Phase 7 First cases

 Month of first cases

As first cases approach, there is an increase in activity. All staff should be hired and trained on all equipment, systems and processes. Training is critical to ensuring the facility can pass clinical inspections and that the first surgical procedures are executed seamlessly.

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Inspections and audits

Before any surgical procedures can be performed, the facility must pass a clinical inspection performed by the governing bodies. This evaluation ensures that the facility and its staff comply with regulatory standards and can provide safe and effective care.

Upon passing the clinical inspection, the 10 test cases can be completed, and the accrediting body can be informed. The accrediting body will execute a surprise audit to review the center’s operations, facilities and practices. It could take several weeks after the 10 test cases are completed for the accrediting body to survey the facility. They will observe at least one surgical procedure from the pre-op phase through recovery. While waiting for the audit, the surgery center must remain operational so that it is prepared for the audit. Insurance cannot be billed for the cases performed during this period as the facility is not yet fully accredited.

Survey results and findings are typically provided within a week of the audit and must be addressed before the facility receives accreditation.

CMS approval

A separate audit with CMS will need to be conducted if the accrediting organization did not have deemed status. This additional audit can add weeks to the timeline. It is not possible to move forward with payer negotiations until CMS approval and a PTAN number has been received.

 

Revenue cycle management

It’s important that the process for revenue cycle management is finalized during this time so that as soon as the surgery center is able to book revenue generating cases there is no delay in billing and collection activities.

Milestones:

  • All staff hired
  • All staff trained
  • Clinical inspection
  • 10 test cases completed
  • Audit by accrediting body
  • Receive and respond to survey findings
  • CMS approval (PTAN number)
  • Launch revenue cycle management solution

 

Next phase of the new build process: Ramp up

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Phase 8: Ramp up

Gradually increasing case volumes will allow staff to become proficient with procedures, equipment and protocols, reducing the risk of errors and ensuring quality outcomes. 

View Phase 8

Phase 6: Final prep

After all building inspections have been successfully completed, the Certificate of Occupancy is granted. This certifies that the facility is in compliance with all building codes and regulations and that it is suitable for occupancy.

Back to Phase 6