Initial Evaluation Phase
Data Collection & Examination
We’ll look at your 6-month prior caseload – specifically surgery counts of different procedures.
We’ll estimate costs of the suite creation as well as ongoing expenses
We’ll review your insurance reimbursement projections in current state (ASC) compared to the future state (in-office suite) and outline your projected increase in revenue.
We’ll provide a detailed projected financial view of the first 5 years of your surgery suite and have in-depth discussions of what you can expect post-launch with each line item.
We begin by analyzing your recent caseload and outlining your opportunities for additional revenue.
We’ll look at your practice’s current layout to determine your options for an in-office suite.
The site buildout specifics will vary widely depending on your wants, needs and what currently exists. For example, converting an existing LASIK suite to an in-office suite usually costs substantially less than creating a new office from the ground up. We’ll help you sort through options and create a design plan. And we’ll be there from the initial brainstorming through to the design, buildout, and implementation.
An in-office suite can typically be incorporated into an existing office. The amount of space needed depends on how you plan to use your office while surgeries are being performed. For example, do you plan on using clinical space (exam rooms) while surgeries are being performed? Or will that space not be used simultaneously and thus be utilized for surgery-related activities? We have a series of questions and discussion points to work through how to best meet your needs.
Equipment and disposable needs
We’ll discuss your equipment needs in detail, but equipment required depends on the type of surgery, state regulations, class of anesthesia, and level and type of accreditation. In general, all need a scrub area, a sterilizer/autoclave, crash cart, defibrillator, and all surgery equipment and instruments. We help our clients with procurement and we have exclusive pricing agreements with multiple vendors.
We’ll talk through the different anesthesia options- the classifications, staff required, facility requirements, and costs – and what makes the most sense for your office.
The two most common classes of anesthesia are:
- Level I (also called Class A): local plus minimal sedation (oral medication + injectable anesthetics)
- Level II (also called Class B): moderate conscious sedation (IV medication).
We help our clients navigate this choice by weighing the clinical distinctions and financial implications.
Site buildout and credentialing
Our specialist will manage the end-to-end process of getting the suite up and running and ensuring accreditation.
For accreditation specifically, an accreditation agency, state regulations, anesthesia class, and insurance agreement requirements determine those. Typically there’s a manual of requirements that must be demonstrated via a survey from the accreditation agency. Requirements include power, staffing, anesthesia, and sterilization, among others. Manuals, records, and logs must be created and kept to maintain accreditation.
Equipment Purchase/Rental and Setup
We’ll coordinate the delivery and installation of your equipment, instruments, and disposables.
We will enroll you in the negotiated reimbursement agreements that we’ve set up with insurance companies.
We’ll work with you on all billing functions including prior authorization, determining patient responsibility, claim submission, appeals, and payment collection.
We’ll make sure your staff – and practice – is prepared for the upcoming changes. From specific equipment training to new processes to payment collection, we’ll make sure everyone is more than ready on Day One!
Our fees are a percentage of insurance reimbursement collections generated in your office.
We don’t collect fees on any additional reimbursement you generate in the suite(ex. femtosecond lasers, specialty iols, ICLs, RLEs, etc.).
Our fees are required to support our ongoing partnership through every step of the suite’s creation process from initial analysis to implementation (site buildout & credentialing, equipment purchase/rental, inclusion in our negotiated contracts, staff training, anesthesia discussions, and billing) and ongoing support.
Our fee structure has 2 parts:
- An initial $10,000 deposit covers our costs to initiate your project (suite design, anesthesia planning, adding you to our insurance contracts, etc). This will be fully refunded after your first quarter of surgeries.
- A tiered percentage of collections that decreases annually over the first 5 years is based on quarterly surgery numbers. Our expectation is that by Year 5, this will be 14% of your insurance collections. (This is a 14% cost from the nearly 300% additional revenue on average expected from in-office surgery vs if surgery was continued at an outside ASC. This includes the services of our billing team, renegotiating the special insurance contracts, annual recredentialing costs, and ongoing support).