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

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