Healthcare Business Management Association - HBMA
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September 17th Sessions September 17th Sessions - HBMA Healthcare Business Management Association


Life, Liberty, & Happiness
9/17/2020 at 1:00 PM – 2:00 PM ET

Glen Guyton, Speaker, Author, Advocate for Cultural Competency

The American Dream is the belief that anyone, regardless of where they were born or what class they were born into, can attain their version of success in a society where upward mobility is possible for everyone. It's time to move beyond the dream and do the work to be a more inclusive and equitable society and workplace.

At the end of this session, attendees will be able to:

  1. Become more aware by understanding why workplace diversity is beneficial.
  2. Improve business practices with tools to move beyond inclusive dreams to inclusive action.
  3. Prepare for succession by appreciating that diversity in itself impacts us all in diverse ways. 


Anatomy of a Healthcare Fraud Investigation-the OIG Perspective
9/17/2020 at 2:15 PM - 3:15 PM ET

Eric Rubenstein, MS, CFE, Director of Litigation Fraud, Waste and Abuse Support

This presentation will provide attendees with information on the variety of ways in which an OIG healthcare fraud investigation is initiated. The presentation will then provide a high-level overview of the life-cycle of the investigation, and include areas where compliance professionals (including compliance officers and billing and coding staff) can work in a proactive manner to ensure that billing, coding and professional relationships are conducted in a way that can mitigate an OIG healthcare fraud investigation.

At the end of this session, attendees will be able to:

  1. Engage in an interactive discussion of OIG case management and priorities as they relate to the published OIG Work Plan 
  2. Recognize proactive measures that can be taken internally to understand OIG investigations and navigate the complexities of the healthcare fraud investigative lifecycle
  3. Identify how OIG cases are initiated, why some issues are investigated (and why some are not) and where healthcare managers, compliance professionals and staff can work together to increase fraud, waste and abuse awareness through internal processes.


Bring Revenue Integrity Back to the Claims Process During COVID-19
9/17/2020 at 2:15 PM - 3:15 PM ET

Timothy Mills, Chief Growth Officer, Alpha II

Studies suggest that most providers see overall denial and rejection rates as high as 15-20 percent. During this compelling time in healthcare, the massive reduction in claim volume only magnifies the urgency of ensuring precise claims for maximum reimbursement. Now more than ever, practitioners are relying on the revenue brought in by accurate claim submission. But with increasingly limited and often overworked resources, a high percentage of those denied and rejected claims never get resubmitted, which results in lost revenue. In this session, Timothy will outline how to identify where claim errors originate within the revenue cycle workflow and the most common causes for claims denials/rejections with special focus on COVID-19 public health emergency (PHE) waivers and flexibilities. The importance of proactive workflow assessments for evaluating and implementing preventative maintenance – pre-visit, at the encounter level, when coding a patient visit, and post-adjudication follow-up – will be demonstrated. So what are your traditional denial management processes really costing your practice?

At the end of this session, attendees will be able to:

  1. Assess the rising costs of denied claims and industry trends in response to typical claim error origination within the overall revenue cycle workflow    
  2. Identify common causes of denials and claim rejections related to the COVID-19 PHE and what methods can help to avoid or eliminate those issues before they happen
  3. Apply a preemptive workflow assessment, a proactive approach to process improvement, along with technology to effectively prevent these types of errors from occurring


New Tools for a New Decade: Redefining RCM and Boosting Productivity
9/17/2020 at 4:00 PM - 5:00 PM ET

Kristin Callaway, CEO, Strategic Practice Solutions (SPS) and Matt Seefeld, EVP, MedEvolve

With a new decade upon us, revenue cycle management has become more complex, forcing healthcare organizations to look inward, and pay closer attention to their margins, and focus on what they can change and improve.    Smarter analytics and machine learning technologies are helping healthcare leaders gain the real-time, actionable insights they need to improve performance and drive change. Perhaps the most transformative technology of all is AI-powered workflow automation technology. When used correctly, workflow automation can transform every aspect of revenue cycle management — staffing levels, productivity, claims processing and more.  The result: a healthier, more robust bottom line.    In this presentation, Kristin Callaway, CEO of Strategic Practice Solutions (SPS) will discuss the need for healthcare businesses to explore smarter workflow automation technologies. SPS, a leader in medical billing consulting and services to specialist practices, will detail the ways workflow automation is helping SPS derive the analytics and reports needed to streamline billing and collections, boost staff productivity and raise profit margins for its clients. Callaway and co-presenter Matt Seefeld, VP of MedEvolve, will also discuss challenges that can arise during implementation of workflow automation technology — such as staff buy-in — and how billing companies and other healthcare businesses can overcome those.     Callaway will also address larger industry challenges healthcare businesses face in the 2020s — from the rise of consumer healthcare costs to finding and retaining skilled billing staff in general — and why smart workflow automation tools are essential, for productivity monitoring, ensuring staff members are in the right role and repurposing them if necessary. She’ll also answer question on how analytics-fueled technologies can support a proactive RCM strategy in a collaborative healthcare environment.

At the end of this session, attendees will be able to:

  1. Identify workflow challenges associated with under-performance among staff in one or more areas of billing and/or collections.     
  2. Analyze productivity gains through the use of AI-driven workflow automation tools, which can track performance in real time.     
  3. Utilize best practices in using workflow automation technologies to streamline operations, drive process improvement and boost financial performance.