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September - October 2011 •
Volume 16, Issue 5

And the Heat Goes On!
Message from the President
By Jackie Willett, CHBME
Is the song that so many were singing this season referring to the scorching summer heat that so many of us encountered? As frustrating and draining as the summer heat was, so is the uncertainty of the Patient Protection and Affordable Care Act. In the midst of so many unknowns and challenges within our industry, it was a welcome relief to be refreshed at our Annual Conference. Click for more

News from Around the HBMA
Billing Editors
Board of Directors Election Results; HBMA Value; Newly Minted HBMA Members; HBMA 2012 Compliance Course information Click for more

SPOTLIGHT ON! Certification Committee
HBMA Committee Profile
By Susan Chandler, CHBME
As I look back at the many years that HBMA has been in existence, it is amazing to see all the changes that have occurred in the healthcare industry. Gone are the days of the healthcare executive running a billing company that is only hired to submit claims and post payments for physicians... Click for more

HBMA Members Sound Off on Billing Issues
Billing Editors
Pros and Cons of Providing Client Access to Your Practice Management System Click for more

Fall 2011 Conference Wrapup
What Happens in Vegas...
By Madelon Berger, CHBME
The HBMA Education Committee, chaired by Joe Schendel, CHBME, outdid itself this September with our recent meeting at the Bellagio in Las Vegas. Who needs to hear Wayne Newton sing when we can listen to Bill Finerfrock give his timely Washington Update? Why see David Copperfield or Lance Burton when our own Dave Jakielo, CHBME, ended his informative and entertaining session, "Why It's the Best Time To Be in the Medical Billing Industry," with a magic trick? ... Click for more

EHRs Increase Liability
Medico-Legal Issues Abound in EHR Implementation and Usage
By Mark R. Anderson, FHIMSS, CPHIMS and Dr. Larry Ozeran, MD
In the past 18 months, there has been an uptick in the number of malpractice claims filed against providers who are using established Electronic Health Record (EHR) products. In fact, the problem has led to a few Medical Liability Carriers considering raising the cost of medical malpractice insurance for physicians using an EHR. Just a few years ago, these same Medical Liability Carriers were offering physicians a discount for implementing an EHR. So why have EHR products transformed from being the darlings of Medical Liability Carriers to scary step? Click for more

Medicare's Provider Enrollment Revalidation Process
Medicare Update
By Eileen Turner, Senior Technical Advisor, CMS
Over the coming months and years, CMS's Medicare Administrative Contractors will begin to request that practitioners revalidate their Medicare provider enrollment information. Click for more

Tips on Preparing for 5010
5010 Data Reporting Changes
Published with permission of the American Medical Association (AMA)
If you use the current version of the HIPAA electronic administrative transactions, such as checking a patient's eligibility, filing a claim, or receiving a remittance advice, you are required by federal regulation to use the updated version of these transactions, version 005010 (5010), by Jan. 1, 2012. There are data reporting changes in these transactions that will impact the data that you send and receive. It is important for you to make these changes and test the 5010 transactions to be certain that they will process correctly on Jan. 1, 2012. Be prepared for the 5010 transactions to avoid claim rejections and interrupted cash flow. Click for more

The Key to Transparency
Business Intelligence and Comparative Analysis
By Michael Sanderson, President, RemitDATA
Practicing medicine has become increasingly challenging. Beyond adhering to new standards stemming from healthcare reform, the costs and risks associated with the "business" of medicine are being impacted by the decreasing reimbursement rates. As a result, some physicians are retiring or selling their practices to hospitals. Click for more

Towards A Harmonious Workplace
Workplace Environment
By Mike Mirarchi, Esq.
The focus of this article is on practical employee relations, designed to keep you out of court and to keep your employees convinced that they are treated fairly. Click for more

Sign Up for Free Practice Management Alerts
Published with permission of the American Medical Association (AMA)
Improve your organization's efficiencies and increase your bottom line. Sign up for the Practice Management Alerts from the American Medical Association (AMA) Practice Management Center. Click for more

What You Should Know About Multi-Tasking
Feature Article
By Kimberly Medlock, CPO
Multi-tasking — the ability to do multiple things at the same time. New definition of multi-tasking — the ability to mess up multiple things at the same time. Actually, I'm a really good multi-tasker. However, I may have an advantage over most because of the amount of reading and research I have done on the subject. I know that there is a right way and a wrong way to effectively multi-task. Many people that multi-task have got it wrong. Click for more

What is a Medical Billing Service?
Billing companies can prepare for presentations with potential clients by reviewing points made in this article.
Published with permission of the American Medical Association (AMA)
A medical billing service helps physician practices save time and increase profitability by reducing billing expenses and increasing revenues. Billing companies can ease paperwork requirements, staffing concerns, space requirements, and other expenses, as well as the intense stress created by the health insurance claims billing process. Click for more

Data Ownership Issues
For the Physician Practice and Medical Billing Service
By the American Medical Association & Healthcare Billing and Management Association
Medical billing services assist physician practices in billing, coding, accounts receivable, and management activities. By outsourcing to a medical billing service, a physician practice may realize increased profitability by decreasing the administrative time and expense involved in the billing process. The relationship between the physician practice and a billing service is an important and complex one... Click for more

The Law Touches Everything You Do
Legal Issues
By Lee R. Phillips, JD, US Supreme Court Counselor
A solid financial life should start with a rock solid legal foundation. The law touches everything you do. If you know the law and have a solid legal foundation, you can make more money without working harder, sleep better at night, pass more money to your heirs, and actually grow your business a lot faster. You do not have to be an attorney or a student of the law, but you do need to know enough to direct the financial and business affairs in your business and personal life. Click for more

The Only Constant is Change…
Coding Corner
By Melody W. Mulaik, MSHS, CPC, CPC-H, RCC, PCS, FCS
Another year has quickly flown by and it is already time to prepare for 2012. In today's environment, it is impossible to predict exactly what is going to happen in the world of physician reimbursement. One thing we know for sure, change is constant. Click for more

How to Find (and Replace) What You're Looking For
Software Issues – Excel
By Nate Moore, CPA, MBA, CMPE
If you still haven't found what you're looking for in your Microsoft Excel® spreadsheet, you've found the right place. Finding and replacing text and numbers in Excel 2007 and 2010 is easy. Here's how to do it. Click for more

Navigating the New World
AMA Perspective
By Catherine I. Hanson, Esq.
ACOs, CO-OPs, and Other Options: A 'How-To' Manual for Physicians Navigating a Post-Health Reform World Click for more

Payer Reimbursement Rates Are Key
By Penny Noyes
When negotiating provider contracts with payers and networks, the reimbursement rates are certainly the first and most important factor to address. However, there are 20 to 30 contract provisions that should be reviewed that can negatively affect the practice's revenue or cause significant administrative burdens. Listed below are a few questions you should ask, along with quick tips for some of these provisions to use when reviewing an agreement to ensure that you protect the practice's interests. Click for more

Sanction Checking
Compliance Issues
By Joe McCloskey
Earlier this year, both Holly Louie, CHBME, and Cindy Pittmon, CHBME, spoke of the need to address compliance in our client relationships. Billing organizations' adherence to vetting all prospective employees, and rechecking current employees, against government sanction/exclusion lists is part of our obligation to our clients. The Office of the Inspector General (OIG) mandates that health care organizations not hire or do business with excluded or sanctioned individuals or vendors. Click for more

Patient Portals, EHRs, and Third Party Billing
EHR Issues
By Ron Sterling
Patient portals provide cost effective tools to interact with patients on a wide range of administrative, billing, and scheduling issues at lower costs for your organization. They offer an added value benefit to your clients. Click for more

It's the Best Time to be in the Medical Billing Industry if…
From the Road
By Dave Jakielo, CHBME
In times of uncertainty you are always faced with two choices. One is to be reactive to what is happening around you – to "Roll with the punches," as they say. The other is to be proactive and forward thinking, which will allow you to shape your own destiny. Click for more

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