8 6
O U T P AT I E N T S U R G E R Y M A G A Z I N E O N L I N E | J U LY 2 0 1 4
or evening appointments: we're open until 8 p.m., although we're not
open on weekends. We make sure that patients know that, through
most insurance plans, their co-pay will be the same as it is for a physi-
cian's office visit, as opposed to the higher co-pays due at the hospital
emergency department or an urgent care facility.
Another benefit: The rules that apply at the hospital don't necessari-
ly apply here, so we can let patients and their families stay together
pre-operatively and in recovery, which reduces stress for both. Plus,
there won't be patients suffering heart failure, pneumonia or severe
traumatic injuries in the next bay.
Convenience for the patient demands flexible, efficient scheduling, of
course. When we get an add-on fracture case, we find ways to manipu-
late the schedule to fit the case in. Plus, the extended hours require
extended staffing to provide trained, compassionate, quality patient care.
We've recently discussed setting up a rotating staff schedule for the
evening hours, to let our nurses and techs plan ahead.
Controlling costs
Medicare has eliminated the requirement in its ASC Conditions for
Coverage that prevented facilities from scheduling and performing
surgery on the same day (due to the need for advance notification of
patients' rights and disclosure of facility ownership). That rule change
was made largely due to add-on, emergency cases such as fracture
care and surgery. It opened the door for such procedures, and for the
subsequent reimbursement for them.
One of the most important things we've done to sustain our service
is to remain diligent about our contracts and case costs. Good negoti-
ation is key to reimbursement and implant pricing.
Many insurers' contracts don't separately reimburse for implants
— which are the biggest expense of a fracture care service — so we
O R T H O P E D I C S
OSE_1407_part2_Layout 1 7/3/14 8:49 AM Page 86
