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September - October 2009 •
Volume 14, Issue 5
It's All About You
Message from the President
Randal Roat, CHBME
At the risk of breaking with good writing protocol, I’m going to start this report with “I.” As business owners and parents, how many times do we have to deal with sentences starting with I? I think.... I want.... I can’t.... Only to have the discussion quickly turn to “you.” Click for more

Risks and Costs You Can’t Afford to Ignore
Stark Law Basics and Anti-Markup Rules
By Andrew B. Wachler
The Stark II ban on physician self-referral generally makes it unlawful for a physician to refer Medicare or Medicaid patients for designated health services (DHS) to an entity with which the physician (or an immediate family member) has a financial relationship. Click for more

HBMA News
News from Around the World of HBMA
Billing Editors
Your Association at Work, HBMA Establishes New Electronic Medical Record Task Force; HBMA Member Newsletter; Annual Auction and Fundraising Special Event at the Fall Conference... Click for more

Spotlight On: Executive Committee
Committed Leadership Supports HBMA
By Randal Roat, CHBME
HBMA’s board and executive committee demonstrate those values every day. It’s been my honor and pleasure to be a member of the HBMA Executive Committee for three years, and I can assure you that it is as impressive and committed a group of people as I’ve ever worked with. Click for more

Beware of Missed Opportunities
How Leaders Can Bring Out the Best in Their Employees
By Aleta Norris
The responsibility of a leader is to “drive consistent actions and behavior (of people) toward a defined vision.” A leader does this by carefully balancing accountability for results with the inspiration of the people involved. I would like to underscore the inspiration part of this. Click for more

Smoothing the Ride to Financial Success
Global Outsourcing: Are You a Candidate?
By Randall E. Wall
The Grateful Dead’s Jerry Garcia was right: “What a long, strange trip it’s been.” And continues to be. Actually, the U.S. economy has not spiraled downward to its current level since the Great Depression of the 1930s, when many investors, teetering on the verge of economic ruin, tiptoed precariously onto high-rise window ledges debating the merits of Hamlet’s infamous soliloquy. Click for more

When Will The Paper Be Gone?
The Healthcare Remittance Gap
By Jim Ribelin
If you take a look at the evolution of healthcare data transactions and the many businesses that surround them, a telling story about the healthcare industry as a whole reveals itself. The industry is comprised of three principal groups which exchange data, including physicians and hospitals (collectively referred to as ‘providers’), payers and employers. Click for more

Beware the Long Reach of the Prosecutor
Reimbursement Depends upon the Correct Place-of-Service Codes
By Gretchen Segado, MS, PCS, CPC, CCP-P
The importance of correct place-of-service codes on a claim form is an often overlooked part of many billing and compliance programs. Place-of-service (POS) coding errors are significant enough to have been identified by the Office of the Inspector General (OIG) in several of its reports. In January 2005, an audit by the OIG determined that some medical practices were reporting claims with an incorrect POS. Click for more

Coding It Correctly
2010 Brings ICD-9 Changes
By Jackie Miller, RHIA, CCS-P, CPC, PCS
The big buzz in the billing community over the past six months has been the implementation of ICD-10-CM, which is scheduled for October 1, 2013. But until ICD-10 goes into effect, annual updates will continue to be made to ICD-9-CM. Click for more

Economic Climate Change
Key Elements to Monitor or Adjust
By David F. Jakielo, CHBME
Global warming isn’t the only climate change we’re living through. Many of us have never experienced an economic downturn of the current magnitude. We have seen our 401Ks drop so low that they are now going to be renamed 200.5Ks. The Blue Chip stocks of 2007 may become a penny-stock listing in 2010. Click for more

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