Healthcare Business Management Association - HBMA
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July - August 2013 •
Volume 18, Issue 4

The Halfway Point of the Year
President's Message
By Jud Neal, CHBME
I don't know about you, but the old cliché, "Where has all the time gone?" jumped into my head as I started to think about writing this article. It is so true when I say, "There is so much yet to do and so little time to get it done!" Click for more

Spotlight On! Request for Information Program
HBMA Launches a Free, Major Member Benefit: Access to New Business
By Brad Lund, Executive Director, HBMA
Every week, the National Office receives calls from providers looking for billing services. These providers are aggravated by the complexities of claims adjudication, irritated by a lack of payor responsiveness, and frustrated by their inability to manage their current billing processes. For some time, HBMA has offered a solution to these queries: the "Find a Biller" search engine on the website. Click for more

How to Perform a Physician Practice Internal Billing Audit
Published with permission of the American Medical Association (AMA)
Help Keep Your Clients on Track
An internal billing audit can help ensure appropriate payment and compliance with applicable laws. Auditing physician charges and billing practices is burdensome, but it will typically yield improved claims management processes, cash flow, and compliance with applicable laws and regulations. An annual audit allows physicians, practice staff, and the billing company to identify specific coding issues that may recur in similar claims submissions. Click for more

Productivity is Key to Financial Success
Help Your Clients Analyze Their Productivity
By Dixon Davis, MBA, MHSA, CPPM
The most important factor in achieving financial success in a practice is productive providers. Higher productivity directly results in greater revenue, and lower productivity the converse. Click for more

A Satisfied Customer is NOT the Same as a Loyal Customer!
Learn What It Takes to Keep Loyal Customers
By Jeff Tobe
Just as healthcare billing organizations experience turnover in their employee ranks, turnover occurs in their customer bases as well. The extent to which both occur has a significant influence on your bottom line. Click for more

High Commitment from Low Performers
Communication is Key
By Kevin Herring
Cindy started out okay. She made it through her six-month probationary period well enough to be put on the regular payroll, but then she started slipping. Sometimes she "forgot" to do things that were on her personal check sheet that she completed and sent to the next team. Other times, she did not seem to pay attention to what she was doing and fell way behind on her work. Click for more

Doing Business With Aetna Has Never Been Easier!
Learn About Aetna's Services and Where to Find Them!
By Aetna Staff Members
At Aetna, we are always looking for easy ways to work together. From our suite of electronic transactions to listing our policies on our website, we want to give you the tools and information you need so that you can focus on your business. Click for more

A Payor Tool Case Study for Emergency Department Services
When Out-of-Network Claims are Paid as In-Network
By Jeanne A. Gilreath, CHBME and the Commercial Payor Relations Committee
An HBMA member recently submitted 57 emergency department incidents for an evaluation of claims that were paid at in-network rates even though the group was non-par with those particular commercial payors. Medicaid also represented a small number of these claims. Click for more

Latest Trends and Best Practices for Collecting Healthcare Payments
Four Crucial Areas to Focus On
By Bill Marvin
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. Click for more

The Avoidable Failure to Act
Begin Planning an Exit Strategy Today
By Stephen Klein, CPA
"I haven't decided what I ultimately want to do with my business… or when I want to exit… or how much money I'll need… or whom to sell to. So how can I plan my exit? Besides, I don't want to exit right now." Click for more

Patient Collections at the Point of Care
A Golden Opportunity for Billing Companies
By Jim Bridges
Patient collections are an increasingly vexing problem for health care providers. From operations inefficiencies and fragmented systems integration to soaring bad debt and poor customer service, the collection, processing, and posting of patient payments is enough to make a provider's knees buckle. Click for more

Preview of 2014 Code Changes
Coding Corner
By Jackie Miller, RHIA, CCS-P, CPC, PCS
Even though you may be thinking about your summer vacation right now, it is not too early to begin preparing for the 2014 code changes. In this column, we will give you a preview of potential procedure and diagnosis code revisions for 2014. Click for more

ICD-10 and Implementation Challenges
ICD-10
By Valerie Fernandez, MBA, CPC, CPC-H, AHIMA ICD-10 Trainer
Almost every healthcare journal and online discussion forum contains information about ICD-10. CMS has offered a wealth of information related to providers, and hospital implementation webinars abound from various consultants around the nation offering their expertise related to ICD-10. Click for more

Summing Data in Excel
Unlock the hidden power of this often-used function
By Nate Moore, CPA, MBA, CMPE
Summing data is one of the most common tasks in Excel, and because adding rows and columns of numbers is so popular, Excel provides several ways to do it. This article will start with a basic sum formula, show a shortcut from the ribbon, and finish with a shortcut that sums numbers without even having to write a formula. Click for more

Meaningful Use Audit
Learn the Rules or You May Have to Pay Back the Money
By Ron Sterling
The EHR incentive pays eligible providers money for using an EHR in a meaningful way. CMS has a supporting audit process that verifies the attestation to Meaningful Use by eligible providers. Eligible providers who fail the audit may have to return their hard-earned EHR incentives. Click for more

What Type of "Active" are You?
From the Road
By Dave Jakielo, CHBME
In today's medical billing arena, you will find two types of companies. Those that are growing and taking their business to the next level have embraced a "proactive" approach. Others that continue to shrink may decide to remain in a "reactive" mode. Click for more

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