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September - October 2013 •
Volume 18, Issue 5
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My Vision(s) for HBMA
President's Message
By Jud Neal, CHBME
Many of us have visions and vision statements, although if they are truly vision statements, they do not have to be on the wall to read. They are what we see and, therefore, we can recite them from memory. This is true for me.
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Everest College Announces Partnership with HBMA
HBMA Benefit
By Sherri Dumford, HBMA Director of Operations
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...
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Sound Off!
Tell us how you are preparing for ICD-10 (internally and with clients)
By Billing Editors
Our coders have received intensive ICD-10 training from the AAPC. We are conducting client outreach and education, and are determining payor testing timeframes and parameters....
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2013 Fall Annual Conference Program Preview
THE IDEAS YOU GLEAN FROM SPEAKERS WILL HELP YOU GROW YOUR BUSINESS. YOU CAN BET ON IT!
By Billing Editors
The Healthcare Billing and Management Association is holding our Fall Annual Conference at Caesars Palace in Las Vegas, Nevada from September 18-20. Join us for two and a half days of educational sessions, legislative insights, and networking opportunities. This event is specifically designed to confront the challenges facing third-party medical billers, as well as to address the unique needs of healthcare providers who manage their own billing.
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Win-Win
Achieve Incentives and Report Compliantly with Four CMS Quality Initiatives
By Missy Lovell, BSN, RN, MBA
As physicians continue to accurately report their data, compliantly file claims, and achieve success and incentives, it is important that they become aware of the measures and requirements surrounding CMS quality initiatives for 2013 and beyond.
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Patient Payments 101: Analyze, Implement, Collect
Impress Your Clients with Increased Patient Collections
By Cheryl Gundry, CPA, CHBME and Megan Reymann
In this challenging economic climate with increasing out-of-pocket patient responsibility, it is more important than ever that billing companies and healthcare providers collaborate for an engaged strategy of collecting patient balances. Through tried and true efforts, our billing team has worked hard at tackling the problem of lost patient revenue, and we have discovered great results!
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Are You Ready for the ACA-Driven Patient Influx?
Help Your Clients Prepare for More Patients
By David Doyle
As the health insurance mandate provision of the Patient Protection and Affordable Care Act (PPACA) takes effect next year, it is estimated that more than 20 million Americans1 will be newly enrolled in health insurance plans – some for the first time in their lives. These Americans will be looking to take advantage of their new benefits by seeking primary healthcare services.
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Receive Payments Quickly Through Standard Electronic Payments
Electronic claims payments can boost cash flow and increase efficiencies
Published with permission of the American Medical Association (AMA)
Change is coming soon to health plans' claims payment processing. Beginning January 2014, all health plans must be able to make claims payments to physicians and other health care providers using the newly-designated healthcare electronic funds transfer (EFT) standard under the Patient Protection and Affordable Care Act (PPACA). In addition, Medicare will soon reimburse physician practices' claims solely through the use of the healthcare EFT standard.
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Reporting Prolonged Services
Coding Corner
By Jackie Miller, RHIA, CCS-P, CPC, PCS
Most of the CPT® codes for evaluation and management (E/M) services have a "typical" service time associated with them. The CPT manual states that "the specific times expressed in the visit code descriptors are averages and, therefore, represent a range of times that may be higher or lower depending on actual clinical circumstances."
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ICD-10 CM and Structural Changes
ICD-10
By Valerie Fernandez, MBA, CPC, CPC-H, AHIMA ICD-10 Trainer
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 specificity.
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Calculating Weekdays in Excel
Software
By Nate Moore, CPA, MBA, CMPE
Medical billing companies store a wide variety of data that can really help the practices they support. In this article, we will look at how dates of service or other dates in a billing system can be converted to weekdays so that medical practices can analyze things like weekend call premiums or productivity by day of the week. Here are two ways to show whether or not a given date is a weekday or a weekend.
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The HHS Omnibus Rule
Compliance Issues
By Dorothy Henslee, CHBME
In the May/June 2013 issue of Billing, we were privileged to have two attorneys share their knowledge regarding the HIPAA Final Ruling – both articles were informative recaps of the new HIPAA regulations. In this article, I will be exploring the changes of the Security Rule from a business associate's (BA's) viewpoint.
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HIPAA Omnibus Challenges for Third Party Billers
EHR Issues
By Ron Sterling
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.
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Best Practices from Around the Country
From the Road
By Dave Jakielo, CHBME
What I like most about my vocation of helping billing companies improve their operations and grow their businesses is that I get to meet so many great people who work in this industry from all around the country.
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