1 00:00:00,080 --> 00:00:02,319 Are your patients looking for an easy way 2 00:00:02,319 --> 00:00:04,480 to pay for health care? Want to level 3 00:00:04,480 --> 00:00:06,639 up the way you do business? Then the 4 00:00:06,639 --> 00:00:09,199 CareCredit Health and Wellness card just might be 5 00:00:09,199 --> 00:00:09,859 the answer. 6 00:00:10,160 --> 00:00:13,539 For over 30 years, CareCredit, a Synchrony solution, 7 00:00:13,759 --> 00:00:16,454 has been providing patients with a modern, flexible 8 00:00:16,454 --> 00:00:18,375 way to pay for their health and wellness 9 00:00:18,375 --> 00:00:18,875 expenses. 10 00:00:19,414 --> 00:00:22,875 CareCredit seamlessly integrates with your business, helping minimize 11 00:00:23,015 --> 00:00:25,975 account receivable, all while your patients enjoy budget 12 00:00:25,975 --> 00:00:27,595 friendly financing options. 13 00:00:28,054 --> 00:00:30,214 To learn more about how CareCredit works for 14 00:00:30,214 --> 00:00:31,274 you and your patients, 15 00:00:31,679 --> 00:00:32,420 visit carecredit.comforward/beccarspodcast. 16 00:00:36,399 --> 00:00:38,479 This is Gracelyn Keller with the Becker's Healthcare 17 00:00:38,479 --> 00:00:40,560 Podcast, and we are live at the business 18 00:00:40,560 --> 00:00:42,020 and operations of ASCs. 19 00:00:42,560 --> 00:00:44,799 I am joined right now by Michael Gail, 20 00:00:44,799 --> 00:00:47,924 who is the administrative director of Centerra Obici 21 00:00:47,924 --> 00:00:51,365 Ambulatory Surgical Center. So, Michael, thanks for joining 22 00:00:51,365 --> 00:00:52,965 me today. Would love to have you take 23 00:00:52,965 --> 00:00:55,365 a moment to introduce yourself and talk a 24 00:00:55,365 --> 00:00:56,804 little bit more about your role in the 25 00:00:56,804 --> 00:00:57,304 industry. 26 00:00:57,685 --> 00:00:59,284 Oh, sure. I've been in health care senior 27 00:00:59,284 --> 00:00:59,784 leadership, 28 00:01:00,405 --> 00:01:03,000 for better than 20 years. Currently, I'm at 29 00:01:03,000 --> 00:01:04,060 Sentara Obici, 30 00:01:04,439 --> 00:01:08,140 Ambulatory Surgery Centers on the campus of, Sentara's 31 00:01:08,280 --> 00:01:09,260 Suffolk Hospital. 32 00:01:09,959 --> 00:01:10,459 Sentara 33 00:01:10,760 --> 00:01:13,640 is a health care large health core large 34 00:01:13,640 --> 00:01:15,340 health care organization that, 35 00:01:16,165 --> 00:01:18,984 that is mostly in North Carolina and Virginia, 36 00:01:19,364 --> 00:01:21,064 and it also has a health plan. 37 00:01:22,245 --> 00:01:23,145 So there's, 38 00:01:24,724 --> 00:01:26,564 8 surgery centers in the region that I 39 00:01:26,564 --> 00:01:28,885 participate in. The I'm I'm a director at 40 00:01:28,885 --> 00:01:29,865 one of those facilities. 41 00:01:30,359 --> 00:01:32,859 I was recruited from, Southern California 42 00:01:33,400 --> 00:01:35,020 where I ran, endovascular 43 00:01:35,400 --> 00:01:36,380 surgery corporations. 44 00:01:37,719 --> 00:01:39,960 Wonderful. Well, thank you for being here. And 45 00:01:39,960 --> 00:01:42,780 let's start our conversation today talking about ASC 46 00:01:42,920 --> 00:01:45,655 volume. So this is expected to increase by 47 00:01:45,655 --> 00:01:46,155 16% 48 00:01:46,615 --> 00:01:48,795 across the country by the year 2032. 49 00:01:49,575 --> 00:01:51,334 With this growth, what is the most pressing 50 00:01:51,334 --> 00:01:53,834 challenge to maintaining a positive patient experience? 51 00:01:54,855 --> 00:01:56,599 Well, it's it's that's 52 00:01:56,900 --> 00:01:57,560 a multifaceted 53 00:01:58,020 --> 00:01:58,520 question, 54 00:01:58,980 --> 00:02:00,040 with a lot of answers. 55 00:02:00,420 --> 00:02:02,659 I I would say it starts with, ramping 56 00:02:02,659 --> 00:02:03,159 up, 57 00:02:03,780 --> 00:02:06,040 labor resources for the patient's benefit. 58 00:02:06,500 --> 00:02:07,799 And and that means 59 00:02:08,355 --> 00:02:10,294 resources for patient patient education 60 00:02:10,754 --> 00:02:12,855 as well as counseling for patients on, 61 00:02:13,635 --> 00:02:14,935 their financial obligations, 62 00:02:15,474 --> 00:02:16,935 pre and post op education, 63 00:02:17,555 --> 00:02:20,514 coordination with the referral sources for physical therapy, 64 00:02:20,514 --> 00:02:21,175 home health. 65 00:02:21,474 --> 00:02:24,330 There are transportation issues, of course, but most 66 00:02:24,330 --> 00:02:26,909 of our resources as a facilitator of surgery, 67 00:02:27,849 --> 00:02:28,349 are 68 00:02:28,810 --> 00:02:31,789 are dedicated to the day of and preparing 69 00:02:32,250 --> 00:02:34,330 getting clearance for those patients to to come 70 00:02:34,330 --> 00:02:36,810 to the facility, educating them about what to 71 00:02:36,810 --> 00:02:37,310 expect, 72 00:02:37,655 --> 00:02:39,974 talking to them about the financial obligations they 73 00:02:39,974 --> 00:02:40,634 may have, 74 00:02:41,495 --> 00:02:42,235 and coordinating, 75 00:02:43,094 --> 00:02:44,634 heavily with the physician 76 00:02:45,014 --> 00:02:45,514 surgeon's 77 00:02:45,974 --> 00:02:46,474 office 78 00:02:46,775 --> 00:02:48,074 to make sure those patients, 79 00:02:49,254 --> 00:02:51,194 are able to pass through all those bureaucratic 80 00:02:51,334 --> 00:02:51,834 hurdles 81 00:02:52,640 --> 00:02:55,040 without much exposure to them. But I would 82 00:02:55,040 --> 00:02:55,439 say, 83 00:02:56,400 --> 00:02:57,780 it's already a challenge, 84 00:02:58,879 --> 00:03:01,120 across the board in health care, finding competent 85 00:03:01,120 --> 00:03:01,620 people, 86 00:03:02,400 --> 00:03:04,319 to help shepherd patients through an ever 87 00:03:05,064 --> 00:03:06,764 through the ever increasing complexity 88 00:03:07,625 --> 00:03:09,324 of, of that experience. 89 00:03:09,784 --> 00:03:11,884 A lot of patients, depending on their socioeconomic 90 00:03:12,425 --> 00:03:12,925 backgrounds, 91 00:03:13,224 --> 00:03:14,685 you know, they they're barely 92 00:03:15,145 --> 00:03:16,764 keeping their heads above water, 93 00:03:17,465 --> 00:03:18,425 with with, 94 00:03:18,745 --> 00:03:19,564 with life. 95 00:03:20,159 --> 00:03:22,319 So it it can be a challenge adding 96 00:03:22,319 --> 00:03:25,199 on, you know, complexities of healthcare that have 97 00:03:25,199 --> 00:03:26,180 concepts that, 98 00:03:26,719 --> 00:03:28,020 are alien to them. 99 00:03:28,959 --> 00:03:31,680 Oftentimes, they just want the conversation reduced to 100 00:03:31,680 --> 00:03:32,959 what I have what do I have to 101 00:03:32,959 --> 00:03:33,699 pay you? 102 00:03:34,205 --> 00:03:36,224 And issues that that are more profound 103 00:03:36,844 --> 00:03:38,064 that have to do with, 104 00:03:38,764 --> 00:03:39,664 on our side, 105 00:03:39,965 --> 00:03:41,965 because we're experts in the field. They have 106 00:03:41,965 --> 00:03:44,284 to do with our side, about good clinical 107 00:03:44,284 --> 00:03:47,564 outcomes and their proper the proper informed consent 108 00:03:47,564 --> 00:03:48,064 process 109 00:03:48,610 --> 00:03:50,069 leading up to their their, 110 00:03:50,530 --> 00:03:51,349 their surgery, 111 00:03:52,450 --> 00:03:53,510 is is oftentimes 112 00:03:54,050 --> 00:03:55,830 things that they can't process, 113 00:03:56,210 --> 00:03:58,450 are too busy to process, or unwilling to 114 00:03:58,450 --> 00:04:00,710 process for all the all the same reasons. 115 00:04:01,794 --> 00:04:02,294 Absolutely. 116 00:04:02,834 --> 00:04:05,634 And going along with that, what strategies have 117 00:04:05,634 --> 00:04:07,474 worked for your organization to tackle some of 118 00:04:07,474 --> 00:04:09,634 these challenges, and what is the recommendation you 119 00:04:09,634 --> 00:04:11,235 have for health care leaders to stay ahead 120 00:04:11,235 --> 00:04:11,814 of them? 121 00:04:12,754 --> 00:04:15,735 Again, another another very good question, very broad. 122 00:04:17,220 --> 00:04:19,300 I'll give you a quick example to sort 123 00:04:19,300 --> 00:04:21,079 of silo this a little bit, 124 00:04:21,459 --> 00:04:22,599 make it more comprehensible. 125 00:04:23,220 --> 00:04:23,720 The 126 00:04:24,099 --> 00:04:26,439 we started a total joint program this year. 127 00:04:26,819 --> 00:04:28,680 So total knees and total shoulders. 128 00:04:29,379 --> 00:04:29,879 So, 129 00:04:31,305 --> 00:04:33,144 there's a there's a pre and post op 130 00:04:33,144 --> 00:04:36,105 patient education component to that thing. So if 131 00:04:36,105 --> 00:04:38,125 you if you're having a total knee surgery, 132 00:04:38,665 --> 00:04:41,464 that nurse nursing education, that clinical education you're 133 00:04:41,464 --> 00:04:43,384 supposed to get is very important because you 134 00:04:43,384 --> 00:04:45,064 don't know what to expect. A lot of 135 00:04:45,064 --> 00:04:46,444 these patients are aged. 136 00:04:47,039 --> 00:04:48,500 So, you know, they have Medicare. 137 00:04:49,519 --> 00:04:52,079 And so these can be as simple as 138 00:04:52,079 --> 00:04:53,860 as we may perceive them to be. 139 00:04:54,319 --> 00:04:56,419 That education about what comes next 140 00:04:56,720 --> 00:04:58,720 through that pre and post experience is very 141 00:04:58,720 --> 00:05:00,819 important. So having, for example, 142 00:05:01,394 --> 00:05:03,574 an ambassador, like a nurse ambassador 143 00:05:04,194 --> 00:05:05,175 or a nurse 144 00:05:05,555 --> 00:05:07,795 and another clinical person like a scrub tech 145 00:05:07,795 --> 00:05:08,694 who has experience 146 00:05:09,154 --> 00:05:12,675 in those surgeries, intraoperative experience for those surgeries 147 00:05:12,675 --> 00:05:14,454 supporting supporting those surgeries, 148 00:05:14,949 --> 00:05:16,710 Having those kind of people speak to the 149 00:05:16,710 --> 00:05:18,170 families of the patients, 150 00:05:19,270 --> 00:05:21,370 before they get there for clearance issues, 151 00:05:21,670 --> 00:05:23,830 and then during their stay while they're there, 152 00:05:23,830 --> 00:05:26,389 in coordination with the physician surgeons communication with 153 00:05:26,389 --> 00:05:28,485 them, can be very important. So that's one 154 00:05:28,485 --> 00:05:30,904 example of how to how to prepare 155 00:05:31,444 --> 00:05:32,425 for the transition 156 00:05:33,044 --> 00:05:35,125 that Medicare wants us to make, CMS wants 157 00:05:35,125 --> 00:05:37,125 us to make, to some of the procedures 158 00:05:37,125 --> 00:05:39,144 that are currently done in a hospital setting 159 00:05:39,204 --> 00:05:41,125 that can easily be done in an outpatient 160 00:05:41,125 --> 00:05:41,625 setting. 161 00:05:42,180 --> 00:05:44,759 So when you have a low acuity base, 162 00:05:44,899 --> 00:05:46,279 something that's less complicated, 163 00:05:47,220 --> 00:05:48,040 less challenging, 164 00:05:48,500 --> 00:05:50,920 that has a lower risk factor, 165 00:05:51,699 --> 00:05:53,800 and can be done in an outpatient setting, 166 00:05:54,100 --> 00:05:54,920 that volume, 167 00:05:55,595 --> 00:05:57,514 just by virtue of who's paying for it, 168 00:05:57,514 --> 00:05:58,175 the payers, 169 00:05:58,555 --> 00:06:01,035 they're driving that volume to us. So that 170 00:06:01,035 --> 00:06:02,555 increase in volume, we have to speak to 171 00:06:02,555 --> 00:06:04,095 the challenges of patient education. 172 00:06:04,395 --> 00:06:05,995 In addition to all of the other things 173 00:06:05,995 --> 00:06:08,155 we already do, we just have to ramp 174 00:06:08,155 --> 00:06:08,975 up the game, 175 00:06:09,870 --> 00:06:11,790 for what we already do, especially with the 176 00:06:11,790 --> 00:06:14,209 communication between us and the physician referral source. 177 00:06:15,069 --> 00:06:17,389 Their their office people change a lot, for 178 00:06:17,389 --> 00:06:17,889 example. 179 00:06:18,269 --> 00:06:19,889 And we just have to keep that 180 00:06:20,189 --> 00:06:23,069 that knowledge bin rotating through that cycle of 181 00:06:23,069 --> 00:06:24,289 ever increasing business, 182 00:06:24,654 --> 00:06:27,055 more demands on us to to process those 183 00:06:27,055 --> 00:06:29,615 imp those patients, without making it seem like 184 00:06:29,615 --> 00:06:31,535 it's an assembly line. And you do that 185 00:06:31,535 --> 00:06:32,274 with more, 186 00:06:32,894 --> 00:06:33,794 labor resources 187 00:06:34,334 --> 00:06:35,314 that are trained 188 00:06:35,774 --> 00:06:36,595 and competent 189 00:06:37,000 --> 00:06:39,319 in communicating with those patients. That's the whole 190 00:06:39,319 --> 00:06:41,720 ballgame right there. Because if you treat people 191 00:06:41,720 --> 00:06:43,180 like it's an assembly line, 192 00:06:43,879 --> 00:06:46,060 they'll react like they're in a factory. 193 00:06:46,680 --> 00:06:49,720 And nameless with a number and just being 194 00:06:49,720 --> 00:06:50,220 processed. 195 00:06:50,944 --> 00:06:52,704 They're just a paycheck to us. And that's 196 00:06:52,704 --> 00:06:54,704 not the case at all. The other issue 197 00:06:54,704 --> 00:06:56,865 I would say is, to prepare for this 198 00:06:56,865 --> 00:06:59,104 is is all the background stuff that happens, 199 00:06:59,104 --> 00:07:01,345 like good clinical out that produce good clinical 200 00:07:01,345 --> 00:07:02,944 outcomes. And I know this is like a 201 00:07:02,944 --> 00:07:04,084 very boring subject. 202 00:07:05,024 --> 00:07:07,079 But, you know, a lot of what a 203 00:07:07,079 --> 00:07:07,740 lot of the 204 00:07:08,600 --> 00:07:10,680 the the adverse events, the bad things that 205 00:07:10,680 --> 00:07:12,139 happen in an in an OR, 206 00:07:12,519 --> 00:07:14,120 we keep track of, right? We keep track 207 00:07:14,120 --> 00:07:15,639 of all of them. And a lot of 208 00:07:15,639 --> 00:07:17,079 the thing all of the things that happen 209 00:07:17,079 --> 00:07:17,579 postoperatively, 210 00:07:18,360 --> 00:07:19,899 that are reported to us 211 00:07:20,504 --> 00:07:21,805 by the physician surgeons, 212 00:07:22,504 --> 00:07:24,845 post operative infections, people had to be hospitalized 213 00:07:24,985 --> 00:07:25,645 for it. 214 00:07:26,504 --> 00:07:28,345 The corrections that they had, revisions that they 215 00:07:28,345 --> 00:07:29,625 had to make on the surgery that they 216 00:07:29,625 --> 00:07:32,025 did. Those things are reported to us, too. 217 00:07:32,025 --> 00:07:33,865 And the more we keep track of those 218 00:07:33,865 --> 00:07:34,365 things, 219 00:07:35,389 --> 00:07:37,250 without letting them fall by the wayside, 220 00:07:37,870 --> 00:07:39,550 the better able we are to correct and 221 00:07:39,550 --> 00:07:42,270 produce better clinical outcomes. So patients can be 222 00:07:42,270 --> 00:07:42,770 assured, 223 00:07:43,550 --> 00:07:43,870 sort of, 224 00:07:45,069 --> 00:07:47,629 on the back end, that we're minding our 225 00:07:47,629 --> 00:07:48,290 own house 226 00:07:48,754 --> 00:07:50,834 from a from a quality outcomes point of 227 00:07:50,834 --> 00:07:51,334 view. 228 00:07:52,034 --> 00:07:53,555 So I would say those kinds of resource 229 00:07:53,794 --> 00:07:54,294 dedicating 230 00:07:54,675 --> 00:07:55,574 those kinds of 231 00:07:55,875 --> 00:07:57,735 labor resources to that process 232 00:07:58,194 --> 00:08:01,480 is important. Forming those committees, participating them, in 233 00:08:01,480 --> 00:08:03,660 them. Again, as boring as it may sound, 234 00:08:03,720 --> 00:08:05,720 it's extremely necessary and it bear it bears 235 00:08:05,720 --> 00:08:08,600 results. You have QI, QA studies that you 236 00:08:08,600 --> 00:08:09,740 produce from those things. 237 00:08:10,199 --> 00:08:11,879 A lot of times, licensure, the people that 238 00:08:11,879 --> 00:08:13,800 license you to do this do this work 239 00:08:13,800 --> 00:08:16,460 on an outpatient setting require you anyway 240 00:08:16,855 --> 00:08:17,514 to have, 241 00:08:17,895 --> 00:08:20,295 those kinds of QA studies? Why not base 242 00:08:20,295 --> 00:08:22,134 them on something that's real instead of something 243 00:08:22,134 --> 00:08:23,355 you go in search of? 244 00:08:24,055 --> 00:08:25,735 Base it on the real challenges you have 245 00:08:25,735 --> 00:08:27,915 every day. There's plenty of them. 246 00:08:28,615 --> 00:08:31,079 Yes. Absolutely. Well, thank you for those insights. 247 00:08:31,319 --> 00:08:33,000 And I'm gonna shift gears a little bit 248 00:08:33,000 --> 00:08:35,559 here toward the financial side. So how can 249 00:08:35,559 --> 00:08:38,039 leaders ensure that their staff are well equipped 250 00:08:38,039 --> 00:08:41,259 to handle patients navigate financial aspects of care, 251 00:08:41,480 --> 00:08:44,459 and how does this benefit patient provider relationships? 252 00:08:45,684 --> 00:08:46,184 So 253 00:08:46,544 --> 00:08:47,044 it 254 00:08:48,264 --> 00:08:48,764 it's 255 00:08:49,125 --> 00:08:50,504 it's easy to say 256 00:08:51,044 --> 00:08:51,544 that 257 00:08:52,565 --> 00:08:54,664 to tell a patient or their relatives 258 00:08:55,444 --> 00:08:57,544 that they always that they owe you money. 259 00:08:58,084 --> 00:09:00,745 The hard thing is is doing it 260 00:09:01,490 --> 00:09:04,149 in a constructive way, in a way that 261 00:09:04,529 --> 00:09:06,470 inspires conversation and compromise 262 00:09:07,089 --> 00:09:09,490 about how to settle that obligation. We don't 263 00:09:09,490 --> 00:09:10,629 do things for free. 264 00:09:11,089 --> 00:09:11,589 And 265 00:09:12,450 --> 00:09:15,009 we have contractual obligations that require us with 266 00:09:15,009 --> 00:09:15,909 some of the payers, 267 00:09:17,115 --> 00:09:19,514 to collect that money. So if if I 268 00:09:19,514 --> 00:09:20,975 were to decide, for example, 269 00:09:21,754 --> 00:09:24,235 just because of what the insurance company pays 270 00:09:24,235 --> 00:09:28,235 me, that whatever the patient obligation is is 271 00:09:28,235 --> 00:09:29,695 superficial and unnecessary, 272 00:09:30,870 --> 00:09:32,470 I would I could be in violation. I 273 00:09:32,470 --> 00:09:33,610 probably am in violation, 274 00:09:34,470 --> 00:09:36,230 of the of the clause in the contract 275 00:09:36,230 --> 00:09:37,830 that says if they have a co pay, 276 00:09:37,830 --> 00:09:39,910 if they have a deductible coinsurance, a share 277 00:09:39,910 --> 00:09:41,750 of cost, I have to make a good 278 00:09:41,750 --> 00:09:43,990 faith reasonable effort to collect it. I can't 279 00:09:43,990 --> 00:09:45,129 just let it go. 280 00:09:48,264 --> 00:09:49,325 Now, a lot of times, 281 00:09:49,705 --> 00:09:52,684 with because of the shifting market of insurance, 282 00:09:52,745 --> 00:09:54,125 the the expense of it, 283 00:09:54,504 --> 00:09:56,264 the higher expense of it, people are choosing 284 00:09:56,264 --> 00:09:59,269 higher deductible plans. And so their share of 285 00:09:59,269 --> 00:10:01,769 cost is not some superficial thing any longer. 286 00:10:01,830 --> 00:10:03,129 It could be very substantial. 287 00:10:04,149 --> 00:10:06,730 So their their their their total, 288 00:10:07,509 --> 00:10:09,269 allowance for the year as a share of 289 00:10:09,269 --> 00:10:11,529 cost could be could be 4 or $5,000. 290 00:10:12,230 --> 00:10:13,605 And if they have a family, could be 291 00:10:13,605 --> 00:10:15,545 even higher than that. So 292 00:10:16,245 --> 00:10:17,945 the point is that 293 00:10:18,485 --> 00:10:20,805 having a conversation with patients well in advance 294 00:10:20,805 --> 00:10:21,465 of surgery, 295 00:10:21,925 --> 00:10:23,705 making them aware of this, 296 00:10:24,165 --> 00:10:25,925 and making them aware that you have payment 297 00:10:25,925 --> 00:10:28,350 plans and that there are options. There are 298 00:10:28,350 --> 00:10:29,409 options like CareCredit, 299 00:10:30,190 --> 00:10:32,429 the sponsors of your program. We use them, 300 00:10:32,429 --> 00:10:34,589 by the way, as I mentioned earlier. That's 301 00:10:34,589 --> 00:10:37,009 that's that long term payment option, 302 00:10:37,789 --> 00:10:40,029 at a low interest rate is often a 303 00:10:40,029 --> 00:10:41,870 a a deal breaker or a deal maker 304 00:10:41,870 --> 00:10:42,370 sometimes. 305 00:10:43,115 --> 00:10:44,174 I, for example, 306 00:10:44,794 --> 00:10:47,294 am willing to take payments over 6 months, 307 00:10:47,514 --> 00:10:49,434 up to 6 months. But I don't carry 308 00:10:49,434 --> 00:10:51,914 anything over $2,000, to give you a concrete 309 00:10:51,914 --> 00:10:52,414 example. 310 00:10:52,794 --> 00:10:54,575 So no matter what you owe me, 311 00:10:55,029 --> 00:10:56,789 I'm gonna divide it by 6 months at 312 00:10:56,789 --> 00:10:58,710 most. And then it's gonna go to a 313 00:10:58,710 --> 00:11:00,950 collections company, if you haven't settled it by 314 00:11:00,950 --> 00:11:03,190 then. But I'll I'll get that understanding with 315 00:11:03,190 --> 00:11:05,350 you in advance. And as long as you're 316 00:11:05,350 --> 00:11:07,589 transparent, you say, here's what happens at this 317 00:11:07,589 --> 00:11:09,509 stage, I'll trust you for this at this 318 00:11:09,509 --> 00:11:11,605 stage, I won't at this stage. 319 00:11:11,985 --> 00:11:13,825 Here are the consequences that could happen if 320 00:11:13,825 --> 00:11:14,965 you don't pay altogether. 321 00:11:15,345 --> 00:11:17,664 You could be refused service if you show 322 00:11:17,664 --> 00:11:18,804 up day of surgery 323 00:11:19,345 --> 00:11:21,205 and and you're not true to the arrangements 324 00:11:21,264 --> 00:11:23,345 that we made. You don't bring in the 325 00:11:23,345 --> 00:11:25,610 the the down payment, so to speak, for 326 00:11:25,610 --> 00:11:27,690 that surgery of the day, no matter how 327 00:11:27,690 --> 00:11:29,370 minor it is. If you don't keep your 328 00:11:29,370 --> 00:11:30,809 word from the very beginning, it could be 329 00:11:30,809 --> 00:11:31,389 a problem. 330 00:11:32,329 --> 00:11:34,730 All of these things go to patient education. 331 00:11:34,730 --> 00:11:36,490 And many times you have to refer the 332 00:11:36,490 --> 00:11:36,990 patient 333 00:11:37,370 --> 00:11:39,470 back to their their insurance company 334 00:11:39,825 --> 00:11:41,125 for that more elaborate 335 00:11:41,504 --> 00:11:43,825 explanation of why they owe that money. Sometimes 336 00:11:43,825 --> 00:11:46,225 they don't know. They legitimately don't know, like, 337 00:11:46,225 --> 00:11:47,745 they have other priorities in life. Now how 338 00:11:47,745 --> 00:11:49,585 does that help the how does that help 339 00:11:49,585 --> 00:11:52,485 our relationship with the physician's office? Easy. 340 00:11:53,230 --> 00:11:55,950 When the patients don't understand why we're asking 341 00:11:55,950 --> 00:11:57,490 them for a couple of $1,000, 342 00:11:58,269 --> 00:12:00,190 they're gonna go back to their physician surgeon's 343 00:12:00,190 --> 00:12:02,429 office and say, why are you making me 344 00:12:02,429 --> 00:12:04,830 go over to this place that wants money 345 00:12:04,830 --> 00:12:06,830 that I don't have? It might as well 346 00:12:06,830 --> 00:12:07,809 have been $1,000,000. 347 00:12:08,674 --> 00:12:09,654 I can't pay $2,000. 348 00:12:10,595 --> 00:12:12,115 So if you didn't take the time to 349 00:12:12,115 --> 00:12:14,534 reason through this with somebody and be reasonable, 350 00:12:15,154 --> 00:12:16,754 it gets back to the physician's office. They 351 00:12:16,754 --> 00:12:18,674 have to call me because I'm just a 352 00:12:18,674 --> 00:12:20,674 facilitator of the surgery. I don't in my 353 00:12:20,674 --> 00:12:22,274 case, I don't own the docs. They're not 354 00:12:22,274 --> 00:12:22,934 my employees. 355 00:12:23,250 --> 00:12:25,250 Now I have had owned docs, but I'm 356 00:12:25,250 --> 00:12:26,629 speaking to the current situation. 357 00:12:27,009 --> 00:12:28,210 It gets back to them, they have to 358 00:12:28,210 --> 00:12:29,809 get involved, and then they catch all the 359 00:12:29,809 --> 00:12:32,950 grief. Mhmm. Because in the patient's perceptive 360 00:12:33,330 --> 00:12:36,629 perception, it's the doctor who set them up 361 00:12:36,954 --> 00:12:39,355 for for that that surprise, that big financial 362 00:12:39,355 --> 00:12:41,195 surprise that they can't afford. And then there's 363 00:12:41,195 --> 00:12:43,375 the humiliation of it. There's the embarrassment. 364 00:12:43,914 --> 00:12:46,394 You know, it people have pride. You don't 365 00:12:46,394 --> 00:12:48,174 wanna speak to peep these are your patients. 366 00:12:48,634 --> 00:12:50,154 And and they and they're emotional about it 367 00:12:50,154 --> 00:12:52,003 because they need the surgery. I mean, what 368 00:12:52,003 --> 00:12:53,149 are you supposed to do? You need the 369 00:12:53,149 --> 00:12:54,830 surgery. You know you need the surgery. You're 370 00:12:54,830 --> 00:12:56,269 gonna say whatever you have to do on 371 00:12:56,269 --> 00:12:58,110 the phone call. If you don't have the 372 00:12:58,110 --> 00:13:00,350 money to get to the place, get the 373 00:13:00,350 --> 00:13:03,070 surgery done, and worry about everything later. Right? 374 00:13:03,070 --> 00:13:04,429 So you might as well have an honest 375 00:13:04,429 --> 00:13:06,590 conversation with people upfront and not put them 376 00:13:06,590 --> 00:13:07,410 in that place. 377 00:13:08,164 --> 00:13:11,065 Absolutely. Well, thank you for sharing your insights 378 00:13:11,125 --> 00:13:13,204 today. Is there any parting words you'd like 379 00:13:13,204 --> 00:13:14,884 to share on the podcast before we wrap 380 00:13:14,884 --> 00:13:15,384 up? 381 00:13:15,764 --> 00:13:17,464 I I would just like to say that 382 00:13:18,084 --> 00:13:18,824 we are 383 00:13:19,764 --> 00:13:22,264 reception people in in nursing clearance. 384 00:13:23,230 --> 00:13:24,750 All of the people that have an interaction 385 00:13:24,750 --> 00:13:25,490 with the patient 386 00:13:25,950 --> 00:13:26,450 intraoperatively, 387 00:13:27,309 --> 00:13:29,389 the pre op nurses, the post op nurses 388 00:13:29,389 --> 00:13:31,629 in a surgery center setting, and in health 389 00:13:31,629 --> 00:13:32,529 care in general. 390 00:13:32,910 --> 00:13:34,290 If we treat people 391 00:13:34,670 --> 00:13:36,269 like we would wanna be treated, I know 392 00:13:36,269 --> 00:13:38,290 it's an old adage, it's an old saying, 393 00:13:38,524 --> 00:13:39,825 It's it's rather cliche. 394 00:13:40,285 --> 00:13:42,205 But if we were to treat people like 395 00:13:42,205 --> 00:13:43,424 they have common sense, 396 00:13:44,205 --> 00:13:45,184 like they have, 397 00:13:45,884 --> 00:13:47,745 like they're middle class people with 398 00:13:48,285 --> 00:13:50,384 other competing priorities in their lives, 399 00:13:51,129 --> 00:13:52,329 especially when they have to take off a 400 00:13:52,329 --> 00:13:53,789 day of work or something at surgery, 401 00:13:54,570 --> 00:13:56,329 they they have to manage all this all 402 00:13:56,329 --> 00:13:58,110 of the things they're going through in healthcare 403 00:13:58,329 --> 00:14:00,970 in addition to just surviving life. And if 404 00:14:00,970 --> 00:14:02,490 we were to have more sympathy for the 405 00:14:02,570 --> 00:14:04,964 for people in the practical sense, speak to 406 00:14:04,964 --> 00:14:07,924 them in the practical sense, considering those issues 407 00:14:07,924 --> 00:14:10,004 that they have to deal with, allowing for 408 00:14:10,004 --> 00:14:11,384 us to have a conversation 409 00:14:11,924 --> 00:14:14,245 that's maybe a little bit broader than just 410 00:14:14,245 --> 00:14:16,004 the issue of the day with the surgery 411 00:14:16,004 --> 00:14:16,825 of the day. 412 00:14:17,240 --> 00:14:19,240 And hearing them, it will go a long 413 00:14:19,240 --> 00:14:20,379 way to helping people 414 00:14:21,079 --> 00:14:23,259 to for them to be more open minded 415 00:14:23,319 --> 00:14:24,379 and less fearful, 416 00:14:25,000 --> 00:14:27,159 not just about what procedure they're having that 417 00:14:27,159 --> 00:14:28,379 might save their lives 418 00:14:28,679 --> 00:14:31,035 and the necessity of it, But just about 419 00:14:31,035 --> 00:14:32,955 what's gonna happen to them afterwards, is that 420 00:14:33,115 --> 00:14:34,575 is the other shoe to drop 421 00:14:34,955 --> 00:14:37,595 some big thing that's in and of itself 422 00:14:37,595 --> 00:14:38,095 unmanageable? 423 00:14:38,634 --> 00:14:40,075 You know, with home health or all the 424 00:14:40,075 --> 00:14:42,394 complexities of health care now. We're getting better 425 00:14:42,394 --> 00:14:44,174 at what we do, more technologically 426 00:14:44,554 --> 00:14:45,054 advanced, 427 00:14:45,759 --> 00:14:47,059 for surgical procedures. 428 00:14:47,759 --> 00:14:50,079 And as we do, we have to explain 429 00:14:50,079 --> 00:14:52,799 how beneficial that that is going to be 430 00:14:52,799 --> 00:14:54,100 for them from 431 00:14:54,720 --> 00:14:56,500 a from a quality of life perspective. 432 00:14:57,039 --> 00:14:59,220 We we have to start being human beings 433 00:14:59,519 --> 00:15:00,500 in that conversation 434 00:15:01,054 --> 00:15:02,654 so that their minds can be open to 435 00:15:02,654 --> 00:15:03,315 the process. 436 00:15:04,574 --> 00:15:06,894 Absolutely. Well, thank you for taking the time 437 00:15:06,894 --> 00:15:09,235 to join me on the Becker's healthcare podcast 438 00:15:09,294 --> 00:15:11,934 and share these insights on this topic. Again, 439 00:15:11,934 --> 00:15:13,714 we are live at the business and operations 440 00:15:13,855 --> 00:15:15,714 of ASCs. Thank you.