this edition of Inside Source, we invite you to consider the aspects of what we term “Tech-Enabled Solutions” which combines industry-leading software with world-class billing services tailored to the ASC community and to learn how by partnering with SourceMedical, your facility can achieve all its operational and clinical goals. In other words, see how your facility can implement and benefit from a true ASC solution.

Patrick DoyleExecutive Vice President Sales and Marketing

WELCOME

Inside SourceWhat ASC Professionals Know

in this issue:

WELCOMEAn ASC Perspective ....................................1

BUSINESS ICD-10 Impact and Preparation: 5 Tips for ASCs ...........................................2

IT TALK Why Cloud Computing Makes Sense for ASCs.................................4

CASE STUDY Massachusetts Avenue Surgery Center .......8

TECHNOLOGY Achieving Connectivity Through Automation ..................................9

SourceMedical is the largest provider of outpatient information solutions and services for outpatient ambulatory surgery centers, specialty hospitals, and rehabilitation clinics nationwide. With 30 years of real-world experience, more than 5,000 satisfied customers, and the confidence of more than 250 consultants and management companies, SourceMedical offers the broadest range of solutions and enhancements available to the industry. The company’s unique end-to-end systems improve operational efficiency and cash flow while enabling healthcare facilities to capture, exchange, and analyze data to deliver a higher standard of patient care. For more information, please visit www.sourcemed.net.

2013 UPCOMIng EvEnTS SCHEDULETBD NJAASC Quarterly Meeting

2/28 McDermott, Will & Emory ASC Symposium

TBD IASCA (ID) Annual Conference

3/7 Semi-Annual GSASC/SCASCA Conference & Tradeshow (Georgia/South Carolina)

3/7 Wills Eye Institute Conference

TBD AASA (AR) Conference

TBD Physician/Hospital Collaborative HFMA Meeting

TBD IFASC (IN) Spring Conference

TBD MNASCA (MN) Annual Membership Meeting

4/17 ASCA Conference

TBD NJ ASC Review

5/1 Hospital OR & Surgery Center Conference

5/15 CASCA (CO) Annual Education Conference

6/13 Orthopedic, Spine & Pain Management-Driven ASC Conference/Becker’s

6/19 Gulf States Conference (LA, MS, AL)

TBD WISCA (WI) Clinical Forum

TBD Arizona ASC Association

TBD NJAASC Meeting

7/17 FSASC (FL) Annual Conference

8/8 GSASC / SCASCA (GA/SC) Semi-annual Conference and Tradeshow

9/11 CASA’s (CA) Annual Conference and Exhibits

9/26 FASCA of TN Annual Conference

TBD PHA’s 10th Annual Conference & Exhibits

Page 3: Inside Source Winter 2012

Winter 2012

ICD-10 Impact and Preparation: 5 Tips for ASCsKevin McDonald, Senior Vice President ASC and Surgical Hospital Billing Services

In August, the Department of Health and Human Services postponed the date by which certain

healthcare entities must comply with ICD-10 diagnosis and procedure codes. The new date for compliance is October 1, 2014. This comes as welcome news to many as the transition to ICD-10 will be an arduous task.

With implementation expected to take 45 to 90 days for a center to be fully up and running, waiting until the go-live date can prove costly in terms of cash flow dips. Taking a proactive approach will minimize the disruptions. To help you in your transition, consider the following:

1. Plan for anatomy and physiology training for coders. What coders know today isn’t going to be sufficient once ICD-10 takes effect. While classes are available today, starting too soon can create unnecessary work and may require additional training as details are finalized. I recommend coders start training approximately six months prior to the deadline. This will also allow ample time to train physicians prior to the go-live date.

2. Talk to your vendors and commercial payers. It is very important for ASC administrators to stay on top of their vendors and business partners to understand their transition plans. This includes requesting a written plan for what will be done to ensure ICD-10 compliance.

3. Make a contingency plan for Workers’ Compensation. A contingency plan for Workers’ Compensation is particularly important if your center is orthopedic-driven. While there is a carve-out that allows non-HIPAA-covered entities to continue to use ICD-9 code sets, it is important to make sure your system can support both ICD-9 and ICD-10 code sets. Additionally, contact your non-HIPAA-covered entities (Workers’ Compensation and property and casualty) to verify if they plan to transition to ICD-10 code sets.

4. Follow a “day in the life” of a diagnosis code within a facility. Because ICD-9 codes are not limited to billing departments, it is important to identify everywhere codes are being used. Evaluate your current workflow to identify processes that will be impacted by ICD-10. Ask employees to identify which forms are electronic -- those that are not will need to be changed.

5. Consider outsourcing. With the potential pool of available coders expected to decline, it is likely they will demand higher rates. Given this information, now is the time for facilities to consider outsourcing. When negotiating with outsourced billing companies, lock in billing rates for as many years as you can since rates will likely climb as ICD-10 nears. Longer-term agreements can provide significant cost savings in the years to come. For centers already outsourcing, now is the time to renegotiate terms to secure a longer-term agreement.

BUSINESS

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Why Cloud Computing Makes Sense for ASCsPatrick Doyle, Executive Vice President Sales and Marketing

IT TALK

In healthcare IT, the advent of cloud computing comes at an opportune time for surgery centers as

demand for more robust clinical applications is on the rise. The paradox facing many surgery centers today is one that pits the desire to implement a paperless clinical solution against the practical reasons for doing so. Often-cited reasons for not implementing an online clinical solution include:

w Physical space constraints found in most ASCs (limiting the ability to house a data center).

w Demand by clinicians to maintain a high level of data security while also allowing for remote access to review and edit clinical data.

Cloud applications address this paradox by shifting IT operations out of the facility and into a secure virtual environment. In doing so, all stakeholders are given access to business and clinical applications while the only space that is required is a shelf to store idle laptops or tablets. Data security is addressed by ensuring the vendor’s cloud maintains a professionally managed data center which is monitored 24/7 with redundant power systems, multiple communication networks, automatic fail-over to backup equipment/co-location servers, and fire suppression systems. In other words, cloud computing provides security standards which often surpass many well-run in-house data centers.

Cloud deployments enable ASCs to get up and running quickly with reduced upfront investment since the only thing needed is a broadband Internet connection. IT resources are provided for you removing the burden and costs associated with purchasing, monitoring, and maintaining the applications and servers. Vendors guarantee almost 100 percent uptime and are responsible for managing all the patches, upgrades, and backups allowing facilities to focus efforts on patients and physicians, not on technology. Security risks are better managed as well. Additionally, cloud computing offers an easier path for upgrading to more advanced software solutions including an electronic health record (EHR) system.

New and improved web-enabled applications offer the potential to eliminate many of the challenges ASCs face in deploying and managing on-premise servers and will drive future growth. Trends that have supported the growth of cloud-based services include:

w Acceptance of Cloud-Based Applications: The popularity and success of Web-based applications such as email, social networking sites, and downloadable apps have given users more confidence in trusting mission-critical functions to the cloud and continue to spur vendor investment.

w Next Generation ASC Applications: Newer web-based applications designed specifically for ASCs

Page 5: Inside Source Winter 2012

Winter 2012

outpace the older client server-based applications in capability and user experience.

w Faster and More Reliable Networks: The speed and reliability of public networks now supports mission-critical applications.

w Security: Encrypted communications are fully accepted as appropriate for confidential data including protected health information (PHI).

w Cost Management: The need to lower costs while improving performance and service is increasing.

w Virtual Servers: Virtual server technology securely supports multiple ASCs on high-powered servers.

w Increasing Storage Demand: EHRs and scanned documents exponentially expand data storage demands. Fifty gigabyte databases are now common and are difficult to manage on a standalone server within an ASC.

w Anywhere/Anytime Access: Cloud computing offers the opportunity for vendors to provide access to applications and data on the chosen devices of users such as smartphones, tablets, and thin client PC workstations that require minimal investment and attention.

w Interoperability: Demand for ASCs to connect to physician systems, IDNs, HIEs, and other stakeholders will continue to increase. Based on our experience, a cloud-based platform is a superior platform for developing and maintaining interfaces.

The shift to cloud computing will change the way ASCs access and use applications forever. When you consider advanced solutions that are available on a subscription basis with little upfront capital investment, it’s a compelling value proposition. For ASCs under pressure to implement an EHR challenged by increasing competition, changing reimbursements, and increasing oversight, cloud computing is very appealing.

SourceMedical Vision OnDemand When it comes to managing financial, operational, and clinical information and processes, ASCs require a customized solution tailored to their specific needs. Vision OnDemand answers this need while eliminating the expenses associated with deploying and maintaining software on a local server. Because it is a web-based solution, the only requirement is an Internet connection and a laptop, PC, or tablet computer. Vision OnDemand also requires significantly less capital investment because clients simply pay a subscription fee based on usage which provides a faster return on investment.

Designed specifically for ASCs, Vision OnDemand automates the management of patient information and facility operations while allowing secure anywhere/anytime access to information resulting in enhanced patient care and higher levels of service to system users and physicians. It enables rapid deployment while eliminating financial and technical barriers.

Vision OnDemand provides an easier upgrade path to more advanced software solutions including an EHR system improving back office operations, and providing enhanced reporting. It is highly customizable allowing ASCs to quickly and easily select desired modules. Standard features include:

w Scheduling w Electronic Document Management w Remote Scheduling – Surgeon Portal w Facility Reporting Module w Patient Registration w Workflow Manager w Preference Cards w State Reporting w Case Management w Electronic Claims Support w Case Costing w Advanced Collections Manager w Inventory Management w Customized Patient Tracking w Accounts Receivable w Quality Assurance Tracking w Auto Post – Electronic Remittance w Physician & Staff Credentialing

To learn more about the benefits of cloud computing and Vision OnDemand, please contact 800-719-1904 or visit us at http://sourcemed.net/vision/sourceplus/vision-ondemand/.

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The right product, for the right procedure at the right time

At Cardinal Health, we focus on making healthcare more cost-effective so our customers can focus on delivering exceptional care to their patients.

We’re a full-service provider of: • Medical-surgicalproducts• Pharmaceuticals• Presourceprocedurepacks• Technologysolutions• Customizedservices

cardinalhealth.com©2012CardinalHealth.Allrightsreserved.CARDINALHEALTH,theCardinalHealthLOGOandESSENTIALTOCAREaretrademarksorregisteredtrademarksofCardinalHealth.Allothermarksarethepropertyoftheirrespectiveowners.Lit.No.2AMB10087(09/2012)

Want to learn more? Contact us! email: [email protected]

Historically, when rolling out new software, ambulatory surgery centers (ASCs) have had to rely solely on on-site instructor-led training. Staff members were pulled from their duties and required to participate in multiple full-day training sessions, operations were interrupted, and travel-related costs were incurred.

Fortunately, technological advances are providing facilities with greater flexibility when it comes to training options. By leveraging web conferencing,technology sessions can now be successfully conducted over the Internet. Multi-day classes can be split into several smaller sessions delivered over a period of weeks. Two-way interaction enables staff to ask questions and get real-time answers. Additionally, trainers have the ability to take control of a facility’s system remotely to conduct step-by-step demonstrations.

An ancillary benefit reported by facilities is that staff members are more focused on results than during traditional on-site training. Because staff members

are not seated in a room with their peers, they focus more on the online lesson, feeling they must take more of an initiative in mastering material.

Another remote training option is on-demand Web-based training (WBT). WBT provides anytime access to software training programs including previously recorded sessions, interactive eLearning lessons, and training guides. It is ideal for the self-learner as it does not offer two-way interaction with a trainer. WBT is also a great way for facility staff to learn more about the software they are already utilizing.

Because people learn in different ways, it is important for ASCs to be able to choose how their staff is trained. Fortunately technology has enabled software vendors to offer more options to their clients.

Mitch Stein is the Director of SourceMedical’s Learning Center of Excellence. He has been leading teams dedicated to the development and delivery of business productivity and learning solutions for more than 25 years.

Achieve greater Flexibility with Remote Training Mitch Stein, Director of SourceMedical’s Learning Center of Excellence

TECHNOLOGY

Page 7: Inside Source Winter 2012

Winter 2012

The Sounding BoardA Source for Voicing Your ASC Insights

The Sounding Board’s mission is to gather feedback, insights, and opinions from you, the ASC experts, on the latest news, trends, and outlook facing our industry today and to publish the best of your insights to help benefit our peers.

We’d like to hear from you. Selected feedback/insights will be recognized in SourceMedical’s newsletter, magazine, or website as well as submitted for publication. To show our appreciation, authors will be awarded a $500 gift card for their feedback. Deadline for submissions is March 30, 2013.

fEEdBACK

What impact do you think the healthcare reform legislation will have on the ASC market?

What top 3 operational concerns do you have for the future of ASCs?

1.

2.

3.

Your Name: ______________________________________________________________________________

Your Title: _______________________________________________________________________________

Your Phone: ______________________________________________________________________________

Best Date/Time to Reach You: _______________________________________________________________

Facility Name: ____________________________________________________________________________

Facility Address: __________________________________________________________________________

City: ______________________________________State: ________________ Zip: _____________________

Please fold your completed feedback form on the dotted line, tape the bottom and mail. No need for postage. You may also fax this form back to 205-278-1416 or go to our website at http://sourcemed.net/surgery/sounding-board-feedback.php to complete the form online. 6

Page 8: Inside Source Winter 2012

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Page 9: Inside Source Winter 2012

Winter 2012

How One ASC Improved Reimbursement Rates, Reduced Expenses, While Saving Time

CASE STUdY

The Situation Massachusetts Avenue Surgery Center is an outpatient surgery center specializing in orthopedics, urology, podiatry, gynecology, and pain management. The center performs approximately 3,000 cases a year. Each procedure requires an operative report that serves as the basis for coding and billing.

Historically, the center relied on a transcription service for the development of operative reports. There were numerous problems inherent in this process. Staff had to continually remind doctors to have their surgeries transcribed and to sign them, demographic information was often incorrect, and there was no standardization. Additionally, lengthy turnaround times resulted in billing delays while transcription costs were high.

Selecting a Partner After Randy Gross, executive director at Massachusetts Avenue Surgery Center, learned about a web-based operative reporting service, SourcePlus OpNote, from their technology partner SourceMedical and agreed to become a beta test site for the system.

The Results Feedback from surgeons as well as other facility staff participating in the beta was extremely positive. As a result, a broader rollout of the system occurred with a goal of having the majority of the center’s surgeons using SourcePlus OpNote by the end of 2012.

Standardized Reporting and Fewer Billing Delays Since deploying the system, transcription costs are down and bills are being processed much faster. Rather than waiting for over a week for information to be transcribed and distributed, operative notes are created immediately after a surgery is completed, thus eliminating billing delays.

Ease of Use and Quality Improvement Because demographic information is pulled directly from the center’s Vision clinical and management system, errors resulting from surgeons, incorrect spelling, or transcribers not understanding surgeons

are no longer issues. Now rather than dictating the operative report, surgeons sign in to a personalized dashboard and select a patient from his/her schedule. A personalized default operative report is produced with the applicable procedure and diagnosis codes. Having this information readily available has eliminated standardization issues and incorrect postings which negatively impacted reimbursement rates.

Operational Efficiency and Increase in Profits An additional benefit includes less time spent managing operative reports. Previously, the center relied on a full-time person to manage operative reports; responsibilities included chasing down surgeons to remind them to have their surgeries transcribed, reviewing and editing operative notes, and ensuring surgeon signatures were obtained. Since deploying SourcePlus OpNote, significantly less time is spent managing this process, thus reducing valuable staff hours and costs. Now upon completing their OpNote online, surgeons quickly review and electronically sign the report which completes the process quickly and efficiently.

“OpNote has proven to be a real time saver,” said Gross. “Information is complete, codes are correct, and reports are automatically available to whoever needs them. As a result, cases are converted to claims much quicker which has a positive impact on accounts receivables. Our surgeons are happy and I am happy.”

To learn more visit http://sourcemed.net/sourceplus/sourceplus-opnote/

OpNote has proven to be a real time saver“ ”

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Achieving Connectivity Through AutomationRon Pelletier, Vice President of Market Strategy

In the ASC industry, there are many stakeholders: The facility, referring surgeons, anesthesiologists,

patients, and insurance companies. While all of these stakeholders have an independent role, there is a substantial requirement that they communicate and share information throughout the entire lifecycle of a patient’s healthcare encounter. Facility staff must communicate with patients and the insurance company, anesthesiologists must communicate with the facility and patients, surgeons must communicate with the facility, and so on.

Historically, the sharing of information has been done using very labor-intensive manual methods. Consider the process of scheduling a procedure. Relying on phone calls and faxes to coordinate scheduling, gathering patient information, and preparing for a case is very inefficient and expensive in terms of labor costs and time spent.

Fortunately, technological advances are enabling surgery centers to automate communication between key stakeholders. By electronically connecting all stakeholders and enabling a seamless, automated flow of information from one system to another, processes are more efficient and information more accurate. Thus, customer satisfaction is much higher.

Using automation technology, surgery centers can greatly streamline processes like the scheduling of procedures while significantly improving communication between key stakeholders. Surgeons’ schedules can be easily coordinated with the facility online. Additionally, using data information exchange technology, patient information that is already in the surgeon’s system can be integrated into a facility’s system eliminating the need to re-key, therefore, reducing errors.

Rather than manually calling patients in advance of a procedure to gather medical histories, technologies exist that enable surgery centers to bring the preoperative process online. Patients can securely create and submit their own medical histories at a time and place that is most convenient to them which yields more accurate medical histories. Certain features like medication reconciliation eliminate the need for nurses to copy medications onto specialty forms.

Automation technology can also improve the postoperative process including education, billing,

and collections. Today, surgery centers can publish and push postoperative information electronically. In addition to improving the patient’s postoperative experience, bringing this information online eliminates the possibility of lost paperwork. Customized websites offer patients answers to issues related to their procedure once they return home.

Consider also postoperative reports. Leveraging technology to automate the development and distribution of these reports to key stakeholders eliminates the whole dictation-and-transcription process. Information is more accurate as the report is developed while information is still fresh. Cases can be converted to a claim much quicker since reports are available to all parties instantaneously.

Having more accurate information also decreases the likelihood of denials caused by errors on a submitted claim. From a clinical perspective, accurate information is extremely important, especially if a patient is on a medication or has an allergy that you really need to know about in advance of a procedure.

The ability to improve accuracy and efficiency also has a significant impact on the customer experience. Patients appreciate not being interrupted at work. Automated data collection and exchange technology makes it more convenient for surgeons to do business with a facility and its patients. This, in turn, can have a positive impact on a facility’s case volume.

Effective and efficient communication between key stakeholders is essential to ensuring a positive patient experience and a profitable facility. Information technology enables surgery centers to connect all of these separate parties, all of whom play an important role in the surgical procedure.

Getting Started Determining where to start can be an overwhelming endeavor. Replacing manual processes with automated technology requires a phased approach. To determine where to start, consider the following:

Determine pain points. Start with a problem analysis to determine where your facility has opportunities to create efficiencies. Identifying areas where your facility has the biggest problem is often the most obvious place to start. For example, if the turnaround time for getting a transcribed operative

TECHNOLOGY

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Winter 2012

report is several days to a week, it is likely that your ability to generate bills is subsequently delayed. Replacing manual transcription processes with an electronic solution ensures operative notes are available almost immediately, eliminating needless delays in bill generation.

Perhaps your facility is having problems with patient collections; maybe you are not collecting the patient portion of the bill accurately or early enough in the process. As a result, you are not getting an upfront, accurate picture of your patients’ financial responsibilities. In this situation, a solution that automates the collection of insurance eligibility information and allows staff to more accurately provide patients with an estimate of their responsibility prior to a surgical procedure makes perfect sense.

Identify staffing issues. Maybe you have a shortage of nursing resources. To offset this shortage, implementing a tool that automates the preoperative process is an excellent solution. Bringing your preoperative process online and enabling patients to enter their own medical history has proven to significantly shorten pre-op calls. Additional benefits associated with bringing your preoperative process online are more accurate, complete medical histories, and demographic information.

If you are experiencing front office turnover, consider bringing in tools that automate how cases are booked. This will allow the electronic transfer of information from your surgeon’s office thus reducing disruptions.

Consider the financial impact. All of these different connectivity points have substantial return on investment (ROI) associated with them. They are very measurable enabling facilities to cost things out and predict with a solid level of accuracy their expected savings once a tool is implemented (when considering the cost associated with performing a task).

Make a plan. Step back and take a look at your facility. Look at it from the perspective of connecting stakeholders. Identify what tasks you want to automate, prioritize your list based on most meaningful impact, and then set a target date for completion. Tackle one process at a time; and once it is completed, move on to the next. At the end, you will see a demonstrable return on investment.

You can read the full article by visiting SurgiStragies online at http://www.surgistrategies.com/articles/2012/07/achieving-greater-connectivity-through-asc-automa.aspx.

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John Adams, Account Executive [email protected] 803-802-5132

Tyler Strain, Sr. Account Executive [email protected] 205-420-8252

Sean Tenney, Sr. Account Executive [email protected] 205-305-8083

Chris Finelli, Account Executive [email protected] 205-948-3214

SourceMedical Account ExecutivesSourceMedical is the leading provider of tech-enabled services. With more than 2,200 clients and the confidence of more than 250 consultants and management companies, we are uniquely position to address the issues vitally important to surgery centers and specialty hospitals.

For more information about how we can assist your facility improve operational efficiency and cash flow while enable your facility to deliver a higher standard of patient care, please contact one of our Account Executives today.