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RCM Advisor

November - December 2018 - Volume 23, ISSUE 6

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Passionate Engagement for a Successful Future

President's Message

By Ginger Ryder, CMPE, CHBME, CPC, HBMA President

This has been a year I will never forget. The rescheduled HBMA 2018 Healthcare Revenue Cycle Conference in Charlotte was amazing, educational, and full of new and old friends. I hope you got the chance to say farewell and thank you to Andre Williams, our former executive director, at the fall conference.

HBMA News

News from Around the HBMA

By RCM Advisor Editors

Are You Maximizing Your HBMA Membership?; New HBMA Members; CHBME Quiz Questions

Commercial Payer Portals Survey Results

Commercial Payer Relations Committee Report

By RCM Advisor Editors

The Commercial Payer Relations (CPR) Committee’s mission is to be an advocate for our membership and industry by establishing meaningful relationships with payers through cooperative initiatives that strive to reduce costs and administrative burdens, and aid our membership in dealing with the increasing complexity of billing and reimbursement process.

4 Critical Trends for an Effective Patient Engagement Strategy

Eliminate the stress of patient collections.

By Chris Seib, Chief Technology Officer and Co-Founder, InstaMed

The healthcare industry is often compared to the technology and retail industries, where the bottom line is exclusively tied to a consumer’s choice. However, it should be acknowledged that healthcare is fundamentally different from most other industries.

Improving Efficiency and Security in Electronic Payment Enrollment

The ACA's requirement to use the ACH EFT standard saves time and resources.

By Contributed by the AMA

In order to propel the industry into efficient health insurance payments to providers, the Affordable Care Act (ACA) requires all health plans to send payments using the NACHA Automated Clearing House (ACH) electronic funds transfer (EFT) standard upon physician request. Compliance with this ACA mandate is enforceable under the Health Insurance Portability and Accountability Act (HIPAA).

Be a Better Communicator

How to set patient expectations and get paid.

By Deirdre Ruttle

The healthcare landscape is changing as patient responsibility continues to increase and providers are relying on patients—rather than only payers—for more of their revenue than ever before. Yet, in response, the healthcare payments experience has been slow to change.

Beyond the Exam Room

By Eric Arnson

By The increasing role of the patient financial experience in access to timely care.

Few physician practices or specialty providers have escaped the impact of high-deductible health plans (HDHPs), which now account for nearly 43 percent of all private health plans. Out-of-pocket maximum patient responsibility increased nearly 30 percent between 2015 and 2017, now averaging $4,400, putting greater financial strain on patients and providers alike.

Denied Claims Are Everyone's Business

7 tips to understand how to do better.

By Timothy Mills

Claim denials are the bane of every RCM company. That money is costly to chase through the maze of regulations, coding edits, and health plan particularities, and it can flummox even seasoned billing professionals.

Preparing and Selling Your RCM Business

Learn how a potential buyer looks at your company.

By Jeff Hillam

No matter why you’re selling your RCM business, you only get one shot to do it, so you have to maximize this unique opportunity. I have spent years building an RCM company by acquisition. In the process, I have reviewed several dozen billing companies, big and small, from California to Florida.

9 Fundamentals of Mobile Device Management

Studying how to control usage and data access on mobile devices is critical.

By Adnan Raja

Managing mobile devices is a particular challenge that has become increasingly important with the increase in mobile use. It’s been two years since mobile use first had the lion’s share of the traffic, with desktop browsing dropping to 48.7 percent per a prominent 2016 analysis (with tablets and mobile browsing representing 51.3 percent of traffic).

Still More Diagnosis Code Changes

Coding Corner

By Cindy C. Parman, CPC, CPC-H, RCC

The 2019 ICD-10-CM code set, which went into effect on Oct. 1, 2018, includes 279 new codes, revises 143 existing codes, and deactivates 51 codes. In addition, there are hundreds of typographical and grammatical corrections, changes to instructional notes, and updates to the coding and sequencing guidelines.

Leadership: What You Inspire

Leadership

By Michelle Durner, CHBME

Are you a leader? Henry Givray of Leadership’s Calling says that “Leadership is not something bestowed upon you or granted to you by virtue of your lofty title or set of responsibilities...

Arrays Part II

Software Talk

By Nate Moore, CPA, MBA, FACMPE

This article continues our discussion of arrays. It may help to review the last article in RCM Advisor to refresh your memory on arrays before tackling this article. Arrays can add a terrific amount of power and flexibility to Excel formulas, but they take practice to get used to the syntax.

There's a New Customer in Town: The Patient

From the Road

By Dave Jakielo, CHBME

In the past, our success as medical billing companies has been possible because of our relationships with various partners such as practice management software firms, statement vendors, clearinghouses, third-party payers, outsource vendors, and so on, to accept personal responsibility.

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