Message from the President
By Mick Polo, CHBME, HBMA President
As I began in the medical billing field, some of the highest “business intelligence” needed was simply convincing healthcare providers they should change from their antiquated internal system of pegboard accounting and ledger cards to using a billing company that could computerize and organize all their accounts. A no-brainer!
News from Around HBMA
Are You Maximizing Your HBMA Membership?; New HBMA Members; CHBME CEU Questions
Integrating automation with offshore processes creates a complex, though better model.
Sourcing of claims processing activities to offshore resources by RCM companies has been a standard practice since its introduction 10 to 15 years ago. For ALN, as is the case with most RCM companies, the original driver was cost reduction and scale surrounding manual billing activities, primarily achieved by sourcing to lower-cost workers. Today, the use of offshore is a standard ...
RCM companies can leverage the industry trends to collect more and prove the value of your organization's partnership.
When it comes to patient collections, trends in healthcare payments tell us that providers are struggling. Though patients owe more for services, providers still rely on the same collection methods from decades ago: print and mail statements....
Always make sure a business associate agreement is in place.
By Marcia Brauchler, MPH, FACMPE, CPC, COC, CPHQ
Business associates, such as billing companies, have been off the radar of the Office for Civil Rights since the inception of HIPAA. However, recent enforcement resulted in a small pediatric gastroenterology practice in Illinois being fined $31,000 because of an infraction by their business associate...
Framing the key questions around your business pillars will ensure you don't miss evaluating the main areas in your business.
Being a small business has its perks: you’re fast and agile. The downside is that, as a small business, you may not have the time, effort, and budget available to put into a two-week-long leadership retreat to evaluate your business and make plans to improve...
Analytics has become the primary path to improve financial, operational, and clinical outcomes.
Healthcare is just like any other industry: If you stop building new things, you’ll go out of business very soon. Healthcare data is exploding at an incredible rate, which is a huge opportunity for a new generation of innovators to build (and sell) brilliant new things...
The onus of policing clinicians to stick with actions that bring value to healthcare is on their administrative partners -- like their billing companies.
In 2015, Congress passed the Medicare Access and CHIP Reauthorization Act (MACRA) to reform the Medicare physician payment system, align the quality programs, and replace the sustainable growth rate (SGR). The SGR was intended to cap Medicare program growth. But, for over a decade, the cap had failed and resulted in steep payment cuts to physicians...
If you can demonstrate better performance quantitatively, you can beat your competitors, get more revenue, increase profits, and maybe even sell your company and retire.
Analytics is a hot area, and it seems like every conference has presentations on analytics and data, but how many are actually useful? We are focusing on a very practical application of analytics in RCM, which is how it can help you win deals and grow your business...
SPECIAL Government Relations Update
By HBMA Government Relations Committee
On June 11-12, the HBMA Government Relations (GR) Committee held its annual advocacy visit to the Baltimore/Washington, D.C., region to meet with policymakers from the Department of Health and Human Services (HHS), the Centers for Medicare and Medicaid Services (CMS), the U.S. House of Representatives, and the U.S. Senate.
Coding Corner
By Melody W. Mulaik, MSHS, RCC, CPC, CPC-H
It seems like whenever you turn around, there is another hoop to jump through to get a claim submitted to the payers. The Centers for Medicare and Medicaid Services (CMS) frequently creates new rules that don’t always apply to other payers so they can track specific information and/or ensure they pay things correctly according to their policies...
Software Talk
By Nate Moore, CPA, MBA, FACMPE
This article builds on the complexity of our discussion of arrays. Please review the first four articles in RCM Advisor to refresh your memory on arrays. This article will show another example of using arrays to calculate a common medical practice request and introduce arrays that span multiple cells.
From the Road
There are still some dinosaurs in this wonderful world of medical billing—myself included. My career has spanned over five decades, before it was even called revenue cycle management...
