Welcome to the HBMA Public News area. The HBMA website includes a great deal of news and resources for our members as well as the general public in the area of health care. Please feel free to browse our public news and view samples of our Member
News areas, as well as samples of our monthly 'Billing'
The HIPAA Omnibus Rules, released in January 2013, dramatically
change the HIPAA Security and Privacy challenges for your third party
billing organization in a way that will affect how you serve your
clients and also redefines what constitutes quality services.
ICD-10 CM offers more detailed coding opportunities than ICD-9,
increasing the available codes from roughly 14,000 to approximately
72,000. Updates and advances in medicine and medical technology are more
appropriately documented in ICD-10 CM due to the increase in
Everest College, a provider of career-oriented diploma and degree programs at more than 100 campuses across the nation, recently announced an alliance with the most influential healthcare revenue cycle and management services association, HBMA (www.hbma.org). Under the agreement, HBMA will provide externship and placement opportunities within its large membership base for Everest's Medical Insurance, Billing, and Coding (MIBC) students and assist in the development of the school's MIBC curriculum.
The healthcare payments industry is growing and changing rapidly, and this change is influencing the way that many in the industry, including billing services and their clients, do business. Data from the 2012 Trends in Healthcare Payments Annual Report shows that as the healthcare payments industry evolves, billing services must take steps to accommodate these changes.
The HBMA Government Relations Committee has published a 'Government Relations Update' which includes updates on the following topics covered during the HBMA visit to CMS during the June 12-13 meeting in Baltimore and Washington D.C.
HBMA takes your concerns to the national stage
Just announced - Opening Keynote speaker for the HBMA 2013 Fall National Conference is Steve Rizzo!
According to the False Claims Act, fraudulent billing under Medicare includes, but is not limited to, billing for tests not performed, performing inappropriate or unnecessary procedures, upcoding by using more expensive billing codes when lower priced procedures were performed, and various other billing inflation practices. When billing, health care providers must remain vigilant of the ever-changing billing and coding laws and pertinent state regulations to ensure that they are not improperly submitting Medicare claims.
Data from the 2011 "Trends in Healthcare Payments" report shows that the use of payment plans for healthcare payments has doubled since 2009.
In the same report, 63 percent of surveyed patients said that they would utilize payment plans for their healthcare bills if given the option.
In testimony before the NCVHS Subcommittee on Standards, Holly Louie,
CHBME, Chair of HBMA’s ICD-10/5010 Committee (hbma.org) presented the
association’s views on “lessons learned” from the 5010
implementation and how those lessons can and should be applied to
avoid problems with ICD-10 implementation.
This month we'll feature updates on the Plan Finder, Limited
Income Newly Eligible Transition (LINET) program, and a presentation on
Medicaid eligibility and enrollment.
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.
This article, taken from the May/June 2013 issue of HBMA Billing, addresses key provisions of the Final Rule applicable to billing companies and their subcontractors, enforcement changes, and recommended action items needed for compliance by billing companies and their subcontractors.
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).
The stated purpose of the Final Rule is to both "strengthen the privacy and security protections" established under HIPAA and to "increase flexibility for and decrease burden on the regulated entities." The Final Rule amendments can be found in 45 Code Federal Regulations Parts 160 and 164. The amendments became effective on March 26, 2013 and will be enforced by the OCR beginning September 23, 2013.
The Final Rule implements most of the revisions to the Privacy and Security Rule of HIPAA that were proposed in the interim final rules published in 2009. It is expansive and this article will address just a few of the amendments affecting health care providers.
Focusing on building the resources to compete – especially a workforce culture of employees actively working to improve business results – should be at the top of the strategic plan.
The May/June 2013 issue of HBMA Billing
is now online. Click here
to read and be up to date on recent news in the medical billing industry.
Organizations are bustling with performance grading, self-reviews, rank ordering, goal setting, final performance evaluations, and merit pay raises, all in the name of managing performance. The amount of activity and anxiety the performance review process produces create stress for everyone involved. So what is all the fuss about?
An article by Ron Sterling taken from the March-April 2013 edition of HBMA Billing.
If We Resist Change In Our Business Models, We Will Crash. An article by Phil Ellis, taken from the March/April issue of HBMA Billing
In the January/February issue of HBMA Billing, members were asked to 'Sound Off' on how HBMA has benefited them.
All the information you need for the HBMA 2013Spring Educational Conference - sessions, speaker and vendor info, maps, alerts, and so much more. Be informed and get the most out of your conference education!
An article by Robert Burleigh, CHBME, from the January/February issue of HBMA Billing.
We have all heard the saying, "The
more things change, the more they stay the same." Well, that saying just
does not hold water any more. The medical billing industry is changing
more today than I have seen in my five decades in this business.
Meet Bob Woodward at the meet-and-greet session during the HBMA Spring Conference on Wednesday, April 17th.
An article by David Doyle from the January/February issue of HBMA Billing.
As more management companies and medical practices transition their electronic records to private clouds, they risk long-term data outages and other crippling failures that may pose significant threats to their bottom lines.
Ober | Kaler, Attorneys at Law, provides information on keeping your mobile devices compliant and safeguarding Patient Health Information (PHI)
An article by Marc Oestrich published in the November/December 2012 issue of HBMA 'Billing'.
Every small business owner should use one tax shelter every
year. It may mean the difference between retiring comfortably and not
retiring at all: a Section 408 trust.
An article by Chris Seib, taken from the November/December 2012 issue of HBMA Billing. www.hbma.org/billing
Check out the latest issue of HBMA Billing for November/December 2012.
Over the past few weeks, HBMA has engaged in various discussions with you and others about the state of 5010 readiness within the industry.
Deep within the Affordable Care Act (ACA) are technical provisions that most of the press have ignored. They are directed squarely at the administrative burden faced by providers in the reimbursement process.
CHBME certification renewal time. Please visit your 'My CHBME' page and review your credits.
An article by Marc Oestreich from the September/October issue of HBMA Billing.
The latest trends in the healthcare industry are driving change in the payments process for billing services. These include the rise of consumerism, increasing pressure on administrative costs, and ongoing reform mandates. In order to maximize performance for their clients in this evolving environment, billing services must be aware of how the industry is changing, acutely understand the challenges, and focus on specific areas of their services and solutions to improve performance and ultimately succeed and thrive in this new climate.
An article by Connie S. Ditto, Esq., taken from the September/October issue of HBMA Billing.
Going to the HBMA 2012 Fall Conference? Click here to get information about downloading the HBMA Fall Conference Mobile App! Maps, schedules and communications will help you keep on top of the meeting events.
The United States lacks a culture of organizational
innovation in health care. As we begin to implement the new health care law,
there's a lot we can do to change that.
Business is where you make your money
and home is where you have your family and want to retire. This final
installment of my series will concentrate on ensuring that you protect
your personal residence and provide for your retirement. This will not
be your standard retirement advisor's pep talk.
If I ask you not to think about pink elephants, what will you think about? Be honest! You're thinking about pink elephants! But why would you, when I asked you not to?
Share HBMA news and events with your friends and contacts on social media websites.
HBMA hosted the Former Speaker of the House of Representatives and 2012 Presidential
Candidate, the Honorable Newt Gingrich, at the HBMA 2012 Fall Conference.
In the flurry of activities associated with EHRs, ICD-10, and
other healthcare industry challenges, many organizations have not
maintained proper attention to evolving HIPAA Security and Privacy
issues. Of particular importance to your billing service are changes to
HIPAA Security and Privacy that were included in the HITECH Act, making
Business Associates responsible for liability and remedy of HIPAA
Privacy and Security issues. Penalties for these breaches have been
increased to a maximum of $1.5 Million.
An article by Bill Marvin taken from the July/August issue of HBMA Billing
The HBMA Government Relations Committee has published a 'Government Relations Update' which is now posted on the HBMA website (www.hbma.org).
An article by Mark R. Anderson, CPHIMS, FHIMSS, taken from the May/June 2012 issue of HBMA Billing.
Tips on how to stay on top of your medical bills and determine and fix errors in medical billing charges.
FREE Audiocast for HBMA members on the Supreme Court decision on Healthcare Reform. Join Bill Finerfrock, HBMA Director of Government Affairs for this important overview of what the Supreme Court decision means to our industy.
In addition to the functional capabilities of any EHR options
that you may be considering for your billing service, you need to verify
the technical design of the EHR to ensure that not only will your
clients be able to manage workflow and chart patient notes, but that
their information will also be protected and managed within the EHR.
View post conference and post event pictures here!
The Department of Health and Human Services recently announced its intent to push back the October 1, 2013 ICD-10 compliance deadline for certain health care entities. The new proposed date is October 1, 2014. Based on what the industry has learned from the transition to 5010, we all know that it is never too early to start preparing!
An article by Patick Newcombe, CFP, from the May/June issue of HBMA Billing
The sweep of consumerism in healthcare has brought changes to
the healthcare payments process, driving billing services to evaluate
their collection tactics. While providers previously relied almost
exclusively on payer payments for their revenue, patient responsibility
payments are now an increasingly important provider revenue source.
Billing services must increase their focus on collecting from patients.
A thank you to all contributors that participated in helping HBMA prepare comments that were
distributed to CMS on behalf of the members of HBMA.
For a wide range of reasons, many hospitals are actively
promoting EHR products to their medical staff physicians. In some cases,
hospitals offer specific products that they support and host.
Alternatively, some hospitals promote one or more selected EHR tools on a
preferred EHR vendor list.
One experienced, highly efficient data entry person can post approximately 4,000 remittances per month. Automating the process easily increases that same person's output by 300%.
Navigating through the lists of
Medicare contractors can seem overwhelming. QIO, MACs, FIs, RAs, CERT,
ZPICs? As healthcare professionals, we need to understand the roles and
objectives of these contractors and how they affect our practices.
This article sets the record straight on a
very specific aspect of the HIPAA Security Final Rule: the Data Backup
and Disaster Recovery Specifications within the contingency plan
standards. We separate myth from reality about what exactly is required
of whom and by what dates Covered Entities (CEs) and Business Associates
(BAs) must comply with these specifications.
The Spring Conference mobile app has been created for attendees of
the HBMA 2012 Spring Educational Conference. This is available for
smart phones and tablets and will allow
you to have all the Spring Conference information right at your hands.
An article by Steven Peltz from the Jan/Feb 2012 issue of HBMA Billing.
If a practice is contracted as a participating provider with commercial
insurers and networks, it must pay close attention to the patient "Hold
Harmless" sections of the agreements.
The upcoming ICD-10 start date of October 1, 2013 creates a critical
path that can affect the EHR strategy and plans of you and your
Dave Jakielo, CHBME and past president of HBMA, gives his healthcare predictions for 2012. Taken from the January/February issue of HBMA 'Billing'.
The Congressional Management Foundation (CMF) is a non-profit
organization based in Washington, DC that works with congressional
offices to make them more efficient and responsive to constituent
requests. According to CMF's most recent survey, over 95 percent of
congressional offices identified personal communications from
constituents as the single most important factor influencing the
members' views on an issue. Personal visits are at the top of the list,
but written letters or emails are not far behind.
With skyrocketing costs and declining payer
reimbursements, practices are struggling to find ways to increase – or just
maintain – the bottom line. Practices can improve their revenues through an
aggressive payer contracting strategy. How?
OIG posts a new video and an audio podcast, “Tips
for Implementing an Effective Compliance Program,” the seventh of 11 HEAT
Provider Compliance Training video and audio presentations on top health care
How much information can a biller leave on an answering
machine when calling for address or insurance updates? Check out our 'Compliance FAQs' for more information
Another year has quickly flown by and it is already time to prepare for 2012. In today's environment, it is impossible to predict exactly what is going to happen in the world of physician reimbursement. One thing we know for sure, change is constant.
Patient portals provide cost effective tools to interact with patients on a wide range of
administrative, billing, and scheduling issues at lower costs for your organization. They offer an added value benefit to your clients.
Over the coming months and years, CMS's Medicare Administrative Contractors
will begin to request that practitioners revalidate their Medicare
provider enrollment information. Between now and April 2012, CMS will
continue to improve internet-based PECOS to make it easier for the
providers to update their information and submit their revalidation
Be Proactive: Prepare Now for 5010 Data Reporting Changes!
If you use the current version of the HIPAA electronic
administrative transactions, such as checking a patient's eligibility,
filing a claim, or receiving a remittance advice, you are required by
federal regulation to use the updated version of these transactions,
version 005010 (5010), by Jan. 1, 2012. There are data reporting changes
in these transactions that will impact the data that you send and
receive. It is important for you to make these changes and test
the 5010 transactions to be certain that they will process correctly on
Jan. 1, 2012. Be prepared for the 5010 transactions to avoid claim rejections and interrupted cash flow.