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January - February 2012 •
Volume 17, Issue 1

The Difference
Message from the President
By Don Rodden, CPA, CHBME
It is an honor and pleasure to begin serving as HBMA's president for 2012! Thank you for the privilege. Click for more

Interview with HBMA's Director of Education
Billing Editors
In Billing, we have described the roles of committees. Beginning with this issue, we will find out more about ISAM staff. Paul Myers, Director of Education, has agreed to be the first interviewee in this series. Click for more

Pros and Cons of Charging Set-Up Fees
Billing Editors
HBMA Members sound off on hot topics in the billing industry. Click for more

Interview with: President Don Rodden
Face-to-Face with HBMA's Newest President
Billing Editors
The Publications Committee held a face-to-face meeting at the Fall Annual Conference in September. During our discussion, we spoke about conducting an interview with HBMA's incoming President, Don Rodden, CHBME. Don was receptive to our request and graciously provided responses to the questions presented to him (questions, courtesy of Tyler Olson, Alec Raatz and Frank Cabrera – Hinsdale South High School, Darien, IL). Click for more

Competition: What You Don't Know Can Hurt You
Feature Story
By Angelo J. Devita, MPH, Healthcare Administrative Partners
Americans love competition. From the time we are very young, virtually everything we do is colored by competing with others. We compete for grades in school, college admissions, sports, games, mates, jobs, and on and on. Click for more

Communicating with Congress
More Important Now than Ever Before!
By Bill Finerfrock, Washington Representative, HBMA
"Why should I write? They never listen." "My one voice can't make a difference; it's a waste of time." I cannot tell you how many times I have heard those words or something similar over the past 30+ years that I have worked in or with the United States Congress and federal agencies. The fact of the matter is that those meetings, letters, and phone calls do make a difference. Click for more

Your Living Trust: Does it Work?
Feature Article
By Lee R. Phillips, JD, US Supreme Court Counselor
The previous article in this series talked about the four elements of your personal foundation: the will, living trust, durable power of attorney, and living will. The living trust is the centerpiece of your personal plan, and this article will give you more detail on this vital element of your financial stability. Unfortunately, the vast majority of people who have a living trust never get much benefit from it, and after spending the big bucks up front for the trust, it doesn't do them any good. Click for more

A Paperless New Year Through the Use of Electronic Claims Processing
AMA Perspective
Published with permission of the American Medical Association (AMA)
Billing companies can share the following information with their clients about free resources from the AMA to help physician practices streamline their claims processing through the use of electronic health care transactions. Click for more

A Reminder
Opportunities to Expand and Keep Your Business
By Steven Peltz
As a medical practice consultant, one the first areas of a medical practice that I evaluate is the billing department or billing company of a practice that has hired me. In my capacity as the president-elect of the National Society of Certified Healthcare Business Consultants (NSCHBC), I have had informal discussions with HBMA President Don Rodden, CHBME, about the consulting services that billing companies provide to practices, sometimes without understanding how important their role is to the practice. Click for more

CMS Releases New CCI Manual
Coding Corner
By Jackie Miller, RHIA, CCS-P, CPC, PCS
Everyone involved in medical billing is painfully aware of Medicare's Correct Coding Initiative (CCI) edits. The edits, instituted by CMS in 1996, are designed to rebundle pairs of procedures that providers should not have billed separately. Many of the edits can be bypassed by applying a modifier to the lower-valued code to show that it is separate and distinct from the higher-valued code; for example, by declaring that it was performed during a separate encounter or on a different part of the body. The challenge for billing professionals is figuring out what makes two services separate and distinct. Click for more

Software Issues – Excel
By Nate Moore, CPA, MBA, CMPE
If you're ready to take your Excel skills up a notch, IF is a great function to start with. The IF function has three parts... Click for more

What to Do When Services are Not Paid by a Commercial Payer
By Penny Noyes
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. Many agreements prohibit billing the patient for services that are unpaid due to the insolvency of a payer (which may be the insurer or a self-funded employer), when the payer deems a service not medically necessary, for lack of compliance with utilization programs, or for failure to file a claim in a timely manner... Click for more

Planning for Operational Compliance in 2012
Compliance Issues
By Holly Louie, RN, CHBME, PCS
With the myriad challenges and opportunities facing billing companies, how do you allocate resources when the same body must do the work on multiple fronts? What issues are already live and what issues are fast approaching? Click for more

The EHR and ICD-10 Connection
EHR Issues
By Ron Sterling
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 clients. Click for more

CHBME Quiz Questions
Read Billing; Earn CEUs!
Billing Editors
You can now earn 0.5 credits towards your CHBME by answering quiz questions in each issue of Billing. Click for more

Predictions for 2012 and Beyond
From the Road
By Dave Jakielo, CHBME
My business of speaking and consulting usually has me on an airplane at least every other week. The downside is the unpredictability of airline schedules; it seems that a flight's posted departure time is just a suggestion – not a commitment from the airlines. Click for more

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