CMS UPDATE FOR HIM PROFESSIONALS


Here is some great information and access to some useful resources via CMS:

Latest News

MLN Connects™ National Provider Call: Transitioning to ICD-10
Wednesday, November 5; 1:30-3pm ET
To Register: Visit MLN Connects™ Upcoming Calls. Space may be limited, register early.
HHS has issued a rule finalizing October 1, 2015 as the new compliance date for health care providers, health plans, and health care clearinghouses to transition to ICD-10. During this MLN Connects™ National Provider Call, CMS subject matter experts will discuss ICD-10 implementation issues, opportunities for testing, and resources. A question and answer session will follow the presentations.Register or visit the November 5 call web page for more information.
Agenda:

• Final rule and national implementation
• Medicare Fee-For-Service testing
• Medicare Severity Diagnosis Related Grouper (MS-DRG) Conversion Project
• Partial code freeze and annual code updates
• Plans for National Coverage Determinations (NCDs) and Local Coverage Determinations (LCDs)
• Home health conversions
• Claims that span the implementation date

Target Audience: Medical coders, physicians, physician office staff, nurses and other non-physician practitioners, provider billing staff, health records staff, vendors, educators, system maintainers, laboratories, and all Medicare providers
Continuing education credit may be awarded for participation in certain MLN Connects Calls. Visit the Continuing Education Credit Information web page to learn more.

Deadline for ICD-10 Allows Health Care Industry Ample Time to Prepare For Change
The U.S. Department of Health and Human Services (HHS) has issued a rule finalizing Oct. 1, 2015 as the new compliance date for health care providers, health plans, and health care clearinghouses to transition to ICD-10. This new deadline gives providers, insurance companies, and others in the health care industry time to ramp up their operations to ensure their systems and business processes are ready to go on Oct. 1, 2015.
For more information read the rule or view the press release.
New Medscape Education Resources
CMS has released three new Medscape Education modules to help providers prepare for ICD-10. The new resources are available on the Provider Resources page. Continuing medical education (CME) and nursing continuing education (CE) credits are available to health care professionals who complete the learning modules, but anyone can take them and receive a certificate of completion.  If you are a first-time visitor to Medscape, you will need to create a free account to access these resources.
• Video: ICD-10: Getting From Here to There -- Navigating the Road Ahead
• Video: ICD-10 and Clinical Documentation
• Expert Column: Preparing for ICD-10: Now Is the Time
Road to 10:  CMS Online Resource for Small Practices
CMS has released “Road to 10,” an online resource built with the help of providers in small practices. This tool is designed to help small medical practices jumpstart their ICD-10 transition.
“Road to 10” includes specialty references and gives providers the capability to build ICD-10 action plans tailored for their practice needs.
Successful Results from CMS ICD-10 Acknowledgement Testing Week
In March 2014, the Centers for Medicare & Medicaid Services (CMS) conducted a successful ICD-10 testing week. Testers submitted more than 127,000 claims with ICD-10 codes to the Medicare Fee-for-service (FFS) claims systems and received electronic acknowledgements confirming that their claims were accepted. Read more about the results of the testing in this CMS eHealth blog.
CMS eHealth University
CMS eHealth University, a resource to help providers understand, implement, and successfully participate in ICD-10 and other CMS eHealth programs, features a full curriculum of materials and information, all in one location. The education modules are organized by level, from beginner to advanced, and simplify complex information in a variety of formats, including fact sheets, guides, videos, checklists, webinar recordings, and more.
Visit eHealth University website to find resources to help you prepare for the compliance date.
CMS/WEDI Implementation Success Initiative
The Workgroup for Electronic Data Interchange (WEDI) is partnering with CMS and other public and private organizations to develop the ICD-10 Implementation Success Initiative. The first phase of the Initiative, a searchable database of ICD-10 issues, is open to the public to submit questions.  WEDI, CMS, and industry partners will update the database with information and resources to help health care organizations who submit issues understand how the new codes and standards will affect reporting of diagnoses and inpatient procedures.
The goal of this initiative is to ensure a successful ICD-10 transition for all stakeholders, including health care providers, payers, clearinghouses, and vendors.
Stay up to date on ICD-10!
Sign up for CMS ICD-10 Email Updates and follow us on Twitter.

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• Page last Modified: 10/08/2014 10:18 AM

J.J. WATT QUOTE

I typically ignore the myriad of quotes and quips that saturate social media these days but this one caught my eye:


"SUCCESS ISN'T OWNED, IT'S LEASED. AND THE RENT IS DUE EVERY DAY"


Wouldn't it be great if everyone embraced this wisdom? It applies to our personal lives as well as our professional lives. So if you are a Revenue Cycle Leader, HIM Director, Hospital CFO or some other key role player, be sure to pay your rent :)


Hope you enjoyed reading this as much as I enjoyed sharing it. We at Nearterm practice it every day!


Jim Matthews
Principal; Nearterm Corporation
(281) 646-1330

CMS OFFERS A DEAL

CMS OFFERS AN INCENTIVE TO SETTLE DISPUTED INPATIENT MEDICARE CLAIMS

CMS and hospitals have historically been challenged to reach agreement on Medicare claims that have been suspended. The volume has increased dramatically resulting in processing backlogs and impasse. Here is a link to a recent CMS publication explaining the new "offering" to pay backlogged claims at a discount if hospitals will accept the discounted rate as payment in full.

http://www.cms.gov/Research-Statistics-Data-and-Systems/Monitoring-Programs/Medicare-FFS-Compliance-Programs/Medical-Review/InpatientHospitalReviews.html

If you are a Hospital CFO and/or Revenue Cycle Leader in a Medicare provider organization, this article may be of interest. Among other services, Nearterm works with hospitals to assist with Medicare billing and collection activities. Most of our work is done at the patient account level but this offering by CMS may be an opportunity to remedy appeals through an administrative discount.

Obviously, the decision to further discount revenue that is already marginal is formidable. Meantime, if you have a Medicare backlog give us a call. We have AR Specialists that can go to work immediately helping you prepare for the CMS deal or moreover helping you avoid the discount deal by resolving your claims at their full negotiated value.

Jim Matthews; Principal, Nearterm Corporation

(281) 646-1330

www.nearterm.com

Revenue Cycle DRP

REVENUE CYCLE DISASTER RECOVERY PLANNING (DRP) IS CRITICAL

Most hospitals have highly detailed disaster plans that are mostly focused on direct patient care issues and that is absolutely the appropriate focus. However, we as revenue cycle professionals advocate the reminder that cash flow is a critical when disaster strikes. The following wikipedia link articulates DRP issues fairly well - http://en.wikipedia.org/wiki/Disaster_recovery_plan

Here are a few questions to think about as you review your revenue cycle disaster plan:

• What is the increased volume capacity of the hospital and how would sudden increased volume caused by a disaster and perhaps sustained for several weeks impact registration, coding, billing and collections? For example, if you are accustomed to X OP/ED visits and Y census, what happens if volumes increase to hospital capacity? Is it a 25% increase, 40% or more? If your system is down and staff can't get to work, what is the plan?
• How quickly can EHR's, subsidiary AR ledgers, patient account histories and other data be accessed and what would the process be to do it?
• Is there a resource in the revenue cycle operation that is well versed in securing funds from various agencies that are involved in disaster relief?

Generally, 99% of hospital employees live in the immediate area surrounding the facility. They are therefore in the effected area and most are either dealing with personal trauma or in other cases they are patients. But the work of financial and revenue cycle professionals must continue in order to maintain patient services and to support the viability of the hospital. This includes management and technicians as well.

The contemporary and increasing practice of using remote hospital resources for certain functions is an option to consider, not only during disaster conditions but routinely. This option delivers an experienced labor pool and/or leadership team when the need arises.

Nearterm is in the business of providing interim resources to healthcare providers as part of the business model. Nearterm has clients routinely accessing this model as part of their routine non-disaster operation but it is easily applied when providers face disaster management challenges. Resources might include senior financial leaders, department heads, HIM Directors, Patient Financial Service Managers, Coding Managers, Collectors, Billers, call center personnel and more.

We are always interested in sharing solutions developed by hospitals and colleagues. Please feel free to share your experience by responding to this blog. If you would like to hear more about how we can be of assistance or simply get acquainted, let's talk.

Jim Matthews; Nearterm Corporation

(281) 646-1330

jmatthews@nearterm.com

REVENUE CYCLE EMPLOYEE DRESS CODE

HOSPITAL DRESS CODE IS CHANGING

Eric Chester has written a very interesting article on the topic of dress code.

http://ericchester.com/2014/07/16/casual-friday-or-casual-everyday/

I found this article and many others written by Mr. Chester to be very informative and practical. If you are a healthcare leader in a provider organization, you know that our industry has unique dress code protocol. Some is related to occupation at a facility, some driven by public business acumen and certainly culture and location influence dress code policy.

Because our business is revenue cycle services, we visit many hospitals every week. It is our observation that revenue cycle employee dress code policy seems to be all over the map. In any case, it is important to adapt and we hope this article provides you with food for thought as it did for us.

Jim Matthews; Principal

Nearterm Corporation

(281) 646-1330

jmatthews@nearterm.com

SEE YOU AT THE HFMA ANI!

The HFMA ANI is not only a great opportunity to access cutting edge education and thought leadership. It is also a great way to meet new healthcare industry friends and strengthen existing relationships. I hope you will stop by the exhibit hall and come see us at BOOTH 2101. We would love to meet you and we are giving away an iPad 2!

Check it out at the ANI website http://www.hfmaconference.org/

NEARTERM EXPANDS AS WE KICK OFF 2013!

Thanks to our prestigious clients, successful business strategy and diligent employee owners, Nearterm again expands. We have brought aboard additional professional staff and upgraded offices as we approach 2013 with excitement and confidence. If you would like to learn more about our revenue cycle services and how Nearterm can help you, let's talk.

 

We wish all of our friends and associates a Very Happy and Prosperous New Year!

 

Jim Matthews

jmatthews@nearterm.com

REVENUE CYCLE EFFICIENCY

Most of the 8,700 layoffs this year were non-clinical jobs. The Bureau of Labor Statistics leads to dire projections as we move into 2013. As revenue cycle professionals, we have always been challenged to streamline revenue cycle operations, reduce revenue cycle labor cost and become more efficient. I submit that the challenge is now a mandate. Check this out.......

News in brief - Nov. 5, 2012

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Hospital mass layoffs for 2012 expected to match 2011’s numbers -At-risk teens interested in seeing their medical records online

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Hospital mass layoffs for 2012 expected to match 2011’s numbers

Thirteen mass layoffs occurred in hospitals in September, affecting 817 people, according to a monthly report released Oct. 23 by the U.S. Bureau of Labor Statistics. If numbers hold steady for the remainder of 2012, the industry is on track to have a similar annual count of mass layoffs as it did in 2011.
Ninety-three layoff incidents occurred in the first nine months of 2012, leading 6,529 people to claim unemployment benefits. At this rate, the year would end with about 124 mass layoff incidents with roughly 8,700 people affected. This is comparable to the totals for 2011, which had 121 mass layoffs with 8,098 people losing their jobs.
The BLS does not break numbers down by occupation, but people who hire health workers say administrative rather than clinical staff tend to be most at risk of losing their jobs during mass layoffs.A mass layoff is defined as a minimum of 50 people losing their jobs from one company at the same time. Smaller incidents are not counted. is startling as we consider mass layoff statistics for hospitals in 2011 and 2012.
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At Nearterm, we specialize in assisting provider organizations toward more effective revenue cycle practices through revenue cycle process improvement, better use of revenue cycle technology and revenue cycle management practices.Our revenue cycle consultants, HIM Professionals and interim leaders deliver results. If we can help as you brace for future revenue cycle mandates or if you simply want to share speculation about how the revenue cycle will "morph" in the future, let's talk.

Jim Matthews
Principal; Nearterm Corporation
(281) 646-1330

 

EMR EFFICACY

A practical observation presented in this article and the cited study is that whether medical records are maintained hard copy or electronically, the source is still the same - people. In either environment, providers will continue to be challenged toward improving accuracy and the consequences are far reaching . Check it out;

http://medcitynews.com/2012/12/electronic-medical-records-not-a-panacea-for-patient-safety-problems/

If you are a CFO, HIM Professional or have a role in Health Information Management, you may find this snippet insightful. If you would like assistance with process innovation supporting your HIM, EMR or related revenue cycle objectives, let's talk.

Jim Matthews
Principal; Nearterm Corporation
(281) 646-1330

AFFORDABLE CARE ACT

Here is some information about the impact of the Affordable Care Act. While we have known the "rules" for some time, hospitals are now beginning to feel the impact in the form of revenue penalties and the demand to provide care differently than in the past. Re-admission penalties are a current target and most thought leaders expect more to come.

http://www.kaiserhealthnews.org/Stories/2012/November/27/medicare-spending-hospital-readmissions.aspx?utm_source=feedburner&utm_medium=feed&utm_campaign=Feed%3A+khn%2Ffulltext+%28All+Kaiser+Health+News+%28Full+Text%29%29

If you have innovative thoughts about how hospital chief financial officers, revenue cycle professionals and others can mitigate or minimize the impact of ACA mandates, please share.

Jim Matthews
Principal; Nearterm Corporation
(281) 646-1330
jmatthews@nearterm.com

DRESS FOR SUCCESS

For a lot of hospital employees, dress code is a matter of policy. However, in revenue cycle operations, HIM, hospital finance and other non-clinical work environments, there is greater flexibility regarding attire. Read the article below and think about how your appearance may impact your career.

http://under30ceo.com/4-ways-dress-success-increasingly-casual-workplace/?utm_source=feedburner&utm_medium=feed&utm_campaign=Feed%3A+Under30CEOAll+%28Under30CEO%29

Jim Matthews
Principal; Nearterm Corporation
jmatthews@nearterm.com

MANAGEMENT TIPS

Below is a link to an easy read that I found to be provocative. Check it out and see how these tips might help you be a stronger leader. At Nearterm, we specialize in assisting healthcare provider organizations to reach their revenue cycle, health information management and other financial goals with the support of our expertise and human capital. As such, we are always interested in articles like this one as we continue to advance together with our national client/partner base.

http://www.howdesign.com/design-business/design-management/how-to-be-a-good-manager/?utm_source=twitterfeed&utm_medium=linkedin

Feel free to call or email if you have comments or would like to learn more.

Jim Matthews
Principal; Nearterm Corporation
(281) 646-1330
jmatthews@nearterm.com

The Impact Of Healthcare Reform

I found this article insightful.

http://www.beckersasc.com/asc-turnarounds-ideas-to-improve-performance/how-will-obamas-re-election-impact-healthcare-4-asc-industry-leaders-respond.html

If you are a revenue cycle professional interested in specific impacts on revenue cycle performance or if you have thoughts about how it will impact your organization, let's talk. www.nearterm.com

EAST COAST HOSPITALS ARE PREPARED FOR THE STORM

At NEARTERM, we work hand in hand with provider organizations to help them "prepare for the storm" as we brace for the imminent changes that impact revenue cycle performance. We support our clients with expertise, human capital and thought leadership.

 

But this time, we salute our clients on the east coast as they prepare for a very different storm - HURRICANE SANDY. Here is a recent track;

 

http://www.cnn.com/2012/10/25/world/americas/tropical-weather-sandy/index.html?eref=mrss_igoogle_cnn

 

But after SANDY is long gone, keep us in mind as you prepare for that "other storm".

 

Jim Matthews

Principal; Nearterm Corporation

jmatthews@nearterm.com

HOW WILL REFORM IMPACT ME-AN EXERCISE TO HELP YOU FIND OUT

The media bombards us with spin on the impact of healthcare reform. I read through the following article as though I recently moved to America and had reason to better understand impacts on me personally. See what you think........ http://www.healthcare.gov/

If you read this publication and have thoughts or interpretations you would like to share, please weigh in. As a revenue cycle professional, I found this interesting and hope you will too. If you are a chief financial officer, revenue cycle director, revenue cycle consultant or otherwise involved with healthcare financial management, I submit that contemporary knowledge about changes that effect patient financial services is important.

Jim Matthews
Principal; Nearterm Corporation
www.nearterm.com

THE CUSTOMER IS NOT ALWAYS RIGHT

We often hear "the customer is always right" as a moniker supporting customer service training and related service management initiatives. Here is a modified version that I think makes more sense; "THE CUSTOMER IS NOT ALWAYS RIGHT BUT THE CUSTOMER IS ALWAYS THE CUSTOMER".

Our patients are not always right and we are not helping them by treating as if they are. Here are a few common examples:

"you have to take my insurance"
"you cannot deny service under any circumstance"
"you cannot come after me for payment as long as I am making payments"

There are many more examples. The point is we have an obligation to educate patients about patient financial services and that means tactfully addressing misunderstandings they may have. The best way to do that is by addressing them as the valued customers they are.

I could and may write a book on this topic but please feel free to contact me if you would like to contribute your ideas.

Affordable Care Act - Going right to the source......

We are constantly bombarded with opinions about contemporary issues. Often, we depend on the interpretations of others or "cliff's notes" in order to keep up with our changing environment. I thought you might find it interesting to see the actual ruling on ACA.....no wonder we rely on interpretations! http://www.supremecourt.gov/opinions/11pdf/11-393c3a2.pdf

Please call me if you can explain this in 100 words or less.

Jim Matthews
jmatthews@nearterm.com
(281) 646-1330

HFMA ANI - A great experience!

If you attended the ANI this year, I hope your experience was as rewarding as ours. And speaking of "rewarding", congratulations to Seth Bohrer of Dosher Memorial Hospital. Seth won an iPad at our event drawing!