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Outpatient Surgery E-Weekly

Contact Congress Over Drug Shortage Issues

A Kentucky congressman is urging surgical facilities to contact their members of Congress and request that they sign his letter demanding changes to...

N.J. Posts ASC Inspection Reports Online

State and federal inspection reports of New Jersey's ASCs are now available online, giving patients an opportunity to make more informed choices abo...

Are Opioids Necessary?

While it's not always practical, or even possible, to eliminate opioids from your post-op pain management regiment, reducing their use in favor of n...

Archive > January, 2006 Vol. VII, No. 1

Ideas That Work

Beating PPOs at the out-of-network game

Edited by Diana Procuniar, RN, BA, CNOR

Diana Procuniar, RN, BA, CNOR By now, most providers and patients understand the network game. Doctors prefer the typically higher out-of-network reimbursement with no contractual restrictions, while patients would rather compromise on physician selection to use an in-network provider for the substantial out-of-pocket savings. What you may not know is that there is a happy compromise for both in your facility.

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Categories: Code/Bill/Reimburse, Business Management, Ideas That Work, Infection Control, Staffing/Training, Supplies/Implants
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Earning Back Lost Funds; Teaching Through Games; Ever Go to the Supply Room to Pull an Item and Find Out...; Amy N. Riley, RN, BSN; Nancy Petty, MBA; Connie Meyer, RN, CIC; Joyce Danels, RN, CNOR; BSN Vice President; Back Lost Funds Shortly; CIC Director; CNOR Director; Center; Control; Danels, RN, CNOR Director; Doctors; Drop; ENT; Funds Shortly; Games As; Health Center; Item; January; Lost Funds Shortly; Meyer, RN, CIC Director; N. Riley, RN, BSN Vice President; President; Pull; Quality Services Community Health Center; RN, BSN Vice President; RN, CIC Director; RN, CNOR Director; RNs; Riley,... show all keywords
Earning Back Lost Funds; Teaching Through Games; Ever Go to the Supply Room to Pull an Item and Find Out...; Amy N. Riley, RN, BSN; Nancy Petty, MBA; Connie Meyer, RN, CIC; Joyce Danels, RN, CNOR; BSN Vice President; Back Lost Funds Shortly; CIC Director; CNOR Director; Center; Control; Danels, RN, CNOR Director; Doctors; Drop; ENT; Funds Shortly; Games As; Health Center; Item; January; Lost Funds Shortly; Meyer, RN, CIC Director; N. Riley, RN, BSN Vice President; President; Pull; Quality Services Community Health Center; RN, BSN Vice President; RN, CIC Director; RN, CNOR Director; RNs; Riley, RN, BSN Vice President; Room; Services Community Health Center; Supply Room; absorbing; accounts; addition; additional; adds; admission; agency; aligning; answering; apathetic; apparently; areas; arriving; audit; benefit; benefits; big; bill; billed; billing; billings; board; break; brought; business; called; caveat; celebrations; center; centers; certified; check; claim; clinical; co-insurance; co-pay; co-payment; collected; collection; communicate; communications; community; companies; company; compromise; concept; contracted; contractual; control; correctly; cost; couple; created; creating; daily; day; decided; departments; determined; developing; difference; difficult; director; discovered; divide; doubt; educated; effect; effectively; effort; eligible; employees; engaged; ensure; equal; equate; extra; faces; facility; favorable; financial; find; forced; game; gather; general; giving; good; happy; health; higher; hires; hiring; holiday; honor; huge; impact; improved; in-network; income; infection; infectious; influence; initial; insurance; inventory; investing; items; larger; learn; lectures; legal; letter; levels; line; lunches; made; make; materials; meant; mismanagement; money; months; motivated; motivating; negotiate; network; nosocomial; notice; notification; notify; object; occasional; office; opened; ophthalmic; orientation; orthopedic; out-of-network; out-of-pocket; overcome; paper; par; patient; patients; pay; penalized; people; percentage; physician; picnic; piece; playing; poorer; portion; prefer; present; proactive; problems; promoted; provider; put; quality; questions; received; recover; reduced; refuse; reimbursement; reminding; rendered; represent; requests; responsibilities; rules; scrub; selection; sending; services; set; showed; significantly; slice; solving; spaces; specialist; spend; staff; stale; stamp; stance; standardized; stating; step; substantial; supplies; supply; surgery; taking; task; team; techs; thousands; three-year-old; time; total; traceable; trail; turnover; typically; uncollected; understand; witnessing; worked; worth; would've; writing

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