In addition to increased flexibility, expanded patient load, and greater freedom to schedule procedures, there are a variety of surgeon benefits from office-based surgery. Here are three ways iOR Partners can help you get the most out of your OBS practice.
1. Get Reimbursed for Office-Based Cataract Surgery
If you are confused about reimbursements for office-based surgery, you are not the only one. There are misleading statements out there claiming that Medicare does not reimburse for office-based cataract surgery. While it’s true Medicare does not reimburse a facility fee, they pay an enhanced professional fee for office-based cataract surgery. This is in addition to the standard professional fee.
iOR Partners understands the regulatory and billing requirements needed for office-based surgery reimbursement. We review every OBS case prior to submitting a claim and work with all 12 Medicare Administrative Contractor (MAC) jurisdictions on the appropriate billing method to ensure you the greatest return above and beyond your professional fee. By redirecting the payment formerly going to the surgical facility, we assist you in retaining 100% of surgical fees in your practice.
2. Ensure Patient Safety & Compliance
iOR Partners is here to help ensure you keep your patients safe by working with your staff to implement national accreditation standards, facilitate peer review of cases, and provide quality assurance and performance improvement (QA/PI).
iOR Suites® operate at the same safety standards of care and are accredited by the same national organizations as ambulatory surgery centers (ASC) or hospitals. As part of our accreditation program, iOR Suite® physicians must provide quarterly data on their surgical outcomes. The iRWD Registry™ consists of nearly 30,000 real-world cases performed in an office-based surgery facility to match or beat safety outcomes in other outpatient settings. See current safety data.
3. Leading the Movement in Ophthalmic Office-Based Surgery
iOR Partners is focused on perpetuating the shift to office-based surgery as a new standard of care that is better for patients, providers, and payors. Since inception, we have been advocating with CMS on behalf of our surgeon partners for national safety standards and adequate reimbursement for ophthalmic office-based surgery.
Why is this important? Office-based surgery emphasizes the healthcare movement toward physician-led healthcare resulting in high-quality of care and greater patient satisfaction. This is a shift in healthcare, affecting the entire industry.
Additionally, OBS puts money back into ophthalmology. According to Market Scope research, around 2% of cataract procedures (the #1 procedure in healthcare) are being performed in OBS suites. 85% of these cases were previously performed in corporate ASCs or hospitals. Bringing these procedures to OBS brings significant dollars back into ophthalmology.
iOR Partners has and will continue to advocate for CMS to develop a consensus-driven plan to provide payment for these ophthalmic OBS procedures with key stakeholders, including:
- Leading the comment movement from surgeons, staff and patients significantly changing the comment opinions since the last review period in 2016.
- Leading the request to CMS for revaluation of non-facility codes for additional reimbursement in 2023
- Continued meetings with congressional leaders to gain support on Capitol Hill
- Ongoing discussions with AAO, ASCRS, AECOS, OMIC, the Joint Commission, and Quad A on standards for OBS
- Sharing peer-reviewed data supporting OBS safety (to be published in Q1 2023)
- Urging CMS to request comparable peer-reviewed safety data from ASC organizations
- Submitted 2024 proposal to CMS for revaluation of non-facility payment rates with additional information on OBS safety data and accreditation standards.
iOR Partners is committed to empowering surgeons to create office-based surgery suites with exceeding benefits for their practice and the healthcare industry.
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