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March - April 2012 •
Volume 17, Issue 2
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"Invest in Yourself..."
Message from the President
By Don Rodden, CPA, CHBME
On Monday, August 29, 2005, New Orleans and the Gulf Coast regions were ravaged by hurricane Katrina, which damaged, interrupted, and destroyed the lives and livelihoods of millions. The lives of 1,836 people were lost and the physical damage was estimated at $81 billion. Since that time, we have witnessed horrific tornados, earthquakes, and tsunamis. What perpetually stands out in the aftermath of these disasters is the perseverance and fortitude of the human spirit to respond to and overcome the overwhelming challenges presented by these situations.
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SPOTLIGHT ON! Cindy Rounds
HBMA Profiles
HBMA Associate Director
Hello, this is Cindy Rounds, Associate Director of HBMA, working in the national office! I have probably spoken to almost all of you at some point in time and you probably wonder what a typical day at the office looks like for me.
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SOUND OFF!
Pros and Cons of Using Online Coding Tools
Billing Editors
PROS: I love using online resources. I find it very helpful but I always check the date and source. It is a good way to communicate with other coders.
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HBMA 2012 Spring Educational Conference PREVIEW
Program Highlights
Spring Conference Speakers
The HBMA 2012 Spring Educational Conference will provide a plethora of information to billing companies, putting attendees on the cutting edge of our industry. Professional speakers will address key issues such as disaster preparedness, information technology, EHRs, growing your business, ICD-10, business continuity, Washington updates and much more. Get a sneak preview from six of our speakers below.
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The Alphabet Soup of Medicare Contractors
Feature Article
By Dina Benedetto CPC, CPC-H, CPMA
Navigating through the lists of Medicare contractors can seem overwhelming. QIO, MACs, FIs, RAs, CERT, ZPICs? As healthcare professionals, we need to understand the roles and objectives of these contractors and how they affect our practices.
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Checking the Pulse on 5010
Working Through the Rejections
By Jackie Griffin
There is absolutely no denying it now – 5010 is here, and we're all feeling the weight of it. Over the past few weeks, I've been presenting on 5010 with associations and talking with representatives from all different areas of the industry to get a feel for the main points of pain that are out there.
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Evaluating and Negotiating Emerging Payment Options
AMA Perspective
Published with permission of the American Medical Association (AMA)
The healthcare delivery system in the United States is undergoing a paradigm shift with regard to physician and other healthcare provider payment methodologies. In an effort to control the growth of healthcare costs, payment methodologies involving risk are slowly replacing fee-for-service as the predominant means through which physicians and providers will be paid...
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The Truth about HIPAA-HITECH and Data Backup
Feature Article
By Bob Chaput
This article sets the record straight on a very specific aspect of the HIPAA Security Final Rule: the Data Backup and Disaster Recovery Specifications within the contingency plan standards. We separate myth from reality about what exactly is required of whom and by what dates Covered Entities (CEs) and Business Associates (BAs) must comply with these specifications.
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Squeezing More Money and Asset Protection Out of Your Business
Legal Issues
By Lee R. Phillips, JD
The million dollar question for a small business is how it should be legally structured. Should you use a corporation (S or C), a limited liability company, a limited partnership, a general partnership, or just a sole proprietorship for your business? I am sure that you have talked to an accountant and gotten one story and then talked to an attorney and heard another story. In fact, you may have spoken to several attorneys and received different advice from each one.
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New Year, Newly Improved Website from the AMA Practice Management Center
AMA Perspective
Published with permission of the American Medical Association (AMA)
Have you resolved to streamline your practice operations in 2012? Determined to save time and money by adopting the latest version of the HIPAA electronic health care transactions? Decided to obtain a better understanding – and greater control – of your dealings with payers?
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Medical Banking Streamlines Paper EOB Processing
Feature Article
By Aaron J. Grandison
One experienced, highly efficient data entry person can post approximately 4,000 remittances per month. Automating the process easily increases that same person's output by 300%.
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E/M: Physician Versus Facility
Coding Corner
By Jackie Miller, RHIA, CCS-P, CPC, PCS
A physician practice biller who was concerned about possible inappropriate billing practices at a local hospital contacted a coding consultant. One of the biller's physicians saw a patient in the hospital's outpatient clinic, and the biller was horrified to discover that the hospital had submitted an Evaluation and Management (E/M) code to Medicare for the clinic visit. She explained to the consultant that this was clearly fraudulent billing because only physicians can use E/M codes, and she questioned whether it would be appropriate for her to turn in the hospital to the Office of Inspector General.
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CHBME Quiz Questions
Read Billing; Earn CEUs!
Billing Editors
You can now earn 0.5 credits towards your CHBME by answering quiz questions in each issue of Billing.
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Use Excel to Manipulate Patient Names and More
Software Issues – Excel
By Nate Moore, CPA, MBA, CMPE
To concatenate means to connect or link together, and the CONCATENATE function in Excel does just that. It's an easy way to combine two or more pieces of information into one cell. Once you're familiar with CONCATENATE, you'll wonder how you ever managed without it.
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Overpayments & Underpayments -- Denials & Offsets
Operations
By Penny Noyes
Denials and the recoupment of monies by payers due to retroactive eligibility problems and other claim overpayments present ever growing issues for practices. Old payer contracts tend to be absent of language that specifically addresses these issues, while newer agreements spell out very clearly what the payer has the right to do. In these circumstances, as expected, the provisions favor the payer.
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Hospital EHRs and Your Billing Services
EHR Issues
By Ron Sterling
For a wide range of reasons, many hospitals are actively promoting EHR products to their medical staff physicians. In some cases, hospitals offer specific products that they support and host. Alternatively, some hospitals promote one or more selected EHR tools on a preferred EHR vendor list.
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Managing Multiple Generations
From the Road
By Dave Jakielo, CHBME
For the first time in history, there are four generations working together in the workplace, and this leads to new challenges for today's managers. If you have been in management for over ten years, the leadership style that helped you to get where you are today may no longer be effective.
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