become an ally. By telling them,
"These are 1 or 2 small steps you
can take to maximize the bottom
line," you're essentially helping
that person increase their financial
security without any compromise to patient care or legality.
Get retroactive authorization. Sometimes a physician will post a
case based on what he anticipates he's going to do in the surgery.
If things change in the course of a surgery and the surgeon has not
communicated any additions he might have done, your business office
needs to go back and get retroactive authorization for the procedure. If
it's documented in the chart but not the op report, have the surgeon
amend the op report. Otherwise, you can't bill for it, so you're basically
performing an additional procedure — having already incurred the
cost — without any reimbursement.
This happens in a lot of cataract surgeries. Most cases of anterior
vitrectomy are unplanned, but if we're able to catch and bill for the
"planned anterior vitrectomy," the reimbursement will make up for
other non-billable services. For example, a Malyugin ring, which is
used to retract and support the iris during small-pupil cataract
cases, is non-billable and it costs the surgical center about $790.
Billing for the anterior vitrectomy will help the facility minimize or
eliminate the overall loss in cases like this.
Cultivate champions. Our lead orthopedic nurse, Elizabeth, is
our go-to expert — our champion, if you will — in orthopedics.
She can recite every preference card and knows what will be needed
with just about every orthopedic procedure. She can work with mate-
rials management before surgery to make sure all the necessary
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F E B R U A R Y 2 0 1 7 • O U T PA T I E N TS U R G E R Y. N E T • 2 5
We must be as energetic and
vigilant about nurturing our
profits as we are about
caring for our patients.
