Healthcare Business Management Association - HBMA
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May - June 2013 •
Volume 18, Issue 3

So, Why Be a Member of HBMA?
President's Message
By Jud Neal, CHBME
In my first President's Message, I touched on my vision for HBMA. As part of that vision, I shared with you that I wanted to see HBMA continue to create value to help you grow as leaders and to be a place where you can learn how to better handle the challenges of running your businesses. Click for more

HBMA Profiles
By John Howard, Ph.D. and Bill Carns, CHBME
In March 2009, Performance Resources, Inc. began providing the HBMA EmployerPages system ( as a complimentary member benefit. The site allows members to obtain a free online recruiting and hiring system as part of an umbrella site branded for HBMA and individually branded for participating members. The site has proven to be a very effective hiring tool for HBMA members and has steadily grown in popularity. At this writing, 251 HBMA members are using the service. Click for more

Offering Payment Plans to Patients
By Billing Editors
HBMA Members Sound Off! on Hot Billing Industry Topics. Click for more

How the New HIPAA Regulations Affect Billing Companies and Their Subcontractors as Business Associates
Develop an Action Plan for Your Company and Subcontractors
By Robert A. Polisky, Esq.
On January 25, 2013, the Office for Civil Rights of the U.S. Department of Health & Human Services (OCR) published the anticipated final omnibus rule (the Final Rule). This rule created significant changes to the Privacy, Security, Breach Notification, and Enforcement Rules under the Health Insurance Portability and Accountability Act of 1996 (HIPAA), many of which are required by the Health Information Technology for Economic and Clinical Health Act (HITECH Act). Click for more

HIPAA Final Rule
Help Your Clients Learn Some of the Nuances
By Connie Ditto, Esq.
On January 25, 2013, the Office for Civil Rights (OCR) of the Department of Health and Human Services (HHS) published its Final Rule of modifications to the Health Insurance Portability and Accountability Act of 1996 (HIPAA) in accordance with the Health Information Technology for Economic and Clinical Health Act (HITECH) and Title I of the Genetic Information Nondiscrimination Act of 2008 (GINA). Click for more

Creating Value in Your Business to Get Top Dollar When You Leave It
How to Prepare For Selling Your Company
By Stephen Klein, CPA
Did you ever wonder why one business has buyers lined up willing to pay top dollar while another sits on the market for months – or even years? What do buyers look for in a prospective business acquisition? Click for more

Billing Medicare for Non-Physician Providers
Become Fluent in the Federal Rules
By Richard R. Wier, Jr., Esq.
The Centers for Medicare and Medicaid Services (CMS) and federal law enforcement agencies have increased efforts to combat healthcare fraud. In order to help fund these efforts, the Patient Protection and Affordable Care Act (PPACA) has increased the Health Care Fraud and Abuse Control Program's funding by $350 million from fiscal year 2011 to fiscal year 2020. Click for more

Good to Great Strategic Planning
Your Workforce is Your Best Resource
By Kevin Herring and Killen Herring
In 1995, two Harvard Business School professors, Collis and Montgomery, published a paper that shook the strategic planning world. The mavericks argued in the article that it is not enough to know your marketplace in addition to what you do and do not do well. (In strategic planning parlance, think Strengths, Weaknesses, Opportunities, and Threats [SWOT].) Click for more

Your Clients' Patients Stay Healthy with Check-ups... So Can Their Practices!
AMA Perspective
Published with permission of the American Medical Association (AMA)
A new "Prescription for a healthier practice" check-up series from the AMA can help your clients' practices stay healthy. The monthly check-ups help practices examine the health of their everyday administrative processes and provide related resources in areas that include practice automation, fair contracting, ensuring accurate payment, physician efficiencies, and clinical quality issues. Click for more

Filing Wellpoint Appeals
What You Need to Know
By Kimberly Stevens
An appeal (also known as a grievance by some insurance regulators) is a formal request for a health plan to look at an adverse coverage decision. Two types of appeals exist within the industry: member and provider appeals. Click for more

5 Best Practices for Using Payment Plans to Ensure Patient Payments
What You Need to Know
By Bill Marvin
As health insurance premiums continue to grow (at an average annual rate of 7.1 percent [AHIP 2010]), employers are switching to lower cost, high-deductible health plans. This trend is resulting in an overall decrease in payor payments and a consequent increase in patient payments. This will continue throughout the next decade as the Affordable Care Act rolls out. Click for more

Is Failure an Option?
Success can be elusive, but failure is easy. It's up to you!
By Mark LeBlanc
So much of what I write and speak about will help you become more successful in your business and your life. Over the course of my career, I have had the good fortune of working with over 1,000 small business owners and speaking across North America to thousands more. Click for more

Meaningful Use Requirements are Less Than Meaningful
A Look at the State of EHRs in Today's Practices
By Marc Oestreich
The mandate from Uncle Sam is clear as a bell: create a complex digital system of recording, storing, sharing, and manipulating secure patient information in and across your campuses. Ensure that this new technology operates seamlessly with your current systems. Click for more

ICD-10: What is End-to-End Testing?
Coding Corner
By Holly Louie, RN, CHBME, PCS and the HBMA ICD-10 Committee
The gravity of undertaking a complete replacement of one of the most essential elements of the healthcare reimbursement mechanism cannot be overstated: if the ICD-10 CM implementation is executed flawlessly, there will be little difference between "before" and "after;" if there are problems, the impact will range from painful to cataclysmic. Click for more

CMS Guidance on Place of Service (POS) Coding
Compliance Issues
By Missy Lovell
The Centers for Medicare and Medicaid Services (CMS) published Transmittal 2407, entitled "Revised and Clarified Place of Service (POS) Coding Instructions," in February of 2012 with an (at the time) effective date of April 1, 2012. There were many awaiting the February 2012 issuance, as in 2009, CMS attempted to clarify the POS instructions for the professional (PC) and technical components (TC) of diagnostic tests and later rescinded that clarification in anticipation of future guidance. Click for more

Conditional Formatting, Part 4
By Nate Moore, CPA, MBA, CMPE
Wehave discussed many ways to use Excel's conditional formatting feature in the past three issues of Billing. Now that we are familiar with conditional formatting, we will add icon sets to make your spreadsheets even more informative. Click for more

EHR Data Interface Issues for the Third Party Biller
EHR Issues
By Ron Sterling
Third party billers face a variety of business and technical challenges in interfacing with electronic health records (EHR) and other systems. Indeed, some of the initiatives in the healthcare industry will continue to complicate the establishment and maintenance of data interfaces for the foreseeable future. Click for more

Lead, Follow, or Turn Out the Lights
From the Road
By Dave Jakielo, CHBME
I was rereading a booklet written in 1988 by Pritchett and Pound entitled "Business as Unusual." Its premise is how to survive in an ever-changing environment similar to our current medical billing marketplace. It is hard to believe that it was published over a quarter century ago, but could not be more relevant in light of what we are facing today. Click for more

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