Leading the Business of Healthcare
RCM Advisor

Quarter 2 2023 - Volume 28, ISSUE 2

Key HBMA Meetings and Their Purposes

Special HBMA 30th Anniversary Section

By RCM Advisor Editors

The Annual Conference

By Sarah Tolson, Chair, Education Committee

The Education Committee is so excited about HBMA’s 2023 Fall Conference! The annual conference is an opportunity to provide members and attendees with relevant and valuable educational content as well as opportunities to network and share ideas with peers. Those of us on the Education Committee have been hard at work crafting an agenda with content not only for business owners and executives, but one that is relevant for managers as well.

We identify the educational topics that will be presented at the annual conference by combing through and analyzing feedback from HBMA’s membership and attendees of prior conferences. This allows HBMA to provide the most sought-after and relevant content to our membership. After determining the list of topics, HBMA invites industry experts to submit proposals for conference sessions. Additionally, the Education Committee invites known industry experts to submit proposals for sessions addressing the topics requested by membership.

As the conference session proposals roll in, the Education Committee gets to work reviewing each submission to identify those with the highest quality content and the most engaging and knowledgeable presenters. Already this year, the Education Committee has spent countless hours reviewing speaker reels and bios, reading session proposals, and vetting speakers to ensure the sessions at this year’s annual conference are engaging and will bring value to the HBMA membership.

We have all been to conferences that schedule a session after lunch which makes it hard to stay awake. The Education Committee takes special care when producing the schedule for the conference, making every effort to keep attendees engaged from the first session to the last. We’re looking forward to the 2023 Fall Conference and can’t wait to see you there!  

HBMA’s Compliance Course

Focus on Compliance Today and Yesterday for the RCM Industry  

By Holly Louie, RN

HBMA was involved with the initial expectations for corporate compliance programs before the OIG published the Compliance Program Guidance for Third-Party Medical Billing Companies (63 Fed. Reg. 70138; December 18, 1998). A small group of HBMA leaders worked with the Office of Inspector General (OIG) on that guidance. The key win was a modification of a draft requirement to report any client with known errors or patterns of wrongdoing to the government. HBMA convinced the OIG that other viable options existed, such as terminating the client or working with them to correct the issues.

The first HBMA Compliance Course was held in Atlanta, Georgia in 1999. Presenters included Susan Lemanski, OIG, and other government agents. Attorney-led compliance education continued until 2000-2002 when HBMA President, Vic Glorioso chose compliance expert faculty from membership to develop the curriculum for what became HBMA’s unique, in the trenches, compliance course focused solely on RCM issues and risks.

Over the intervening 25 years, the course has included speakers from CMS compliance and fraud and abuse programs, US attorneys, fraud and abuse investigators, forensic accountants, healthcare and white-collar attorneys, and a core faculty of HBMA experts.

To say compliance today is nothing like it was in 1998 is an understatement. Yes, the seven (eight) elements of effective compliance programs still exist. However, changes, modifications, updates, new guidance, ever-growing expectations, new risks that occur almost daily, and new ways of thinking about our compliance programs are an ever-changing reality. Fortunately, the focus on data analytics fits one of HBMA members’ greatest strengths; we have data galore that we can use in improving our programs. The current effectiveness focus on leadership and managers provides a clear roadmap to choosing the right people and holding them accountable. The expectation that we all “teach our employees to think” means we have a  full compliance team,  regardless of the size of the company.

For those members who could use a little more help, the OIG and Department of Justice (DOJ) have provided extensive information on compliance program elements and how to measure effectiveness for everyone. The beauty of these tools is that you can customize them for your company. There is not now and has never been a “check the box” template and call it done.  Our companies are unique and so is your effective compliance program.

At this year’s compliance conference, session speakers and topics included compliance program oversight and leadership using current effectiveness expectations, new and emerging HIPAA risks, cyber insurance requirements, and cyber risks, (including real-time sharing of how my old email from an MGM cloud hack looks on the “dark web”), conducting today’s risk assessments, the No Surprises Act, HBMA Government Relations update, coding compliance for RCM companies (even if you don’t code), multiple mini compliance risk topics, contracts and business associates, and an interactive discussion with attendees on hot topics. ChatGPT was clearly a hot button for most attendees. Information was so current that faculty provided several significant updates to topics in real-time - as they were published during the conference.

Speaking on behalf of myself and my fellow faculty this year, we loved the networking among and with our attendees. Attendees are also invited to contact us after the conference if they have questions or need a little help. Even more exciting is HBMA exploring the options for an attendee faculty message forum to continue networking and discussion.

We are already looking forward to the next HBMA Compliance Conference and hope to see you there!

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The Owner’s & Managers Conference

By Dave Jakielo and Bob Burleigh

For the past two and a half decades, one of the premier educational offerings by the Healthcare Business Management Association (HBMA) has been the Owners and Managers Conference (O&M). The conference was the 1995 brainchild of Bob Burleigh, CHBME, Chris Kellogg, and then board member Dan Smith. In 1997, Dave Jakielo replaced Chris as a permanent member of the faculty.

The concept was to create and construct an educational conference in a workshop format for owners and managers of medical billing companies. Prior to the O&M, nothing existed that was aimed at helping industry leaders take their companies to the next level.

Most owners felt as though they were the only ones facing the issues that confronted them, as well as not having a venue where they could discover the industry’s innovations, trends, and best practices. The O&M brought together HBMA members with a shared goal of exponentially bettering their companies.

In the early years of the O&M, attendees were reluctant to share with others because they thought that their respective companies had all the secrets on how to run a successful medical billing company! In fact, they didn’t know what they didn’t know.

However, what everyone found out was that many faced the same internal and external issues and that the marketplace was so big that every company seemed to have carved out their own niche. It wasn’t so much that they were competitors; rather, what they realized was that they were all in the same boat and had the same goals – to improve productivity, profitability, and maintain growth.

Bob, Chris, and Dave were instrumental in helping the attendees achieve their objectives because the curriculum was designed with their goals in mind. The faculty was able to develop programs that were very beneficial because of their experience as medical billing company executives and industry consultants and advisors. Their experience was gained by working with hundreds of individual billing companies, as well as having previous experience running their own companies.

The conferences have been conducted either once, twice, or three times a year around the country and 80 percent of the curriculum provides new material each year. Some topics were just too good to drop, like Bob’s Key Performance Indicator (KPI) & Benchmarks session, which has grown to cover more areas and is updated annually, addressing new and improved technology that has penetrated the industry.

The programs became so valuable that many of the attendees return every year or every other year. Every audience has at least a few attendees who have participated in the O&M for 10 years or more. Each conference is educational and informative, containing sessions related to the latest industry trends, emerging technology, federal rules and regulations, legislative updates, compliance, ideas to improve sales and marketing efforts, staff and leadership development, and much more.

The conference is intentionally limited to 55 attendees because a crucial benefit to all attendees, besides the educational content, includes the multiple networking receptions where you meet and form relationships with other owners and managers from around the country. Some of our attendees who met over 20 years ago are still great friends.  

Reflecting back over the years, we have presented 130 topics to over 1,000 attendees. Nothing has been more gratifying to the faculty than reading over the evaluations that tell us how our programs have helped them to become more successful owners, with higher profitability, and who remain compliant in this ever-changing industry.