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

AHIMA 2014 Convention - iPad Winner

Nearterm would like to congratulate our iPad winner Diane Brooks, Compliance Auditor/Educator at Central California Faculty Medical Group.

Diane was shocked and super excited. She said she did not own an iPad and had been looking at getting one. She also said she had never won anything at the shows before so this made an impact with her.

Congratulations Diane!

Nearterm at the AHIMA 2014

Thank you to everyone who came to the Nearterm booth at the AHIMA 2014 in San Diego. You made our show a great success.

OUTSOURCE HOSPITAL CODING OVERSEAS?

IMPORTANT CONSIDERATIONS RELATED TO OVERSEAS CODING OUTSOURCE PLANS


AHIMA published this article recently. It provides practical insight for your consideration when contemplating outsourcing hospital coding overseas. Here is a link; http://library.ahima.org/xpedio/groups/public/documents/ahima/bok1_050329.hcsp?dDocName=bok1_050329
Most industries depend on foreign resources either directly or indirectly. Healthcare is no different. Many facilities are outsourcing coding and other functions overseas. However, most HIM Leaders we have talked with about outsourcing coding overseas are reticent about it for a variety of reasons. If you are an HIM decision maker, we would welcome your opinion on this topic.

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