Ep. 123: Improving the Patient Experience: Clinic and ASC Communication
Here’s what to expect on this week’s episode. 🎙️
Misaligned communication between clinics and ASCs is more than an inconvenience — it can damage patient trust and disrupt workflows. Common issues like conflicting arrival times or repeated questions create confusion and inefficiency when patients need clarity the most.
In this episode, Katie Sypher and Michael McClain of LeftCoast Healthcare Advisors share actionable strategies for aligning clinic and ASC communication:
- Use the Three W’s Framework – What info is needed, Who needs it, and When it should be shared.
- Map the entire patient journey to eliminate duplication and gaps.
- Establish a single source of truth before implementing technology solutions.
- Assign ownership or designate it as a QAPI project to ensure accountability.
The takeaway: Communication breakdowns are often process problems — not tech problems. Fixing these gaps improves patient confidence, staff efficiency, and overall ASC performance.
Listen to the full discussion on your favorite podcast platform or watch on YouTube for even more practical tips and recommendations.
Episode Transcript
[00:00:00] Welcome to this week in Surgery Centers. If you’re in the ASC industry, then you are in the right place. Every week, we’ll start the episode off by sharing an interesting conversation we had with our featured guest, and then we’ll close the episode by recapping the latest news impacting surgery centers.
We’re excited to share with you what we have, so let’s get started and see what the industry’s been up to.
Alex Larralde: Hi everyone. Here’s what you can expect on today’s episode. In this week’s conversation, my colleague, Grant Duncan, sits down with Katie Sypher, a registered dietician and healthcare operations leader, and Michael McClain, founder of LeftCoast Healthcare Advisors. Together, they dig into one of the most important but often overlooked challenges for ASCs. Communication. Katie and Michael share practical strategies for aligning messaging between clinics, surgery centers, and patients. Everything from mapping out touch points to documenting workflows so that you can reduce duplication, avoid confusion, and ultimately build trust with your patients and staff. You’ll even hear real world examples of how simple process changes can ease patient anxiety and improve efficiency across the board.
After that, we’ll switch over to our data and insights segment, where this week we’re going to be talking about claim denial rates. The big news ASCs saw their denial rates drop from 8% to 4% in 2024, a 50% improvement. So, in that segment, we’ll talk about what’s going on there and how your center can benefit.
I hope everyone enjoys today’s episode, and here’s what’s going on this week in surgery centers.
Grant Duncan: Hey Michael and Katie, thanks so much for joining us on the podcast today. I’m excited to be speaking with both of you around improving the patient experience with clinic and ASC communication. Before we jump in, can you give quick intros for our audience?
Katie Sypher: Well, my name is Katie Sypher and I’m a dietician. I also have my MBA. And throughout my career I’ve spent a ton of time opening clinics, streamlining operations, standardizing the process across multiple locations as well as within surgery centers, integrating the clinic’s work and communication with the surgery center, all with the goal to improve the experience for the patients, for the staff, and for the physicians. So I’m really passionate about this conversation and the, again, trying to focus on not creating more work, but creating work that is going to really aid in the process and the experience.
Michael McClain: And so for me, I’m Michael McClain. I’m the founder of LeftCoast Healthcare Advisors. We’re a ambulatory surgery consulting firm. In short I’m the kid who didn’t know what he wanted to do when he grew up. But before, you know all this history of ambulatory surgery, where I’ve. Run large clinics.
I’ve run, ASCs, surgery hospitals, was the CEO for a large health system [00:03:00] over all of their ambulatory surgery assets. But before that, I was a hospitalist in critical care PA and spent a lot of time in integrated leadership roles. One in particular working with Ascension, where I oversaw EHR development for integrated clinical teams trying to improve the throughput, and really limit overlap for patients and providers as they go through inpatient stays. So ed to floor, to discharge as hospitalists. So, a lot of experience in this sort of patient communication space.
Grant Duncan: Yeah. Well, I’m grateful that we get to talk with both of you about that.
So let’s start with the information sharing between the clinic, the ASC and patients. As you mentioned, it can be complex, but how can everyone stay aligned and avoid sharing conflicting info and [00:04:00] confusing the patient?
Katie Sypher: Maybe I’ll start. That’s such a great question and there’s a lot to unpack there.
Anytime that I am asked to optimize the communication process, I always like to start with identifying who are the key stakeholders. So in this situation for surgical journey, that’s going to be the clinic, including the surgeon. It’s going to be the surgery center, it’s going to be the patient. It’s going to be the payer.
And those are four different stakeholders that have four very different roles within this process. And each one of those stakeholders is going to need information, and they’re also going to be sharing information. And so. Part of the frustration or some of the confusion that we see occurs when there’s duplication, multiple people saying the same thing, or saying different things.
If there’s unanswered questions, I don’t know where to go to get this answered question or get my question answered. Um, and really a lack of understanding of the entire journey from decision to have surgery all the way to the surgery, all the way to that post-op visit. And so when we identify those key stakeholders, the next step is the documentation.
And I’ll say it starts with the three W’s. So, what information does everybody need? Who is that information being shared with? And what time is that? What’s the timing or when does that information gets shared? And so when you take a few moments and you actually document it from everybody’s lens or everybody’s view or what their role is.
It really highlights the areas of opportunity where you can streamline communication, and then where can you minimize conflicting information and where can you share information so that we’re not doing.
Michael McClain: Yeah, and I think that’s what, what it’s really all about is because when it comes down to it, sort of figuring out and agreeing to what’s going to be a, the single source of information or what we call the single source of truth for the entire care team, whether it’s the clinic or the ASC and the patient and making sure it’s in a single place or an area, whether it’s technology or not.
Having it, that’s easy, easily accessible for the care teams, for the patient, and making sure that everybody knows how to access it and be able to share that information with the patient. So you’re not making the information up. But that means there’s a lot of effort to go in before you deploy a technology solution, which is putting in that effort.
What information do you need? What’s going to be shared? Do both the clinics and the ASCs understand what information is shared with patients in what order and have that work done before? Have the process really dialed in because the last thing you want to do is have patients get conflicting information.
Show up at seven, show up at nine, show up at two hours before, three hours before because you want to improve that trust and clarity, not disturb it at a time when a patient is maybe the most concerned or most confused, which is right before surgery.
Grant Duncan: Yeah, it really resonates with both of what you’re saying and especially for the ASCs where they’re coordinating with multiple physician offices, that becomes even more complex.
You know, some ASCs, it’s, they’ve just got one or two feeders, but if you have a lot, well Michael, you have to do that process with maybe dozens, so that becomes even more valuable. It’s not just, okay, how do we figure out the scheduling? It’s. That communication piece, uh, so important too.
I liked how you were talking about the questions to ask. I feel like you could even throw in other common questions like where, why, you know, the other common — how — these types of things. So those are great frameworks for people to think through. You also talked about how there are multiple stakeholders that have to be involved, and that means there’s a lot of touch points between all of those stakeholders from pre-op to post-op.
How can ASCs go about mapping those out and proactively preparing that thoughtful communication across all of those physician offices they may be working with?
Michael McClain: Well, I think this is where it can’t be done in a vacuum. Right? Because what’s really interesting, and the more work that we’ve done with ASCs, whether it’s a single ASC that’s owned by a single practice, or they have, like my very first ASC had six different surgeon practices and a multi-specialty ASC, it really starts out understanding who needs what.
As you’re looking at the process, you know, we’re talking about everything from, you know, benefit verification, surgery authorization. You know, in some states it’s not just prior authorizing the case, but some states there are payers that require separate facility prior authorizations. So you got two competing prior authorizations going on.
You have the clearance needs, the cardiac clearance, you have pre-anesthesia, you know, have you had dental work? And then it comes down to surgery, schedule, surgery, staffing capacity in the ASC. And a lot of times these teams need the same information, but for different reasons and at different times in the process.
And so, really getting these teams together and understanding what do you need at what point during your scheduling process preoperatively. Intraoperatively postoperatively, you know, when is the patient typically returned to the office? What’s the information that needs to be shared? Getting those teams together, it’s not enough just to send us a copy of the discharge plan.
It’s really understanding and, and working with, getting those individual teams together. Have that conversation, lay out a process for that office that works and document it. Get that those parties on the same page and say, this is who’s going to have that conversation when. And where, and here’s where the patient should go for answers.
And having that, uh, almost scripted process because that can really eliminate that. Multiple phone calls, multiple emails. You know, I, I recently had surgery myself, uh, to repair a biceps tend, and there’s nothing more frustrating than my, my office is telling me to go to the surgery center. Well. I know the surgery center wants you to be there three hours early, but that’s silly ’cause you’ll just sit there.
So show up about 90 minutes ahead. You don’t need to be there three hours early. So I’m on my way and they’re calling me saying, “We’re going to cancel your case because you’re not here three hours early.” And so I rushed to get there and I sit around for an hour and a half to doing nothing, you know? So both parties were right, but there’s nothing more frustrating as the patient to be stuck in that.
Grant Duncan: Oh man, what a tough personal experience. But it totally highlights the conflicts that can arise when there isn’t this alignment.
Katie Sypher: And I’m sure everybody on the phone that’s listening has examples of either duplicative information or conflicting information. And so really how do we, what do we do with that?
How do we minimize that? And that’s where it comes back to. People together and documenting. Exactly. If you lay it all out and you take the whole journey and you map every, with every stakeholder, you can easily see where there is duplication, where there’s opportunity, and then. We don’t have to ask the patient seven times, let’s ask it once and we’ll make sure the right people getting the information that they need, that decreases.
We’re all trying to be more efficient. That also helps with our efficiency. But I think one of Michael and I as we were preparing for this, like what does this sound like? Because this is a lot of work, it’s a lot of effort, effort, and I’m going to take this time and get people together to map this out.
What would, how would this look in real life? Real life example. And so Grant, let’s for a moment. You’re having surgery, you’re, you need surgery. And I am, I’m the MA from the clinic, so I’m going to call you before any of this work has been done. So a typical call. Right. Hey Grant, this is Katie from Dr. McClain’s office. Just wanted to let you know you have a surgery. We have ASCheduled here for August 7th. Just so keep in mind, the surgery center’s going to be calling you with some additional details. They’ll tell you when to show up, all that stuff, but just look for that call. Not sure when it’s going to be, but they’ll be calling you.
We’ll see for post. So I think that’s what we needed to tell you. I hope you have a great day and.
You may have a lot of other questions like, wait a second, wait, what time am I supposed to go? Wait, where is this location? What does my caregiver do while I’m waiting? And unfortunately I may not be able to answer those questions and just say, they’ll call you. They’ll let you know. Versus Michael, what made it sound like if you implemented this whole process and you’ve streamlined the communication?
Michael McClain: Yeah. And, and while there’s still sometimes a gap in the information because they’re two different businesses, that gap can end up looking a lot more like, you know, ‘Hey, grant I’m Michael, I’m the MA at Dr. Cypher’s office, and you’re going to have surgery on August 7th. And the way that the process goes is that the surgery center makes the final decision because they’re the one who are going to be working with you, and they know your medical care and your needs for the surgery best.
So you’re going to be getting a call in the next seven days. That call is going to come and they’re going to review with you the time to arrive for surgery. They’re going to review with you any medications you should take the morning of. They’re going to talk to you about where to park. They’re going to talk to you about anything you should bring with you to the surgery center.
You should get that call within this time period between 7:00 AM and 4:00 PM If you haven’t heard from them in the next three days, here’s the phone number to call or you can feel free to call me back and I’ll make sure that connects, but this is normal. And that’s because they’re setting up this care just for you.
We work with them every day. We’ve already worked with them to schedule what your follow-up appointment with is, but they will confirm with you on that day of surgery when you’ll return because it’ll be based on what the surgeon sees in the office or season the surgery. Then we will see you back here.
Do you have any questions that I can answer for you or can I help make this any easier for you? Even though it’s, it’s a few more words, it’s a little more scripted. It puts the patient at ease to expect a level of uncertainty, but gives them as much information as possible. And that’s because there’s this level of communication and it sort of forces a level of commitment on both sides.
Katie Sypher: I think what it also does is it really builds that confidence within the patient that each of these people are here for me. This is often a scary, overwhelming time, and we want to ease their way. Everyone’s busy, right? You’re on the phone, we talk to patients, we’re in clinics. We do this every day, but this is not what the patient does every day.
This is a very new experience for them, and we want to build that confidence throughout that entire journey from clinic to surgery center, back to clinic. So, it seems like everybody is on the same page and they’ve got my back and they’re here to make this as successful as possible. But it does take time, as we said, and it does take effort.
And so some of the ways to make sure to work through this is. Find an internal person. Maybe you assign an internal person. This is something that you really want to tackle, who can help you and give that person that role, because this is not something that you do on the side in combination with all the other probably seven hats that somebody is wearing.
Having an internal person to really map that out or bringing in an external expert that can really see from each of the different key stakeholders and help map that out and help identify where those opportunities and those gaps are another way to see the entire picture, especially if you.
It’s going, hopefully build that confidence in the clinician and the surgeon that say, I want to go to this surgery center because my patients have a great experience there. And they come back to me and they’re talking about how awesome it is, and that’s what they’re telling their friends. So it’s about the patient, but it’s also about how do we continue to make this experience great during it and then after, and then hopefully that also helps build business.
Grant Duncan: And I would definitely be much more comforted hearing the second scripted talk track compared to the first there. You know, I still might ask, do I really have to get there as early as they say, but ideally they would be on the same page and not say, yeah, cut the time in half. Don’t do three hours.
Do 90 minutes. Katie, who. Who do you typically see as the people being willing to volunteer to take on this internal project? If they’re going to just do it internally? And then second question would be, if someone like Left Coast Healthcare Advisors came in and was going to be helping with this, who would you typically be partnering most closely with to do that?
Katie Sypher: That’s a really great question, and I, it’s hard to just pick out a specific role because there are, uh, really, I would say looking at your team. Some people like to do this and some people are like, this is not what I like to do. So I, when I as a manager, if I was. Asking someone to step up. It really was finding someone that’s passionate about this.
So someone that’s going to be able to sink their teeth in and say, yes, I understand and recognize that this is something that we could do better and this is something I want to work on. And then coupling that with, do you have the bandwidth? Do you have the time? Because you don’t want to start a project and start something like this and then get in over your skis and go, wait a second, we don’t have time.
And then it just falls through the cracks. And so I would say really it’s looking at. A team member that is passionate and that has the time a little bit of extra time to spend. And so that could be maybe a surgery scheduler. It could be a COO, it, I mean, probably not the CEO, but it could be a quality improvement person.
It could, it really depends on who is at your center and what role. But I would definitely start with are they interested and passionate about it, and do they have the bandwidth to take this on? And Michael, I dunno if you have anything extra to add.
Michael McClain: Yeah, I, I would add that it helps if it’s someone who’s in a, in a either preop or perioperative role because so much of the communication involves what happens before and after surgery.
Um, and so understanding what’s the pre-op screening process? Someone who has a regular conversation with the business office team with anesthesia. Because so much of this is about information that’s happening before the patient ever gets there. That doesn’t mean that it has to be a perioperative RN or it has to be anesthesia.
You know, you can be very effectively run by a business office person. But again, there’s so much information back and forth. And I’m always a big fan of volunteering people, uh, meaning asking for volunteers. In a very narrow focus of people who have the right skillset. But Katie’s comment about bandwidth, sometimes you have to make the bandwidth for people and so free them up from other services.
The good news is in an ASC setting, this is a great QAPI project, so you can designate this as a QAPI project and get credit for it on your surveys. And you know, this is important to us. We’ve chosen to put time and energy into this. Just document it. Just document it.
Grant Duncan: Yeah. And Michael, to help listeners connect that further, what could be an example of the before versus after quantitative items to track for that kind of QAPI study.
Michael McClain: Sure. Good data doesn’t have to be complicated data. So sometimes the easiest way to do it is to maybe it’s doing a quick survey of your patients and starting with questions about, and it’s something that’s very easy, is query your patients. Start with 20 patients.
What are the two things that you like the most or you like the least about your communication process? Do the same thing with your schedulers at your clinic office, and then the same thing with your own staff and compare notes. And then from those find, you know, what are the common themes that we could address?
Put together a very simple sort of plan, do, check, act process. So what are you going to plan to fix? Fix something. Measure the results, you know, what did we change? And then come back and do that same set of survey again afterwards and see if you’ve made an improvement in those. Granted, it’s small.
Nobody’s looking for statistically significant reportable, but start small and start just sort of chunking away at that. And if you have an EHR. Great. You can use the tools within the EHR to start getting more data. If you don’t, you can still do this on paper but the idea being start somewhere, make an improvement, check it, do it again.
Just continue to do it again.
Katie Sypher: And Grant your second question is, how would LeftCoast approach this or how would we approach it? And I’ll give it a current example, is we’re setting up a surgery center and there are, in the beginning five different clinics that are going to be utilizing it. And so, it’s going into that clinic and actually working with every key member that interacts with the patient and saying, what questions do you ask?
What information do you provide? What do you tell the patient? And doing that for every. Key stakeholder and then actually putting that entire map together and then pulling the folks and saying, okay, they’re saying X, Y, and Z. You also need that information. What is the best way to get you that information in a timely manner so that when you call the patient, you can say, oh, I see you talk to so and so on this day.
This is correct. We’re going to have you be. NP for For three, for three hours or seven hours or 24 hours, whatever it is. And so really we’ll, we go in and we have those conversations. And what I’ll say is fascinating is oftentimes we assume things are happening and then when we actually go in and verify what we have written out and what is actually happening, doesn’t always, because we get busy or we have workarounds or we recognize that doesn’t actually work and my patient has 20 other questions, so I’m filling in the gaps for them.
And so we really are that interview person that I will say that can really gather that information, map it all out, and then begin to highlight the areas of opportunity to say, this is where you could streamline and this is where you could communicate. And these are some tools and resources whether you have internally or what is is out and available that can really aid you in this conversation.
Michael McClain: And I would add that, that in that scenario and some of the work that, in that example where we’re doing, and this could be with any organization that either we or a third party is working with, then we are also sort of pressure testing the EHR itself.
What does the documentation look like? Does everybody know how to get to the right dropdown menu to access this information? The assumption being, oh, ‘well you just pull this down and, oh, it’s not there.’
Well, I thought that’s how you got to it. Well, it’s not really, oh, well, let’s quick get on the phone, send an email, whatever we need to do to make sure that we have our process.
Now, does our technology match the process that we want to flow so that. So that we’re not creating now a workaround because the technology isn’t matching the process that we want. And so it’s doing that hand in hand. So we’re not what I call paving the cow path, which is we just sort of use whatever tool is in front of us and we figure it out.
Katie Sypher: I just having this conversation that it was another, body of work that we did is we actually mapped out the post-op calls and everybody wants to make sure they’re doing their role and they’re looking at it from their lens. So as a surgery center, an anesthesia, I want to make sure that, they’re okay when they get home.
The surgeon may also say, I want to make sure that they’re okay when they get home. And sometimes the payer also wants to make sure in certain situations. And so as an example, as we mapped it out, this patient. I could be getting four different calls from four different stakeholders post surgery, which can be really confusing, and it’s all asking the same questions.
And so it’s just, another highlighted example to say, wait a second, you’re doing this because it, it makes a difference and it’s where your, it’s your lens. It’s what’s really important. We have to take a step and look at the entire process and the entire journey, and how does my job and my role fit within this larger experience?
Because that’s when we can really optimize it for efficiencies and confidence for the patient.
Grant Duncan: Yeah, that’s right. And when it’s coordinated calls rather than four separate, then you’re also going to avoid differing information being shared.
Katie Sypher: Mm-hmm.
Grant Duncan: What, what other roles do you see EHRs or AI or patient texting tools or automation playing in making this easier for everyone?
Michael McClain: Well, I think that, we think that both EHRs and AI play a huge role, but they have to be deployed with an intent. And what we mean by that is that tools should complement your process and complement your sort of the, the human workforce. And not be the sole reliance on the right way to do something.
Because when you rely only on the technology and not the process underneath, you have the potential to create gaps or further create division between siloed organizations and there, that’s nowhere. Is that more obvious in the sort of the pre-op world where you have outside organizations with information, no matter how well seamlessly organized we think we are.
There’s always gaps. There’s always things that are missing. And so we don’t want to have that kind of just single. You know, nobody here is advocating for Epic, where everything is one thing where, you know, it’s all one massive data that, that doesn’t work either. That’s got all sorts of problems, but it is really important to do it with intent.
And I think that the challenge is, is that, too often I believe that a lot of clients get wrapped up in the tech piece and not the process piece, and they get working on their tables. They get working on creating, oh, let’s get all the data in. We’ve gotta get all our preference cards built. And oh, we gotta, and they forget that you need to have your process dialed in first. And most of the time, good tech follows good process. And so there are, there are obviously really high quality EHRs and the ASC space. We happen to be talking to one of the best here on the phone. So thanks again for having us, but I mean, there’s also no shortage of, I get a call a week from somebody who has an AI-driven tool and a new EHR. Just give us a chance and we’ll show you.
So you have to be really mindful of where you’re getting your technology or resources from. Just because somebody says they have the new best solution. Really, really do your homework. Talk to your colleagues. Talk to trade organizations. Go to your state and local conferences and find out what they’re using, because it should be surfacing information for you.
It should be taking away the projects and the time burning efforts. It should be removing those barriers. It should not be creating new challenges. Not that it’s perfect, but it should be reasonably following good process that you already have in place and making things simpler. It should not be tearing everything out, and now you have to learn everything new. If it is, or if the first question is, okay, you tell us what you do, and we’ll just map it out to match whatever you’re doing — that should be a red flag.
Katie Sypher: I would follow up with that is build a framework. There are so used to joke in diabetes is there’s a new diabetes drug that came out every single week and it was like, how do I keep up with that?
And it’s the same with AI and technology, right? There is so much that is coming out every single day. And they can be shiny and they can be fun and they can be promising. But build your framework. And I always like to start with what problem are we trying to solve? Because if you can go in and go, what problem are we trying to solve?
And go in with the framework to ask the questions is going to help you make smarter decisions and not get excited. And it’s exciting to get caught up in, in the shininess of something, but if it’s not going to actually aid in your process, as Michael said end up getting dusty on a shelf.
So develop a framework and start with the question, what problem am I trying to solve for? Usually that gets you a little farther down the road.
Grant Duncan: I agree There, there’s an acronym I’ve heard, SISP — solution in search of a problem, that is kind of the opposite of what you’re saying. It’s, here’s this shiny thing, what can we solve? And in reality, as you’re saying, starting with the problem is often a much better approach if you want to actually be effective there. A framework that’s coming to mind that’s very similar to what you’re saying is thinking about people, process, technology, and data.
As you were saying, don’t just start with the technology and jump in. Think about those other components there too.
Michael McClain: Absolutely.
Grant Duncan: What other tips do you have for better coordination?
Michael McClain: I like to think about, better coordination really starts with keeping things simple. So, number one, assume positive intent. Rarely is — and this happens. I’ve worked both in the clinic setting and the ASC setting, and I’ve run practices and run ASCs: rarely is the other side doing things wrong on purpose. You know, they’re not doing it to be mean, so assume positive intent on the other side.
I also think it matters to, if you’re not sure, that’s okay. Just don’t tell the patient. If you’re not sure, don’t tell the patient, confirm information and get back to the patient. I know that can be chaos In the middle of a busy day. How am I going to confirm this? I’ve got to get through 25 things. How am I going to get back to the patient?
Don’t guess, because when you guess and tell the patient something that’s not right, chances are you’re going to lose them in terms of trust, and that’s the worst thing that you can do. And I think the other takeaway, is that whenever you’re starting a process, I used to have regularly scheduled staff meetings between clinics and ASCs, schedulers meetings, food, beverages.
Sometimes in the morning, sometimes the evening, coffee or donuts, or, I know Katie’s a clinical dietician, she’ll just be like, no food rewards. Okay, no food rewards. Look at Katie’s size versus mine. I love food rewards, but get people together, break a little bit of bread and talk about things both work related and not because high functioning teams also get along.
So give some opportunity to work together and solve problems together on a regular basis.
Katie Sypher: And that really just coupling up with Michael and there’s no problem with food. We just want to have balanced food and have lots of different options in all the food groups. But social gathering, right? Yes. We, we are we are busy.
We’re in our job, we’re focused and, sometimes you don’t want to pick up the phone if you don’t know the person on the other line, because what if they’re busy? I don’t want to interrupt them. What if they don’t answer? So find some time outside of work, whether that’s a social happy hour or a ball game, I don’t know. Something where you can relate and get to know someone. What are their interests? What do they like to do so that when you have a question, oh, I can call Sally. I just spoke with her. This is awesome. You’re going to feel much more comfortable, and it really is going to create that team environment.
I think when we all became isolated with COVID and worked from home, it really highlighted to me that how helpful it was to have relationships that you knew and you could pick up the phone and call. And we’ve gotta find ways when we work in different clinics and in different areas to recreate that comradery as Michael said, so that we really are realizing the good intent and that we all are here to make this experience as positive as possible.
Grant Duncan: Great insights. Last question for you here. We do this every week with our guests. What is one thing our listeners can do this week to improve their surgery centers? Besides everything we’ve talked about.
Katie Sypher: Okay. Well, I will go first. I actually was at book club last night and I asked the girls in my book club, I said, okay, who’s had surgery?
Who’s had day surgery? And it brought up an idea of something that anybody could do this week is go in the waiting room. Talk to the caregiver. Talk to five caregivers that are waiting for their loved one to come out of surgery and ask them two specific questions.
What went well from a communication standpoint? What did you feel went really well and what were the most frustrating things? You can talk to five people when you could clearly, quickly identify, there may be opportunities to make some really quick changes that could aid in doing what you’re doing, celebrate those wins, and then change the communication, how it’s communicated or communicated to that experience for them.
Michael McClain: And I’m the other way, I’m going to go very anti-technology here today. You know, usually I talk about patient communication and patient satisfaction, but it, you know, survey season is upon us. It seems like lots of places are getting surveyed through the summer and fall. Go in your ASC, grab a grab your camera and a clipboard.
Go look at every single certificate you have on every single wall. Make sure they all are current. You would be surprised how many boiler certificates and licenses are not up to date. You have the right one. It’s probably sitting in your desk. It’s on a file. It’s scanned.
It’s in your EHR, it’s in your quality software, but it’s not on the wall. Just take the time, check everyone, take pictures of the ones that aren’t, and replace them. It just saves you a little bit of headache with the next survey or the patient that’s bored and walking around, or the caregiver that notices this place is not licensed.
It is worth the five, 10 minutes to do the walk around.
Grant Duncan: Thank you very much Michael and Katie. Great speaking to you.
Alex Larralde: This week’s data spotlight comes from the 2024 State of the Industry report from HST Pathways, and it’s a metric that directly impacts your bottom line, and that is claim denial rates. So here’s the headline. In the past year ASCs saw their average claim denial rate drop from 8% to just 4%. That’s a 50% improvement.
So. Why does this matter? Claim denials are one of the most frustrating operational challenges for any surgery center. They slow down your revenue cycle, tie up your billing staff in rework, delay payments, and sometimes lead to lost revenue entirely if the denial isn’t caught and resolved in time. So when the industry cuts the average denial rate in half, that’s a signal.
Something’s working and it’s worth digging in to understand what’s happening so that your center can take advantage of the same trends. So what do we think is actually going on? The report points to a few likely factors, better documentation, improved coding practices, and in many centers, the early use of AI and automation to validate claims before they even go out the door.
All of this means that ASCs are getting smarter about revenue cycle workflows and the payoff is significant, fewer delays, faster reimbursements and less administrative overhead spent chasing dollars that you’ve already earned.
Now if your center isn’t seeing this improvement yet, don’t worry, but do take it as a sign to dig deeper. Here are four actionable steps that you can take to help close the gap.
First, start tracking your denial reasons monthly. Don’t just look at the percentage. Get into the why. Are they coming from eligibility issues, missing pre-authorizations, incorrect modifiers? Knowing the top causes will help you target improvements where they’re going to make the most impact.
Second, make sure you’ve got the right coding support, whether it’s in-house or outsourced. Accurate and up-to-date coding is key in reducing claim denials, especially as payer rules get more complex and more specific.
Third, lean into tech tools that validate claims before submissions. This includes EHRs or billing platforms that can flag missing fields, authorization gaps, and any mismatches in payer policies before the claim ever leaves your center.
And finally tighten communication with your referring clinics. The podcast conversation earlier touched on this, but when clinic and ASC teams are aligned, especially on eligibility and prior auth, the downstream impact on billing is huge.
So to wrap it up, the data point: ASCs have seen their claim denial rates drop from 8% to 4% in the last year, and the centers that are improving in this area are doing so by leveraging smarter workflows, better tech, and stronger collaboration.
So if you would like to join them, be sure that you’re tracking your denials, invest in great coders, validate claims before they’re submitted, and communicate tightly with your clinical partners. This is one metric that absolutely deserves a spot on your leadership dashboard because small improvements here can have a major ripple effect across your entire organization.
That wraps up this week’s episode of This Week in Surgery Centers.
A big thank you to Michael McLean and Katie Cipher of Left Coast Healthcare Advisors, and of course, my colleague Grant Duncan for joining us this week to discuss practical strategies around improving communication between clinics, ASCs, and patients.
As always, we’ll be back next week with more conversations, insights, and tools to help your ASC thrive.
And if you enjoyed the episode, please take some time to leave us a rating or review on your favorite podcast platform. It does help others find our show. Thanks again for tuning in and we’ll see you again next time on This Week in Surgery Centers.