Healthcare Business Management Association - HBMA
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January - February 2013 •
Volume 18, Issue 1

Thank You, HBMA Community!
President's Message
By Jud Neal, CHBME
As I was thinking about writing my first message to our membership, I thought, "Wait a minute!" Before we go forward, I want to stop and say thank you to several people. After all, our association is a community of real people trying to do good things effectively, efficiently, and with integrity and quality. We have much to be thankful for. Click for more

SPOTLIGHT ON! The Technology Committee
Committee Profile
By Curt Cvikota, CHBME, Chair
In 2012, HBMA reorganized the Technology Committee. As committee chair, I was charged with developing a vision and mission that would be a relevant asset to HBMA's strategic vision and membership through education and outreach efforts. After numerous meetings and much discussion, we concluded that the Technology Committee should take a broader view and "look over the horizon," so to speak. Click for more

Pros and Cons of Charging a Percentage Versus a Flat Rate for Billing
By Billing Editors
PRO: This depends on client type. Growing clients should be billed a percentage, as your costs go up to support their growth.... Click for more

HBMA Profiles
By Billing Editors
As incoming HBMA president, I have been asked to write a short bio and discuss my goals for HBMA in the coming year. As you will see, much of my life and experiences have taken place within the confines of corporate America, but from my time as an Army Reserve OR scrub nurse to becoming HBMA board president, my career has had the common thread of focusing on helping others to achieve their goals. Click for more

Retaining Independence While Embracing Accountability
Care Coordination and Integration Strategies for Small Physician Practices (Part 2)
Published with permission of the American Medical Association (AMA)
Physicians throughout the country are trying to figure out the best way to achieve their professional goals in the changing healthcare delivery environment. Physician payments are increasingly being tied to quality and cost effectiveness over volume, and many of these changes place physicians at financial risk. In addition, public reporting of physicians' performance will now be the norm, rather than the exception, with Medicare's expansion of its Physician Compare website in 2013. Click for more

The Story Behind the Story
A Contrarian View of the Inevitable
By Robert Liles, Esq.
In September 2012, electronic health records (EHRs) had their 15 minutes of fame. First, the Center for Public Integrity published a paper showing that Medicare billings go up concomitant with providers switching to electronic health record (EHR) systems. This was followed by a similar front-page story in the New York Times and a subsequent editorial decrying this abuse by EHR users. The reaction to this story was swift and predictable. Click for more

Cooperative Exchange Launches Online Payer Survey
Offers health care payers quantitative means to measure "provider experience"
By Robert Liles, Esq.
DALLAS, TX (November 14, 2012) – Cooperative Exchange, the nation's recognized resource and representative of the clearinghouse industry, announced today a new online survey that provides a means for health care electronic data interchange (EDI) parties ("Users") to evaluate and monitor health care payers' capabilities. Payers will be able to use the results for benchmarking and quality improvement. Click for more

Conducting Business in the Cloud, Part 2
Best Practices to Ensure that Your Data Is Safe
By Chris Seib
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. The first article of this series highlighted some of these concerns, detailed best practices for transitioning to a private cloud, and offered tips to use in discussions with vendor partners. This article offers additional tips and best practices, with a focus on disaster recovery, business continuity, and security. Click for more

Where Your Clients Might Be Losing Money in Their Practices
By David Doyle
Feature Story
These are tough financial times for medical practices. Doctors are serving a greater number of patients, but at the same time, insurance reimbursement for medical care is being reduced. In addition to rising expenses, doctors have to deal with mountains of paperwork and must always keep compliance issues at the forefront in their practices. Click for more

Take Advantage of New Eligibility and Claim Status Enhancements!
AMA Perspective
Published with permission of the American Medical Association (AMA)
It is a new year, and beginning in January, health insurers must send robust information to physician practices and their billing partners that use the eligibility and claim status electronic transactions. When responding to these queries, health insurers must report the co-payment, remaining deductible, and co-insurance for each specific procedure or service... Click for more

Credibility Through Content
The Revival of Expertise and How to Leverage It
By Marc Oestrich
If you are in any business leadership or marketing role, then you are surely familiar with the infamous "Search Engine Optimization (SEO) gurus" of the world. They claim that – through a series of shady link trades, coding tomfoolery, and a lot of finger crossing – they can raise your digital profile for just a couple of burlap sacks of cash each month. Well, the shyster-era of SEO is mostly a thing of the past, and we are welcoming a new era: the era of expertise. Click for more

Management in Real Life
Why We Keep Hiring Paper Pushers
By Kevin Herring
Yes, it is true. We tend to hire paper pushers. Here are some reasons why. Click for more

The Medicare Learning Network®
Your Medicare Education and Information Resource!
By Billing Editors
Medicare providers and their billers often find themselves at a loss when it comes to keeping pace with the latest changes in Medicare policy. One place where you can have access to all Medicare educational information is The Medicare Learning Network® (MLN)... Click for more

Will Your Coding Model Stand?
Coding Corner
By Melody W. Mulaik, MSHS, RCC, PCS, CPC, CPC-H
There are two commonly found philosophies within HBMA when it comes to a billing company's role in coding. Usually, either a company embraces coding as a core function of their business model or they make it the responsibility of the client. Of course, there are variations on every model and some companies may even do a little of both, but as a rule, I am comfortable saying that most organizations fall into one of the two camps. Click for more

HIPAA Transaction Codes Processing Changes
Compliance Issues
By Robert Burleigh, CHBME
A compliance article about HIPAA transaction codes might seem a bit odd. In fact, it is! Fortunately, as it turns out, it also makes sense. Click for more

Conditional Formatting, Part 2
By Nate Moore, CPA, MBA, CMPE
Conditional formatting is a powerful tool built into Excel that allows you to automatically format cells based on their contents. The article in the November/December 2012 issue of Billing introduced the basics of conditional formatting. Now that you are familiar with the Highlight Cells rules and some of the formatting options available, take your Excel skills to the next level by working through these examples. Click for more

EHR Training Strategies and Issues
EHR Issues
By Ron Sterling
Most EHR vendors offer standard training programs that teach practices and billing services how to operate their products. However, these vendors often do not teach how to use the software comprehensively in a practice. For example, staff may learn how to enter a message, but managing messages and assigning work are just as much a part of the training strategy as learning how to send messages and update statuses. Click for more

The Medical Billing Industry is Changing. Are You?
From the Road
By Dave Jakielo, CHBME
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. Click for more

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