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It seems
so tempting to open an ambulatory surgery center in that
empty suite behind your clinic offices. But don't let your
practice get too cozy with the on-site ASC, or
you'll pay the price.
"I
often get calls from physicians who start building an ASC
in their office without realizing they may not get reimbursement
from government programs and other payers," says Caryl
Serbin, president of Surgical Consultants of America in
Fort Myers, Fla.
If you
want to avoid billing and legal problems, management consultants
suggest the following steps:
Pay
attention to state licensure requirements. The only
thing state requirements have in common is that every state
is totally different, says consultant Gary Matthews with
Physicians HealthCare Advisors in Atlanta. Some states require
a certificate of need, which you can only obtain when the
state decides there's unmet demand for services.
Keep
expenses separate. In some states, ASCs must be separate
companies from physician offices, but in all states, ASCs
must have their own expenses and accounts, Matthews says.
It's important to treat the office and the surgery center
as two separate revenue centers. Medicare billing and some
states' licensure depend on billing separately.
"I
discourage the sharing of practice resources with the ASC,"
Serbin says. "It is rare to find practice staff who
also have the ASC coding and billing skills necessary to
maximize ASC reimbursement. The sharing of staff can also
lead to competition between the two entities and staff morale
issues."
"You
can be as precise as having time clocks for when people
check in and out of different areas if it's all connected,"
Matthews says. Or you can make a "guesstimate"
of how much time a person spends in the ASC versus the physician
office. A person could be assigned 0.4 fulltime equivalents
in the office and 0.6 FTEs in the ASC.
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