Leading the Business of Healthcare
RCM Advisor

Quarter 2 2023 - Volume 28, ISSUE 2

Time to Celebrate

Special HBMA 30th Anniversary Section

By Madelon Berger, Editor

Congratulations to HBMA on celebrating thirty years! As with any fledgling business, HBMA had many bumps in the road through the early years. This was compounded by other factors that you will read about. We are fortunate that our past presidents contributed to this issue by writing about their experiences. Thank you to past President Bing Herald who wrote on behalf of the late past President Tim Maher.

We would not be here today if not for the tenacity and dedication of our past presidents, boards of directors, committee members, and other volunteers. Our management team has worked closely with membership to ensure growth and longevity. Thank you to Brad and your team at ISAM! There is no way to adequately thank all of our vendors for their ongoing support as well. Most importantly, we thank the membership for your continued support, attendance at conferences, and sustained membership. If you look at this issue’s SOUND OFF!, you will read consistently positive comments about HBMA. Keep in mind, you can only get out of an organization what you put into it. Think about joining a committee, attending conferences, and becoming more active. You will see a difference in your business success.

HBMA: The Beginning

By J. Dennis Mock (recognized as “The Father of HBMA”)

The past thirty years of memory about HBMA are preceded by the period of time that caused its beginning. Two seemingly-unconnected factors came together between 1989 and 1990.

Kathy Canny and I had, for a period of time, tried to bring third-party medical billers together to meet with various HMO payors. Our hope was that we could collectively bring about some serious communication on the ills of their industry. We quickly learned it was not difficult to bring them to the table individually, but getting two billers into the same room was next to impossible. When it did occur, little to nothing was shared about their HMO problems or their individual businesses.

At the same time, I was trying to purchase Errors and Omissions (E&O) insurance for my company and getting nowhere. It was clear that we were not recognized as an industry, let alone a cottage industry.

However, American Collectors Association (ACA) was facing the opposite of my challenge. They had extensive E&O for their members, and since it was the only place for ACA members to purchase it, ACA had significant purchasing power. The reverse was that they had members who had also become billers and who were using that insurance for their new venture. As a result, they launched a study to see what could be done. Ms. Sam Henry, ACA risk manger, began that process. When she had a grasp of how large the problem was, she went to John Johnson, Executive Director of ACA. Shortly thereafter, John went to Chicago and, thanks to Kathy, met with several billers. A meeting was then held at ACA headquarters and the International Billing Association (IBA) was born. It was to be a separate trade association administered by ACA. John assigned Bill Ryden, an ACA staff member, to oversee what was assumed to be its humble beginning. Bill and I agreed that the first formational meeting should be in Chicago. Thinking this would be of limited attendance, the small ballroom was booked at the Ambassador West Hotel.

Suddenly, the problem of billers not wanting to share and the perception of medical billing as a cottage industry disappeared. At best, the room was too small, as well over a hundred billers gathered at that meeting. We moved on to Phoenix, Arizona for our first annual meeting. We were overwhelmed with vendors and had a very successful meeting. At the same time, we began to see the challenges of our association with ACA.

It was a beginning with many challenges, and leaving the management of ACA did not end the problems for a growing trade association born out of a cottage industry where some of its members needed to learn to communicate and work with a competitor. Twenty years later, it is satisfying to look back, forgetting the challenges the saga took and remembering the friendships and successes that have been made.

HBMA: The Middle 10 Years

By Sherri Dumford, Former Director of External Affairs, ISAM, current member of HBMA

That old saying, “Time sure flies when you are having fun!” certainly applies to the last ten years at HBMA. It has been a period of great growth, fantastic development, and many exciting initiatives as the leadership of HBMA has guided us to where we are today. As I review the many accomplishments that have occurred during the last decade, I wanted to highlight a few of the significant developments that are the direct result of dozens of volunteers and hundreds of volunteer and management team man-hours.

One of the first areas of development that comes to mind is the development of a network of regulatory and legislative relationship forums to promote the interests of medical billing and to advocate on behalf of HBMA members. It is important to point out that this network was not something that was created overnight. It was a long, slow process that developed over many years of knocking on doors, presenting a true picture of the challenges facing our industry, striving to create genuine credibility, and being willing to serve as a resource. Now, this network has learned to turn to us when looking for a credible revenue cycle resource. We would be remiss if we did not thank Bill Finerfrock of Capitol Associates, who supported and continues to guide the association along this path. We have spent countless hours developing resources that go beyond the traditional “third party” medical billing professionals, which have caused us to grow and provide value for the billing managers in both large and small practices. Most recently, we have developed an Academic Membership category to serve those just entering the business.

Did your mother ever tell you to know and be kind to your neighbor? Well, we at HBMA have worked hard to know and be kind to our neighbors in this industry. We have developed many strong relationships with the leaders of related not-for-profit associations that face the same challenges as an association that we do. A few among those relationships are AAFP, AAPC, ACA, ACMCS, AHIMA, AHIP, AHRA, AMA, ACR, CAQH & CORE, Cooperative Exchange, HFMA, HCCA, HIMSS, MBP, MGMA, RBMA, and WEDI. I think we might have the alphabet covered here. The reason this is so important is because there is strength in numbers and being able to comfortably collaborate and work together on issues facing our industry is imperative. Among this group are CORE, the organization charged with developing the operating rules and elements of electronic claims processing, and WEDI, the Workgroup for Electronic Data Interchange. We are happy to be in a position to collaborate with these organizations to ensure meaningful representation from the professional component side of the house.

In a world where technology advancement continues at unprecedented speed, so goes the business of medical billing. HBMA has created ongoing meaningful education and forums to address the emerging technology that impacts our revenue cycles, and the association will continue to create relevant education to provide the roadmaps for your business to stay preeminent in these shifting business models. The education on demand that you see available today evolved from the first webinar program presented from a “mock studio” set up at a hotel some ten years ago. The advancement in the technology allows us to produce these programs at more frequent intervals and at a much less expensive cost!

Where we have succeeded in government relations, we have also forged ahead in the commercial payor community. Over the last ten years – and in particular, the last three or four – HBMA has made great strides in developing relationships with the major commercial payors, focusing on administrative simplification. We have ongoing regularly scheduled calls with several of the major payors and have created a web tool that is available to members to report significant issues regarding 5010, ICD-10, provider enrollment, and other topics.

Many other things come to mind, like the first annual report in 2007, our contributions to charitable organizations, the launching of a technology tool allowing our committees to manage communication and serve as a document repository, the development of a newsletter tool for members and the Employer Pages, affinity programs, the building of a strong regional and state community, the first “Hill” day that our members experienced on Capitol Hill last fall, the launching of many surveys, special edition publications, the Weekly Digest, a more robust certification program, an annual CMS day, and the list goes on. We have over a dozen standing committees and 150 active volunteers who contribute to the success of HBMA.

As I said above, “Wow, time flies when you are having fun!” And we have had a lot of fun building and developing HBMA over the past ten years. And now, as we face some of the biggest challenges and changes our industry has seen, HBMA leadership will continue to navigate the association through those waters. The organization deeply depends upon volunteers, so if you can make the time to give back to an organization that gives so much, and you want to have fun in the process, consider volunteering – the next ten years will fly by just as fast.

HBMA: The Last 10 Years

By Sara Nofziger-Drew, Chair, Membership Committee, HBMA Board Director, member of the Education Committee, Leadership Committee for Education, Government Relations Committee

Another 10 years has passed in what seems like the blink of an eye and HBMA is now celebrating 30 years in 2023! Throughout those years, HBMA has evolved step by step with the RCM industry, providing members access to education, resources, innovative solutions, and advocacy. One constant has been that our HBMA members volunteer countless hours of their time to bring valuable knowledge to our members, while directing our association on the path through transition and evolution.

HBMA has continued to build on the momentum of years past by collaborating with industry associations and by serving as a voice on legislative and regulatory changes, while nurturing our connections with CMS and commercial payors to provide valuable knowledge and feedback that impact the RCM industry.

Many have seen how important it is to have the big rocks in your Mason jar before adding smaller rocks, pebbles, sand, and finally water. HBMA has adjusted our foundation of big rocks to ensure that we can continue to evolve with the healthcare landscape and provide meaningful resources, education, collaboration, and advocacy for our members. Many of you may remember that HBMA changed our name from Healthcare Billing and Management Association to Healthcare Business Management Association. With this being the third evolution of our name, it gives HBMA the opportunity to define that our focus is greater than billing. Our beloved Billing journal evolved to RCM Advisor, complementing our association name change.

HBMA has been here to help our members ensure that they have the knowledge and tools needed to adapt and grow with the RCM industry. We have addressed some areas, but certainly not all over the last 10 years, including: Meaningful Use, QPP through MIPS, MACRA & MVPs, Business Intelligence Analytics & Reporting, CAQH Core operating rules for EFT/ERA mandates, cyber security, the Great Resignation, automation through Robotics Process Automation, (RPA), machine learning and Artificial Intelligence, and the elusive Administrative Simplification.

Perhaps the accepted daily ritual and reality of coding has allowed many to forget that we went through a huge change over the last 10 years from ICD-9 to ICD-10! Still smaller rocks may include changes to claim submissions, attachments, remittances, and appeals. Even statement processing and payments have evolved from paper statements and mailed checks to email, text delivery, and online bill pay through portals. Given that the patient is now referred to as the “new payor” with high deductible health plans, these may seem like significant changes rather than small pebbles to fill the jar.

Still fresh on our minds is the Coronavirus pandemic that started in 2020 and has changed lives forever, both professionally and personally. A multi-generational workforce transitioned to the new work from home (WFH) or remote work in days during March of 2020. HBMA was quick to evolve and adapt alongside our members, providing the latest information on the pandemic and Public Health Emergency (PHE) each week with written updates, remote learning, and networking opportunities, hearing directly from member companies on their actions and plans, providing continued support over the last three years, and even now as we prepare for the looming end of the PHE.

Why is HBMA priceless? It is easy to see, looking through past publication issues, that HBMA was talking about remote staff in 2014, preparing our members for the future of RCM, formerly referred to as “telework.” Identity theft, data breaches and cyber security were also hot topics around the same time. Members have seen since then that cyber and data security are critical to ensuring safety for our companies, their clients, and patients. Do you remember back to the days when distance learning was in a production studio broadcasting the live feed? Now, HBMA can provide educational webinars and networking opportunities multiple times a month, allowing members to ensure their entire company has the knowledge and education needed without leaving their desks. HBMA has offered resources for HR job boards, tools, and assessments, RFI Profile Tool, Company Compliance Accreditation, MIPS Calculator, Member Value Program, and so much more. We even have a weekly Newswire to ensure that you are keeping up with the industry.

However, one cannot pass over the No Surprises Act (NSA) which covers the alphabet soup of IDR, QPA, GFE, and so many more acronyms. Understanding and traversing the various state and federal NSA requirements has been a challenge for our members and HBMA is right in the middle of it, providing written updates, education, FAQs, and additional resources. Our Government Relations Committee works on the advocacy front through industry connections and written comments to CMS and Congress. Through our partnership with Capitol Associates, HBMA has recently started sending a weekly update, Capitol Insights, ensuring that you have the latest information each week on regulatory changes, along with Congressional updates relevant to the RCM industry.

There is one more significant item from the last ten years and HBMA didn’t do it once, but twice. HBMA selected a new management company starting 2014. At the time, HBMA’s desire was to propel forward in the industry with continued growth in membership, industry relationships, benefits, and tools for our members with a new partner. As years passed and with the lack of goals being achieved, HBMA was faced with making another change. HBMA is once again thriving under the guidance of our Executive Director Brad Lund and his team at ISAM. As RCM companies, we know clients come and go. It is when they return that one can reflect to see the excellent service, care, and professionalism left the door open to opportunity.

Through resilience, HBMA has continued to evolve within the healthcare industry. It seems each time we reflect on past years, our members wonder how they made it through. The answer most of them provide is because of HBMA.

Support our current HBMA leadership as existing relationships are strengthened, new ones built, and additional education and resources are provided to our members. Volunteers drive our association. Some give one hour a month, and some give countless hours. If you have one hour to give, please join our volunteer team, and make a difference in the RCM industry. When you look back from 2033, how will you have impacted HBMA?