GEORGIA SCROLL president’s message T SUSAN CLARK the future through people by training new individuals to become the leaders of tomorrow. ime sure passes quickly. It seems like just yesterday I was attending my first Georgia HFMA Institute in Hilton Head and now I have become Chapter President. Connecting through Process—Connecting people with information will enable us to work more efficiently and to develop new processes and modify existing ones. Connecting through Technology—People and processes connect through technology. Disseminating information, testing, and recording are vital to healthcare finance. We need to continue to learn and embrace new technology to move us into the future. As I am writing this, I keep thinking of the words to a song by Trace Adkins: You’re gonna miss this. You’re gonna want this back. You’re gonna wish these days hadn’t gone by so fast. These are some good times, so take a good look around. You may not know it now. But you’re gonna miss this. 1 Through People, Processes, and Technology we can “Connect the Future” of Healthcare Finance and the Georgia Chapter of HFMA. As members, I challenge you to continue to learn and to train those who are coming after you. I challenge you if you are not already involved in TEAMS to get involved. The connections that you make will be useful not only in your jobs but also can lead to lasting friendships. Don’t miss the opportunity! Make sure that you do not miss an opportunity this year. The National Chairman’s theme for 2008-09 is “Making Connections”. I challenge you to “Make Connections” during the next year and Connect through People, Processes, and Technology. Susan Clark Connecting through People—Healthcare is a business of people—patients, doctors, administrators, nurses, finance personnel. Learning from those who have come before us will help prepare us for the future. Connect 1 Trace Adkins - You’re Gonna Miss This Lyrics, http://www.lyricscafe.com/hits/song.php?grid=8&id=1015693. Accessed 6/23/08. mission statement scroll deadlines Issue: Fall 2008 Winter 2009 Spring 2009 To provide informative articles that promote the well-being and educational enhancement of the healthcare professional and the community. GA Chapter HFMA • www.georgiahfma.org 1 Deadline: September 5, 2008 November 17, 2008 March 6, 2009 Summer 2008 GEORGIA SCROLL 2008 - 2009 officers and board President • Susan Clark, CPA, FHFMA President-Elect • Carmen V. Sessoms, FHFMA Program Chairperson • Bill Eikost Treasurer • Karen Newton Secretary • Cynamin Kinard Immediate Past President • Teresa Singley GHA Designee • Robert Bolden, FHFMA 2nd Year Board Members Frank Powell Kay Stanley Roxann Arnold 1st Year Board Members Jane Gray, CPA, FABC, FACHE Jerry Mahrenholz Pat Tewalt Donna Casey Scroll Committee Kimberly Farmer, Editor Alan Cobb, Co-editor Editorial Policy: Opinions expressed in articles or features are those of the author(s) and do not necessarily reflect the view of the Georgia Chapter, the Healthcare Financial Management Association, or the Scroll Committee. Questions regarding articles or features should be addressed to the author(s). The Healthcare Financial Management Association and the Scroll Committee assume no responsibility for the accuracy or content of any articles or features published in The Georgia Scroll. We also reserve the right to edit all submitted articles. The Scroll Committee reserves the right to accept or reject contributions whether solicited or not. All correspondence is assumed to be a release for publication unless otherwise indicated. All article submissions should be forwarded via e-mail (MS Word Document) to Jane Gray at: [email protected]. HFMA Webpage: www.georgiahfma.org COMMUNICATION COUNCIL: Jane Gray Greg Smith Tracey Frederick Eric Bergeon Maria Hallman Kimberly Hackler Kimberly Farmer Alan Cobb Steve Rothchild Lynnette Lytle Sam Thrower Julie Kraemer Julianne Dreon Russell Moore Paul Kearns Mark Kopplemann EDUCATION COUNCIL: Bill Eikost Janelle Padgett Lisa Kimberly Lisa Williams Marianne Wilkie Fred Amtower Thom Kisner Karla Goodson Joshua Livingston Dave Blankenship Amy Harrison Alice Childs John Iodice Jamie Barwick Matt Wallace Chuck Martin Robb Robinson GA Chapter HFMA • www.georgiahfma.org Bridget Sykes Laurence Harris Greg Smith Sharon House Ricky Morris Dominique Bennett FORUMNS COUNCIL: Roxann Arnold Tara Jeffers Paul Kearns Allison Wilson Rick Sherrin Susan Waits Susan Singleton Jacki Meade Karla Goodson Mike Schaefer table of contents 1 President’s Message 3 From the Desk of the Editor 4 RAC’s Coming to a Provider near YOU! 7 Larry Bradley: Forty-one Years of Revenue Cycle Experience 9 Chapter Chatter 10 Welcome New Members 11 Mailing Costs Go Straight to Your Bottom Line 12 3rd Annual GA Healthcare Trade Faire 13 Certification Is All About You! 15 Point of Service Collections is Critical to the Revenue Cycle 15 The Downside of Credit Scoring 17 Corporate Sponsor Benefits 18 Corporate Sponsors 19 13 Ways to Have Fun at Work 21 UnitedHealthcare Admin. Advisory Committee 22 Outreach: Bridging the Gap 23 Photo Gallery 26 Attn: Revenue Cycle Managers 27 GA Spring Institute Agenda 29 Alabama Chapter - Region V Dixie Institiute Steven Ross Linda Fausett Jennifer York David Payne Sharon House Linda Corley Lillian Kloock Ann Chandler David Torrento Glenda Massee Elaine Dixon Darrell Lawson Ellen Silva Diana Lindsey MEMBERSHIP COUNCIL: Pat Tewalt Laura Hosford 2 Michelle Meador Laura Outler James Ellington Jamie Lloyd Nate Dondanville Linda Chailland David Torrento Steve Gunter Henry Ostaszewski Bob Sortino Karen Lloyd OUTREACH COUNCIL: Donna Casey Meghan Lynch Angela Bowers Patty Maddox Donna Fincher PROACTION COUNCIL: Frank Powell Elizabeth Richards Todd Cox Janice Qualls-Harris Cal Calhoun QUALITY COUNCIL: Kay Stanley Tom Morris Jessica Carter Sean Alavi Becky Black Pete Hogan Summer 2008 GEORGIA SCROLL from the desk of the editor.... A are handling the rise in uninsured patients at their facilities, or asking a fellow HFMA member if they know of any job opportunities, or even just trying to find a good summer camp for your children. It is all about making connections with those around you. s the Georgia Chapter moves into a new year under the leadership of our new president, Susan Clark, I find myself in a role that is very unfamiliar to me: editor of the Georgia Scroll. Last Fall, when I found myself being coerced, yes I said coerced, by Carmen Sessoms (thank you Carmen), to serve as Scroll Editor, my first thought “are you crazy”, but then I soon realized that I needed a new challenge in my life. I am sure every one of K I M B E R LY FA R M E R you, have personal and professional challenges everyday, but this one made me feel excited and a little uncomfortable, which isn’t always a bad thing. Georgia HFMA is the perfect opportunity to make those connections in your professional life. I encourage anyone that is not involved to get involved, join TEAMS (Together Everyone Achieves More Success), and start making your own connections. Of course, you may make connections that help in your job, but more importantly, do not be surprised if you make friendships that last a lifetime. As I finish writing my first letter to you, Past President, Tim Betty’s 2000-01 theme keeps popping into my head, “Enjoy the Ride”. So that is what I am going to do, fasten my seatbelt, hold on tight, and “Enjoy the Ride,” some things in life are meant to be frightening, but with all my “connections” in Georgia HFMA, I know I will be ok when the ride ends. This Spring, I began my new responsibilities, which includes gathering all the necessary pieces that the Scroll comprises of, but putting all those things aside, I have found the hardest component has been writing the letter from the editor. I sat down to write my first letter and a strange thing happened, I realized I was at a loss for words. I did not even know where to begin. Who would have ever thought I would be at a loss for words, but after several agonizing days, I finally realized I had plenty to say. There are too many of you to thank, but you all know who you are. Thank you for making me the person I am and continuing to help me grow into the person I still want to be! With warm regards, Kimberly Farmer All I had to do was look at the National Chairman’s theme for 200809, “Making Connections.” That two word statement can apply to almost everything in our lives; whether it is asking a peer how they GA Chapter HFMA • www.georgiahfma.org Kimberly Farmer, Editor [email protected] 3 Summer 2008 lead story GEORGIA SCROLL RACs Coming to a Provider near YOU! By Laura Pait, RHIA, CCS, Senior Manager The RAC program’s mission is to reduce Medicare improper payments through efficient detection and collection of overpayment, the identification of underpayments, and the implementation of actions that will prevent future improper payments. Introduction CMS initiated a pilot Recovery Audit Contractors (RACs) program in 2005. The initial states that were selected for this pilot were California, New York and Florida. These states were selected primarily because they are the largest states in terms of Medicare utilization. Approximately 25% of Medicare payments made each year is to providers in these states. The mission of the RACs is “To reduce Medicare improper payments through the efficient detection and collection of overpayments, the identification of underpayments, and the implementation of actions that will prevent future improper payments.” Dangers Ahead Section 302 of the Tax Relief and Health Care Act of 2006 makes the RAC Program permanent and requires the Secretary to expand the program to all 50 states by no later than 2010. By 2010, CMS plans to have 4 RACs in place. The new RAC jurisdictions match the DME MAC jurisdictions. On March 16, 2007, CMS drafted a “statement of work” that provides details about the program, but more importantly outlines the suggested expansion of the program. Recent expansion of the program brought participation to South Carolina, Massachusetts, and Arizona. States targeted for program expansion in 2008 include Texas, New Mexico, and Oklahoma. States targeted for expansion in CY 2009 include West Virginia, Virginia, North Carolina, Tennessee, Georgia, and Alabama. Section 306 of the Medicare Modernization Act directed CMS to investigate Medicare claims payment using RACs to identify underpayments and overpayments and to collect the overpayments so that they may be returned to the Medicare Trust Fund. For Fiscal Year 2006 RACs identified $289.1 million in overpayments but only $10.4 million in underpayments. Recently published RAC summary documents have revealed overpayments collected for medically unnecessary services in an Inpatient Hospital or Skilled Nursing Facility in FY 2007 at $106.5 million. Congress gave CMS the authority under the RAC demonstration legislation to pay the RACs differently. CMS pays each RAC on a contingency fee basis. It has been identified that RACs get to keep 20-30% of the dollar amount. This demonstration is the first time the Medicare program has ever paid a contractor on a contingency fee basis for a claim review and overpayment collection work. GA Chapter HFMA • www.georgiahfma.org 4 Summer 2008 GEORGIA SCROLL What is this talk about “Medical Necessity” for Inpatient Services? Speaking with board members, senior leadership and Hospital staff this spring resulted in a common question What is this talk about medical necessity for inpatient services? Areas that pose a danger for most providers include: ■ Request for Medical Records The RAC may obtain records by on-site visit and mail/fax. Providers today have not established procedures for handling these requests. Depending on the amount of records the RAC has requested to review, this could be a huge operational issue. To date, most providers are receiving requests for medical records and not an on-site visit. Depending on the size of the facility, some report lists of 100 patients while some report lists of just 15. The key is to be able to locate and send the copies within 45 days from the date the letter was issued, not from the date you received the request. If the RAC does not receive the records within the time frame specified it is an automatic denial. Providers today do not demonstrate a process that can track the request upon entry into their organization, if the request was complied with, and if the RAC received the records. It has been reported that the RACs are reporting they never received records and the provider can not prove they were sent. Homework that each provider can do is to verify with their FI/Carrier what address and contact person they have on file. Addresses change and we do have turn-over from time to time. Financial case management has become a necessary part of every healthcare organization. What will the payer cover for an admission under 30 days? Was a procedure included that the payer will only cover as an outpatient? These are all questions that case managers address every day to help Hospitals ensure that they can bill for the services provided and they will be paid by the payer. So, how can we fit a “clinical” review of medical necessity in all of this? Facilities that have elected to participate in the Medicare program have agreed to follow the “Conditions of Participation.” Specifically 42 CFR Section 482.30 which details the required elements for a Utilization Review (UR) plan. This section notes that the Hospital’s UR plan must review medical necessity of admissions, length of stay and services rendered. This review process is NOT THE SAME as the quality assessment and performance improvement reviews required under 42 CFR Section 482.21. ■ Appeal Process Providers are overwhelmed with the detail required in the appeal process. CMS suspects that there are simply more overpayments made by the Medicare program due to lack of medical necessity and incorrect coding of claims than there are overpayments due to Medicare being the secondary payer. Lack of medical necessity and incorrect coding for Hospital and Physician outpatient claims is not new and although this remains part of the “automated” claim review, the inpatient complex review process has significantly challenged providers. Providers are experiencing a great deal of confusion and lack of expertise when dealing with appeals related to Hospital inpatient services denied for lack of medical necessity relate to the inpatient admission. Providers are reporting the need to establish new positions within their organization just to address these concerns. Providers must establish a clear appeals process. Ownership and accountability must be defined for the internal RAC program. Unfortunately, the RAC provides time restraints on the appeals process as well. If the appeal is not received within the defined time restraints, the denial will stand. Providers must not accept the denial on face value, but research and be sure you are in agreement with the interpretation of the LCDs, NCDs, coding guidelines and InterQual criteria. A 30% overturn rate has been reported on physician claim denials due to effective appeal preparation. These RAC results demonstrate the application of review criteria in the judgment of medical need for the initial admission in particular for one-day stays during the “complex” review process that does include review of the medical record. To date we have not seen outcomes reflecting continued stay reviews. When we reflect on the current UR process in Hospitals today, what do we see? ■ UR absorbed into case management responsibilities ■ Overwhelmed with the steps required to get approval of days for commercial payers ■ No pre-admission reviews GA Chapter HFMA • www.georgiahfma.org 5 Summer 2008 GEORGIA SCROLL ■ Enormous work around or meetings to ensure physician satisfaction The new statement of work notes the new four permanent RACs will be announced the first of 2008 and in early 2008, they will begin issuing letters to providers for medical records. www.cms.hhs.gov/RAC Over time hospitals have seen this function fall to the side. Hospitals are continually challenged with the time involved in review of each medical record and the frequent need to speak with physicians. The other major influencing factor has been the apprehension and reluctance from Hospital leadership when questioning medical staff on the appropriateness of the care plan for this particular level of care. Get Prepared NOW! ■ Start an internal/external assessment plan • The revised statement of work limit claims that RAC contractors may review to those with dates of service from October 1, 2007 and forward. • Identify and correct deficiencies • Educate physicians on documentation requirements • Educate coding and billing staff as needed • Engage case managers/documentation specialists on the medical necessity related issues • Educate stakeholders and board members • Establish Best Practices ■ Familiarize yourself on Medical Necessity issues for both It is now time to buckle down and address ALL the issues that need to be covered. What can you do? ■ Dust off your current UR plan and be sure staff are aware of the steps involved ■ Prepare Hospital leadership to help inform the medical staff of these issues ■ Reinforce “what is in it for them” understanding with your medical staff If your organization is talking about medical necessity of inpatient services, embrace this as your opportunity to make things right. Ensure your compliance with the Conditions of Participation with a risk assessment. Visit your recent coding reviews to see if medical necessity was addressed. Define corrective action, revisit staffing and be sure education and training is provided more than once. Inpatient and Outpatient services ■ Define your internal process for managing requests and appeals Top 12 RAC Issues to Watch For 1. Debridement – procedure code on claim did not match procedure described in medical record 2. Respiratory Failure – principle diagnosis on claim did not match the principle diagnosis in the medical record 3. Discharge status/transfer – claim indicates discharge to home or other facility, but medical record indicates beneficiary was discharged to another hospital or home with home care 4. Inpatient Rehabilitation – services were medically necessary but could have been provided in a less acute setting 5. Neulasta – wrong number of unites billed 6. Speech Therapy – wrong number of unites billed for initial evaluation 7. Admission for scheduled elective procedures 8. Claims with single secondary diagnosis designated as a complication or comorbidity 9. Medical necessity for short stay admission, including chest pain, back pain, congestive heart failure, and gastroenteritis 10. Inpatient only procedures – know what changes from year to year 11. Transfusion – billing more than once per encounter 12. DRG payment window – outpatient procedures As we prepare for RAC review, “Best” practice at any organization will require establishing a clear internal process. An effective UR plan provides a definition of ownership and accountability, but also requires awareness and support from Hospital leadership. Recent Updates October 19, 2007, a Request for Proposal (RFP) was issued by CMS seeking application for a national implementation. October 26, 2007, the American Hospital Association (AHA) issued a letter to CMS expressing concerns with the program and asking reconsideration of several key issues. November 7, 2007, a bill was introduced to place a moratorium on the RAC program. The bill directs CMS to provide Congress a detailed program status. California has expressed particular concern with the RAC process associated with inpatient rehabilitation claims. Laura Pait, RHIA, CCS – Senior Manager, Revenue Integrity Solutions, Dixon Hughes PLLC Healthcare Consulting Group. Active membership with AHIMA and HFMA. GA Chapter HFMA • www.georgiahfma.org 6 Summer 2008 GEORGIA SCROLL Larry Bradley: Forty-one Years of Revenue Cycle Experience A nostalgic look back at one Georgia HFMA members past as he arrives at his future Today that position would probably be called PFS Director or VP, Revenue Cycle. The next twelve (12) years at St. Mary’s saw many changes – we moved into the automation era by installing an 8 K IBM System 3 computer to replace the Pitney Bowes Posting Machine. What was really amazing was that this computer was attached to a “line” printer that would print an astonishing 100 lines per minute. Not even the new IBM Selectric typewriters were capable of such output. This time saw the growth of Medicare and Medicaid with Medicare reimbursement going from cost plus 2% to cost plus 1% to the introduction of something called DRGs. Everyone in hospital patient accounts was thrilled with the advent of the UB82. Finally, a single claim form for all payers. 1967 ■ Richard Petty wins NASCAR Championship. ■ Lester Maddox was sworn in as governor of Georgia. ■ Tenet Healthcare was founded. ■ Haight Ashbury Free Clinic opens with the slogan “Health Care is a Right, Not a Privilege.”. ■ A career in the revenue cycle industry begins for me. My career in the revenue cycle industry actually began in 1967 as I accepted a position as Loan Adjuster at C&S National bank in Athens, Georgia. For those too young to recognize C&S, this bank later became Bank of America. For those who don’t recognize the title of Loan Adjuster, it means “collector”. Yes, I began this career by visiting debtors at their home or place of employment, assisting them by taking their payment to the bank or relieving them of the burden of an automobile or furniture which may have been used as collateral for a loan. My first of three CFOs at St. Mary’s was on the Board of Directors of the Georgia Chapter Hospital Financial Management Association. He was very supportive of my participation in this group which would later change its name to Healthcare Financial Management Association. The first Chapter Institute I attended was in 1971 at the Holiday Inn at Callaway Gardens in Pine Mountain, Georgia. I arrived Wednesday evening prior to the Thursday official start of the Institute. There was a sign at the hotel registration desk inviting all HFMA attendees to a Welcome Reception in the President’s suite. What a tremendous introduction to HFMA! Ann Longshore, Chapter President, was hosting the reception in her suite (living room attached to her hotel room). She had stopped on the way and bought beverages and snacks. Ann took a personal interest in everyone who attended and made sure that new members like me were introduced to everyone and made to feel welcome. Over the next few years I had the privilege of meeting and getting to know many healthcare financial giants. A new friendship circle had begun. A list of names too long to even start became my mentors, advisors, and true friends. 1970 ■ Willie Mays was named Player of the Decade. ■ Nebraska wins college football national championship. ■ AHA President Mark Berke predicted the country would have a national health insurance program by the mid 1970s. ■ Nurses at Deaconess Hospital in Spokane were sporting a new look – pantsuits. ■ Economic Stabilization Act of 1970 was passed implementing mandatory price controls. ■ A career in the healthcare revenue cycle industry begins for me. In July of 1970, Ray Stevens, CFO of St. Mary’s Hospital in Athens Georgia, offered me a position as a Financial Counselor. That title actually meant telephone collector. I accepted this position, to the chagrin of my father who wondered aloud why his son would go from the prestige of a bank to working for a hospital. Within a few months I had assumed the position of Business Office Manager and then of Patient Accounts Manager. With a small increase in pay, I now had the responsibility for the Business Office, Admitting, and Emergency Room Registration. GA Chapter HFMA • www.georgiahfma.org By Larry Bradley My third CFO at St. Mary’s was Dennis Crum. Dennis was a young professional recruited by St. Mary’s from Blue Cross of Virginia. Once I had “trained him”, I realized that even though Dennis was much younger than I there was much I could learn from him. Dennis also saw the benefits in HFMA, encouraged me and supported me as I began climbing the ladder of Chapter Board member and officer. In 1982, greener pastures called and, during 7 Summer 2008 GEORGIA SCROLL my HFMA year of President-Elect, I accepted a position with Hutcheson Tri-County Hospital. The following year I became the third person to be installed as President of the Georgia Chapter HFMA while employed by this hospital, following in the footsteps of Dan Barker (later of Crawford Long and Emory fame) and Bob Jones (later best known at GHA). It is amazing how I became an “expert” on all healthcare financial matters during my time as a Chapter officer and particularly during my year as President. People from all types of organizations called on me for my advice and knowledge. Various vendors explained that they thought so much of me now, they would offer major deals to be able to have the Georgia Chapter president as a client. Later in my career as I became one of “them”, I realized that while I may have lost some of my knowledge, the new officers had certainly gained theirs. Already this year, ■ Eli Manning was awarded the Super Bowl MVP. ■ The LSU Tigers won the college football championship. ■ Fidel Castro resigned as President of Cuba. ■ In August, the Democratic Party will nominate for the President of the United States, for the first time, either a woman or a person of color. ■ Also in August, I will retire from my position at NCO Financial Systems. It has been a long road but one with great experiences. I am thankful for all the people I have come in contact with through the years. Perhaps we will have other opportunities together. Since becoming a Past President of the Chapter, I have worked in two large teaching facilities, worked with a large healthcare software firm, consulted with healthcare facilities in Louisiana, Florida, and Pennsylvania, and currently serve as Vice President of Operations for a large accounts receivable management firm. It is now 2008. GA Chapter HFMA • www.georgiahfma.org Larry Bradley 8 Summer 2008 GEORGIA SCROLL Larry Bradley, Georgia HFMA Past President, and Vice President of NCO Financial Systems, Inc., will retire August 1, 2008. Larry has been in Healthcare Revenue Cycle Management for 38 years (even before, it was called Revenue Cycle Management). Larry has many friends in this chapter and he will be missed, but not forgotten. chapter chatter Diana Lindsey has assumed Larry’s duties at NCO as General Manager, Extended Office Services for the NCO Revenue Cycle Management Center in Norcross, Georgia. It is Summer! Which means it is time for the Georgia Chapter’s Summer Institute. The Institute will be in Hilton Head, July 23-25, 2008. This year will be the first meeting at the Marriott Hilton Head Resort. We hope you will plan to attend this educational and networking opportunity. Pam Harper, formerly of OSI Healthcare Services, joins NCO to be part of the Southeast Region. Pam serves on the Board of Directors for the Tennessee Chapter of HFMA. The passing of the 2007-2008 year was celebrated as the 2008-2009 began at the Spring Institute in Callaway Gardens on Thursday, May 8, 2008. It was another monumental year for the Georgia Chapter under the leadership of Teresa Singley and expectations are high for another phenomenal year under the leadership of Susan Clark. Brooke Rogers, daughter of Karen Newton, Client A. Harkins, PC, will graduate from Michael Coles Business School at Kennesaw State with a Business Degree in Management. According to Gail Scarboro-Hritz, Hritz-Noon Associates, LLC, grandson Aiden has already named his soon to be born baby sister, Olivia. 2007-2008 Awards Best Georgia Scroll Article was awarded to Elizabeth Richards Janie Coxwell, Phoebe Putney Memorial Hospital, and the co-chair of the CPAR Committee, had a grandson graduate from Sherwood Christian School in Albany, Georgia on May 16. He received a scholarship from LaGrange College in football. Georgia Scroll Contributor of the Year was awarded to Pat Tewalt OJ Booker Scholarship was awarded to Alexa Dougherty Ann P. Longshore Distinguished Service Award was awarded to Jonathan Skaggs Eric Bergeon, ExecHealth, Inc., dog of 15 years, Budde, died on May 9. Eric and his family spread Budde’s ashes at Lake Lanier, since he loved being on the boat every summer. Ann P. Longshore Distinguished Service Award Runner Up was awarded to Pat Tewalt Sister Rose Margaret Schweers Most Valuable Member was awarded to Kimberly Farmer BEWARE! The Georgia HFMA Chapter President, Susan Clark, is officially a black belt in Karate! Sister Rose Margaret Schweers Most Valuable Member First Runner Up was awarded to Cathy Dougherty Donna Casey, Floyd Medical Center, is going to be a grandmother for a second time! Donnas’ son and his wife are expecting their first baby in October. It is a girl! Sister Rose Margaret Schweers Most Valuable Member Second Runner Up was awarded to Russell Moore Most Valuable New Member was awarded to Elizabeth Richards Alice Childs, Dixon Hughes, tells us that Dixon Hughes has two new additions to their Georgia Team. Robert “Robb” Hawes as an audit manager, and Amy Harrison as a senior audit associate. We hope to see them at HFMA soon! Charles H. Anderson President’s Award was awarded to Jim Piper and Karen Newton The annual sporting events where held after the TEAMS meeting on Wednesday and the winner are as follows: Golf: 1st Place Low Gross: Rob Kream, Terry Brown, Larry Kloock 1st Place Low Net: Jonathan Skaggs, Nate Dondanville, Eric Bergeon 2nd Place Low Net: Diana Lindsey, Larry Bradley, Doyle Spears, Jim Harris Women’s Closest to the Pin: Diana Lindsey Men’s Closest to the Pin: Jon Buffa Men’s Longest Drive: Jim Harris Women’s Longest Drive: Judy Richards Shirley Carmichael, Emory Healthcare, and her daughter Patty have had a very big adventure! She and Patty were in Singapore, Indonesia, Thailand and Malaysia and while they were close to the cyclone in Burma and the earthquake in China, they were not involved. They were in Bangkok, Thailand and the news said that the earthquake was felt there, but they were not aware of it. They had an interesting and adventurous trip, even though Shirley was very sick with a flu like illness for 10 days. She swore it was bird flu, but says she didn’t die so it must have been something else. Shirley reports: “There were parts of it that were really fun and other parts I don’t think we would like to repeat for instance the bus trip from Malacca, Malaysia to Singapore. If I tell you everything about the now infamous bus trip from Malacca, (all we were missing were the chickens) it would take the entire Scroll. But the bus accident was interesting <smile> and you might wonder how we managed to turn a 3 hour trip into 8 hours.” On your next trip to Asia, I would recommend skipping the bus trip to Malacca. Skeet and Trap Shooting: Top Male: Henry Ostaszewski Top Female: Kimberly Farmer Fishing: Biggest Bream: Jim Piper 1st Place – Most Fish: Jim Piper 2nd Place-Most Fish: Lee Evins 3rd Place-Most Fish: Pearson Talbert And the “Traveling Trophy” the giant stuffed bass pillow went to Lee Evins for winning the biggest or most bass prize this year. Pat Tewalt, Blackstone Resources broke her foot and a toe the end of April; she was not a happy camper! Her grandson, Chase Baylor, graduated from South Forsyth High School and is on the Honor Roll. He will attend GCSU in Milledgeville this fall. Pat was VERY young when he was born! Putting aside how she broke her foot, Chase gets his brains from her. Chapter Chatter is written by Pat Tewalt, Blackstone Resources. Please send your “Chatter” to Pat at [email protected]. Kay Stanley and her husband will celebrate 46 years of wedded bliss August 31! Kay also celebrates 20 years with the Coker Group, July 1. GA Chapter HFMA • www.georgiahfma.org 9 Summer 2008 GEORGIA SCROLL welcome new members New members to the Georgia Chapter are an important part of the Chapter’s continued success. Please take a moment to contact our new members, welcome them, and share your experience with Georgia HFMA. Let them know that we value their membership and encourage them to become active in TEAMs. Continue to help make HFMA the largest and most extensive healthcare financial management network anywhere. Georgia HFMA has over 50 years of sharing opportunities and experience with its members. New Members Enrolled between April 16, 2008 – May 22, 2008 Lisa Bruner Revenue Analyst Phoebe Putney Memorial Hospital [email protected] Kim Hounshell Director - PFS Medquest [email protected] Gregory Faison Healthcare Consultant [email protected] Nikki Porter Manager Compliance 360 [email protected] Grant Stewart Revenue Accounting Manager Regency Hospital Company [email protected] Rachael DiPiazza Director of Finance/Controller Resurgence Health Group [email protected] Lonnie Johns Student - Intern [email protected] Sheila Bolduc Director, Sales Operations Cigna Healthcare [email protected] Bruce Haupt National Vice President Mckesson [email protected] Sara Kay Wheeler Partner King & Spalding [email protected] Florence Davis Director Patient Access Children’s Healthcare of Atlanta [email protected] Edward Alvarez Clinical Business Manager St. Joseph’s/Candler Health System [email protected] James Dennard, Jr Assistant Administrator Gwinnett Medical Center - Duluth [email protected] Brent Southall Controller AGA [email protected] Marc Cohen Director of Marketing RelayHealth [email protected] Carol Romashko Director of Marketing RekayHealth [email protected] Gina Hargrove Patient Services Coordinator Northside Hospital [email protected] Glenda Hutchison Medical Records Coder Emory University [email protected] Nicole Riley Eligibility Specialist [email protected] GA Chapter HFMA • www.georgiahfma.orgg 10 Summer 2008 GEORGIA SCROLL Managing Mailing Costs is an Activity That Goes Straight to Your Bottom Line In May, business mailers were impacted by yet another increase in postal costs. In a time when business mailers are trying to lower operating costs while still meeting consumer demand, there are continual challenges with annual print mail rate increases. Even though there has been some relief with the Postal Reform, which mandates the USPS replace the previous and somewhat erratic system of setting rates for business mailers with something more predictable, high volume business mailers are still facing higher and unexpected postage costs. (CASS) software to validate, correct, and standardize addresses. If CASS does not recognize a mail piece, it will not qualify for presort discounts and will instead be mailed at full rate (42 cents instead of the approximate automated discount rate of 33 cents). Then verify those addresses again: According to the USPS, there are 145 million confirmed mail delivery points in the United States today. “Cycle L,” which began on August 1, 2007, requires mailing lists to be run through DPV (Delivery Point Verification) processing. DPV takes the CASS™ system one step further by comparing your mailing list to the USPS’s own list of known addresses and verifying whether or not a CASS™-certified Zip+4 address is one of these confirmed delivery points. For example, a Zip+4 Code might cover an area with addresses from 100 Main Street to 300 Main Street. Typically, addresses would run 100 Main Street, 102 Main Street, 104 Main Street, and so on. However, if 104 Main Street is an empty lot, this is not a valid delivery point and DPV would mark it “N” for “invalid”—and a First-Class rate applies. DPV confirms all primary number addresses, so addresses missing a secondary number—like a suite or apartment number—remain acceptable, along with addresses that have a secondary number that hasn’t yet been confirmed by the USPS. While DPV can’t correct an invalid address, by identifying these addresses you can eliminate them. Based on the new law enacted in December 2006, the CPI Rate Cap is 2.9 percent. For all classes of mail the average rate increase is not supposed to exceed this percentage. On May 12 of this year, the single piece stamp rate went from to 41 to 42 cents, setting prices up 2.44 percent, which is .46 percent under the CPI Cap. However, for business mailers who provide the largest volume of automated bar-coded three and five digit mail, the rates will increase by 3.59 and 3.85 percent—which is .69 percent and .95 percent more than the CPI. This turns a “minor” rate increase to a major one for business mailers. Refresher tips for driving down postage costs The fact is that for companies mailing high volumes of bills the financial impact will be significant, making it critical to explore and use every avenue possible to offset these costs. If you haven’t already done so, here are some immediate actions a business can take: Keep your mailings letter-size: Automation is key for achieving postal savings. While First Class Mail letters containing odd-shaped items are mailable, they will be charged the “non-machinable surcharge”—$0.055 for pieces mailed at presorted and automation rates—in addition to postage if they weigh one ounce or less. What’s more, the non-machinable surcharge will also apply to flat and parcel mail weighing one ounce or less. Converting flat mail to folded will help you to save money. Follow USPS pre-sort rules: Properly preparing and presorting mail will earn significant USPS discounts. Leverage these discounts aggressively by making sure mail is segmented to reach the critical volumes per zip code needed to qualify for the highest discount rates. To qualify for these rates you must print a delivery point barcode on each mail piece and commingle the mail for concentrated volume to geographical areas. Continue to explore electronic options: Electronic bill presentment is another way to sidestep the postal rate increases. Though reports by the USPS show that more than 70 percent of people still prefer to receive their statements through the mail, converting just 10 to 20 percent of existing customers to electronic bill receipt corresponds to a significant cost savings and is worth the effort. Verify addresses: Nearly one-fourth of all mail that goes through the USPS contains some simple error such as misspelled street names and improper abbreviations, which can result in significant postage cost increases. If a mail piece cannot be delivered (e.g., “undeliverable-as-addressed” or UAA), the cost to correct the piece can be up to 70 cents. A number of tools in the marketplace are designed to identify undeliverable addresses and link old addresses to new move addresses, including Coding Accuracy Support System GA Chapter HFMA • www.georgiahfma.org By Harry Stephens An opportunity to improve Over the last few years, the cost of postage has been rising gradually 11 Summer 2008 GEORGIA SCROLL and this trend shows no sign of slowing. While no one likes to see a rate increase at any time, the silver lining may be an increased focus on print/mail production within your company and better efficiencies within the USPS. By keeping current with changing regulations and available technology that supports them, business mailers can take advantage of savings that go straight to the bottom line. 3rd Annual Georgia Healthcare Trade Faire & Regional Conference Sponsored by HIMSS Georgia Chapter in partnership with Georgia Hospital Association and Georgia Chapter HFMA Harry Stephens is President/CEO, and founder of DATAMATX. For more information about DATAMATX, visit www.datamatx.com. College Park, GA Thursday, September 25th 7:30a.m. – 3:15p.m. For more information please go to: http://www.healthcaretradefaire.com/Georgia/08/ GHFMA members who work at a hospital, health system, or similar provider or payor organization, may attend complimentary by registering at http://www.healthcaretradefaire.com/Georgia/registration/. Choose option #1 or #2. Parking will also be paid for the day. GHFMA members that work for consultant companies or who work for a solution provider company may attend at a reduced price. If any want to attend, use option # 3 in the link above. GA Chapter HFMA • www.georgiahfma.org 12 Summer 2008 GEORGIA SCROLL Certification Is All About You! By Gail Scarboro-Hritz & Barbara Noon You must meet the following conditions to apply for the Fellow of the Healthcare Financial Management Association (FHFMA) designation. Attaining Certified Healthcare Financial Professional (CHFP) and Fellow of the Healthcare Financial Management Association (FHFMA) will distinguish you in your industry. Most healthcare organizations clearly prefer to interview HFMA certified candidates when they have positions open in various areas of financial management. In some cases, certification is a condition of employment; and, in any case, certification typically sets you apart and above other qualified candidates. ■ Five years total as a regular or advanced HFMA member ■ Bachelor degree or 120 semester hours from an accredited college or university ■ Reference from an HFMA Fellow or current elected chapter officer ■ Volunteer activity in healthcare finance within three years prior to applying for FHFMA, including one of the following: Join the Core Study Buddies to support you in preparing to take and pass the CORE exam, one of the basic requirements in the steps to your CHFP certification. The Core Study Buddies is comprised of a group of Georgia Chapter HFMA members who meet monthly at Emory Crawford Long Hospital to study specific chapters of the CORE study guide. Between study sessions, the members study assigned materials and are tested on the material at the next Core Study Buddies session. All HFMA Georgia Chapter members are welcome to join the Core Study Buddies • Earn the Follmer Bronze Award • Volunteer in the chapter and earn two Founders points (under current system) for two consecutive years • Volunteer service for two years in a healthcare industry organization within the past three years • Submission of conforming application with one-time fee You maintain both CHFP and FHFMA status by earning 90 professional development contact hours every 3 years and retaining HFMA membership. You must report all such professional development contact hours, except those maintained by National HFMA, on the National HFMA web site. Gail Scarboro-Hritz, Chairperson for National Certification for the Georgia Chapter of HFMA is the facilitator for the Core Study Buddies. An email notification is sent each month to remind Georgia Chapter members of the date, time and location for the next Core Study Buddies session. Certification coaching sessions are also conducted at each HFMA Georgia Chapter Institute. For more information about certification, please contact the Chairperson or Co-chairperson for the Certification Team. Details about certification may be reviewed by going to www.hfma.org and clicking on the “certification” button on the left side of the page. You must meet the following conditions apply for the CHFP: ■ Two years total as a regular HFMA member Gail Scarboro-Hritz at (404) 274 – 6201 or ■ Two years of professional experience in the healthcare finance industry [email protected] ■ Sixty semester hours of college coursework from accredited institution or sixty professional development contact hours Barbara Noon at (404) 316 – 2252 or [email protected] ■ Successful completion of the HFMA Core certification exam ■ Successful completion of one HFMA specialty certification exam (Specialty exams include: Accounting & Finance, Financial Management of Physician Practices, Managed Care, and Patient Financial Services) ■ References from a current elected chapter officer and your CEO or supervisor ■ Submission of conforming application with one-time fee within 24 months of successfully completing the first exam GA Chapter HFMA • www.georgiahfma.org 13 Summer 2008 GEORGIA SCROLL GA Chapter HFMA • www.georgiahfma.org 14 Summer 2008 GEORGIA SCROLL Point of Service Collections is Critical to the Revenue Cycle By Ann Chandler With the struggling economy, higher living expenses, higher unemployment and a higher number of uninsured patients there are more sources competing for your patient’s dollar making point of service collections more important today than it has ever been. Although collecting patient liability may be more difficult, collecting patient liability at the point of service is critical to the revenue cycle. A strong consistent point of service collection program results in lower self-pay accounts receivable, reduction in bad debt, reduction in collection expenses and improved customer service. them. Clinical staff must know that they play a vital role in ensuring patients are directed to a discharge area for the financial discussion. Administration must support the process if clinical staff balks at directing or escorting patients or becomes slack in directing or escorting patients. Many people are uncomfortable with asking for money. Assume your staff is and train them to do so. Develop scripting to ensure they are asking in such a way that opens the door to financial discussions. Healthcare consumers today are becoming more informed consumers. Medical savings plans and higher patient liability have forced many patients to shop for services. They want to know how much the service will cost prior to the service. Asking the patient for their out-of-pocket expenses opens the door to discussions about payment expectations and patient needs. Workable payment plans and financial need can be resolved prior to service. Ideally, the entire estimated patient liability should be requested. Hospitals are challenged with estimating prices and calculating patient liability. Technology can be purchased and tools can be developed to assist with estimating prices and calculating patient liability. But, don’t wait for the tools to get started. Train staff to ask for co-payments and deposits, ensure you have administration and clinical buy-in and open the door to point of service collections and financial discussions at the time of service. The goal is to know how the patient liability will be resolved prior to final billing. Buy-in from Patient Access Staff, Administration and Clinical Staff is critical to the success of point of service collections. Patient Access Staff must understand the importance of what you’re asking them to do and how it fits into the overall revenue cycle and key performance indicators. They must know that it’s expected of Ann Chandler, Senior Project Architect, Zimmerman, LLC The Downside of Credit Scoring By Elaine Dixon & Earl Winter With more and more patients entering the healthcare system as self-pay patients, healthcare providers are facing the increasing challenge of collecting payments directly from the individual patient. Historically, providers have dealt primarily with insurance companies and government programs such as Medicare to arrange for payment. Recently, however, individual patients, including insured patients, have assumed significant responsibility for paying for care. deductibles for insured patients and the full medical bill for uninsured patients. With the recent shift to consumer-driven healthcare plans and health savings accounts (HSAs), which carry significantly higher co-pays and deductibles than traditional insurance plans, a greater portion of self-pay accounts are derived from insured patients. Additionally, an increasing number of individuals with the financial capacity to purchase health insurance are opting to “go bare” or without insurance. Self-pay is the portion of the medical bill for which the patient is responsible. This includes co-pays and All these trends are having a dramatic effect on healthcare providers’ bottom lines: American hospitals face $40 GA Chapter HFMA • www.georgiahfma.org 15 Summer 2008 GEORGIA SCROLL billion in unpaid bills every year and 47 million Americans did not have health insurance last year. Many providers look to self-pay patients’ credit scores to assess their ability to pay. According to MSNBC.com: “Since the invention of the credit score in the 1980s, risk scoring has become a valuable tool in many industries. Auto insurers have created their own scoring system, for example. Many websites buy software that assesses the risk that any individual credit card purchase may be fraudulent. Meanwhile, Fair Isaac’s core business of selling credit scores to lenders has recently become a more crowded field. Some banks now use their own formulas to generate risk scores, and the nation’s three main credit bureaus have developed their own scoring formula. Scoring risk in the health care industry could be a valuable business, given the rising rate of unpaid bills.” (Source: www.creditcards.com) As more consumers become aware of the security freeze option and utilize it in order to avoid identity theft, healthcare providers will have an increasingly difficult time obtaining a self-pay patient’s credit score. Simply put, while these freezes can help to stop identity theft, they limit a hospital’s capacity to determine someone’s ability to pay for medical services. A more complete, accurate, and available method is required. Healthcare providers can run into problems obtaining someone’s credit score due to rules set forth in the Fair Credit Reporting Act. Section 604 of the Act states that a consumer reporting agency can provide a report only when a patient or guarantor has initiated the request (unless the requestor is offering credit or insurance). For healthcare providers, the only way that request can happen is with a signed document. Without a signed document from a patient, healthcare providers can receive only minimal information (e.g., consumers’ names and addresses) from a reporting agency. This type of legislation hinders a hospital’s access to determine a patient’s ability to pay if the hospital is relying solely on a credit score. Simply using a credit score to determine a patient’s ability to pay, however, does not give a healthcare provider a complete or totally accurate picture. For example, hospitals and other caregivers already can already access credit scores, but credit scoring is not necessarily a good indication of whether a patient will pay a medical bill. Credit scores are based on voluntary purchases, such as a car, where as health care debt is largely involuntary. Other limitations, such as security freezes and state and federal legislation are causing healthcare providers to look at other means of determining ability to pay. As the number of self-pay patients’ increase, healthcare providers will need to look for readily available methods that provide a complete and accurate picture of these patients’ ability to pay for services. Relying on a credit score alone presents a provider with various problems due to recent legislative trends. Implementing a self-pay management system that can better determine a patient’s ability to pay is critical for healthcare providers that want to effectively manage self-pay accounts. State laws mandating credit security freezes have become increasingly common in recent years, as legislatures respond to consumers’ demands for identity theft protection and other forms of fraud. What exactly is a security freeze? According to the Web site www.creditcards.com: “Placing a ‘security freeze’ on [an individual’s] credit files blocks lender access to a consumer’s credit file, preventing new lines of credit from being opened in the consumer’s name. The consumer is later able to temporarily or permanently remove the credit freeze using a PIN number when access to credit is needed. Freezing and thawing credit has no impact on a consumer’s credit score.” A self-pay management system should move beyond obtaining a credit score to establishing an economic profile of the patient via the assimilation of demographic data. For instance, the demographic data used for patient evaluation could include publicly available information, such as a patient’s household income, real estate value, number of people in the household, homeowner versus renter status, and other data. According to one healthcare executive: “We do not use a credit score to determine an individual’s ability to pay simply because our system’s algorithm can be more accurate and does not hold the liability that goes along with obtaining credit scores.” As of November 1, 2007, all three of the nation’s major credit bureaus allow consumers the freeze option, after 39 states and the District of Columbia passed laws requiring it. TransUnion made security freezes available to all consumers October 15; Equifax and Experian followed suit on October 31 and November 1. Their actions should swell the number of people using freezes. According to the Consumer Data Industry Association, a trade group that represents the three credit bureaus, 50,000 to 70,000 consumers currently use credit freezes. GA Chapter HFMA • www.georgiahfma.org Elaine Dixon, Director Patient Business Services, Rockdale Medical Center Earl Winters, CEO, nTelagent, Inc. 16 Summer 2008 ■ Four complimentary Institute registrations per year ■ Eight free guest tickets per year for use at any Institute ■ 50% Reduction in Exibitor Fees with preferred booth assignments at the Vendor Fair hosted by Georgia HFMA ■ Recognition on the Georgia Website with a link to the Sponsor’s Home Page ■ Recognition of sponsors’ name on the Georgia registration bags provided at each of the Institutes $4,500 Gold Member GEORGIA SCROLL ■ Recognition of sponsors’ products and services through literature distribution at each of the Institutes We cordially invite you to contribute to our Chapter. Sponsorship is limited and this will be your only opportunity for pledging support during this coming year. ■ Recognition in all Georgia SCROLL issues ■ Recognition at all Institutes ■ Recognition plaque ■ Easy access to on-line resource guide ■ Two complimentary Institute registrations per year ■ Four free guest tickets per year for use at any Institute ■ 25% Reduction in Exibitor Fees with preferred booth assignments at the Vendor Fair hosted by Georgia HFMA ■ Recognition on the Georgia Website with a link to the Sponsor’s Home Page ■ Recognition of sponsors’ products & services through literature distribution at each of the Institutes ■ Recognition in the Annual Membership Directory ■ Recognition in all Georgia SCROLL issues ■ Recognition at all Institutes To make your commitment, please log onto http://www.georgiahfma.org/sponsors.asp for online sponsorship registration or for a pdf of the invitation. Should you need more information, please contact Cynamin Kinard at [email protected] or at (678)4425635. ■ Recognition plaque Thank you for your continued support of the Georgia Chapter of HFMA. ■ Recognition in the Annual Membership Directory T H E H F M A CO R P O R AT E S P O N S O R S H I P PROGRAM IS DESCRIBED AS FOLLOWS: ■ Recognition at all Institutes GA Chapter HFMA • www.georgiahfma.org $2,500 Silver Member In an attempt to recognize our contributors in a special way, the Georgia Chapter of HFMA has created a CORPORATE SPONSORSHIP PROGRAM. Invitation for participation begins May 1st. Contributions are due June 2008 for sponsorship beginning with the Summer Institute 2008 and ending with Spring Institute 2009. ■ Recognition in the Annual Membership Directory ■ Easy access to on-line resource guide ■ One free guest ticket per year for use at any Institute ■ Recognition on the Georgia Website with a link to the Sponsor’s Home Page ■ Recognition in all Georgia SCROLL issues ■ Recognition plaque 17 $1,000 Bronze Member The Georgia Chapter of HFMA has achieved what few other Chapters ever realize. One of the factors elevating our Chapter in awards and recognition is the large amount of support we receive from healthcare-related companies. Your contributions have enabled our award winning Chapter to excel in many areas of membership services, including superior education programming. Your continued support is vital to the Chapter. ■ Recognition of sponsor through distribution of sponsor provided tokens at Spring Institute sporting events Summer 2008 GEORGIA SCROLL 2008 - 2009 georgia hfma coporate sponsors ACS Chamberlin Edmonds DECO Deloitte Consulting Dixon-Hughes, PLLC Draffin & Tucker, LLP Healthcare Receivables Professionals, Inc. Hollis Cobb Associates, Inc. HSI Financial Services, Inc. KPMG LLP MedAssist, Inc. Pershing Yoaley & Associates PricewaterhouseCoopers, LLP PMAB, LLC RelayHealth - a McKesson company Apollo Health Street Blackstone Resources Bottom Line Systems, Inc. CareMedic Systems, Inc. Clark, Mascaro & Aziz, PC Collection Choice Corporation Emdeon Business Services ExecuHealth, Inc. Franklin Collection Service, Inc. Hritz Noon Associates, LLC Professional Medical Services Receivables Management Bureau, Inc. Siemens Medical Solutions The Law Office of Carmen Porreca TPL Company Accounts Receivables Collections, Inc. Accuro Healthcare Solutions AMCOL Systems, Inc. Bank of America, N.A. Cherry, Bekaert & Holland Commerce Bank Contract Callers, Inc. Credit Bureau Associates Cymetrix Data Integration, Inc. DATAMATX Decosimo Diversified Account Systems DST Technologies, Inc. Georgia Hospital Health Services, Inc. Healthcare Insurance Resources King & Spalding MD-X Solutions MedAssist, Inc. Medical Data Systems, Inc, Ontario Systems Passport Health Perot Systems Healthcare Prestige Staffing RGL Associates, Inc. The Coker Group Triage Consulting Colquitt Regional Medical Center Floyd Medical Center Gwinnett Medical Center Northside Hospital Piedmont Healthcare gold silver bronze provider We would like to thank all of our Corporate Sponsors for making a financial commitment to our Chapter, and we ask that all members make a special effort to thank them for their continued support and include them in the RFP process when applicable. Many thanks to the organizations that have committed to support the Georgia Chapter of HFMA in the 2008-2009 Corporate Sponsorship Program. This list includes all companies/providers who have committed to participating in the 2008-2009 Corporate Sponsorhsip Program as of May 23, 2008. Anyone interested in renewing or becoming a Sponsor for the Georgia Chapter should contact Cynamin Kinard at (678) 312-5635 or by email at [email protected]. GA Chapter HFMA • www.georgiahfma.org 18 Summer 2008 GEORGIA SCROLL Creating a Fun Workplace... 13 Ways to Have Fun at Work! By Jody Urquhart Creating a Fun Workplace: When Hokey Pokey Is “What It’s All About” When something funny happens do people stop and appreciate it? There are three ways to motivate people to work harder, faster and smarter: ❑ YES 1. Threaten them. Does your organization have fun activities at least monthly? ❑ YES ❑ NO 2. Pay them lots of money. 3. Make their work fun. Do you have tools (fun giveaways, draws) to invite patients to participate in having fun in your environment? ❑ YES ❑ NO In today’s workplace, threatening people has not been effective. Paying them lots of money (even if you can afford it) has only shown short-term success. Only number three, making their workplace enjoyable, has a track record of effecting real change. It is time managers learned how to create an atmosphere that is challenging, creative, and fun for employees as well as for themselves. Are managers usually optimistic and smiling at work? ❑ YES ❑ NO If you answer no to two or more of these questions, your staff probably suffers from “terminal seriousness,” which is negatively affecting morale and productivity. HOW FUN IS PRODUCTIVE Imagine a work world where people love their work environment and they are calm, stress-free, and happy all day long. People who are in good spirits are more likely to be productive. Their mental attitude produces increased oxygen, endorphins, and blood flow to the brain, which enables them to think more clearly and creatively. They are more relaxed, more accepting of others, and more likely to share their sense of humor. More Benefits of Humor in the Workplace Dr. Norman Cousins said, “Laughter is an igniter of great expectations.” Children laugh an average of 400 times a day and that number drops to only 15 times a day by the time people reach age 35. Preschoolers must know something we do not. Laughter releases endorphins (a chemical 10 times more powerful than the painrelieving drug morphine) into the body with the same exhilarating effect as doing strenuous exercise. Laughing increases oxygen intake, thereby replenishing and invigorating cells. It also increases the pain threshold, boosts immunity, and relieves stress. Laughter creates a bond that brings others together; people like to be with employees who are having fun. Creativity, intuition, and flexibility are key to successful operation of organizations today. In stimulating environments, employees enjoy their time at work and they will excel at work. Attracting customers is easier in an environment of hospitality. A fun workplace is not only more productive, but it attracts people and profits. Humor also levels the playing field to create an atmosphere that encourages honest dialogue, open communication, and increased risk-taking. Creating more equality in power or control shows people respect and builds pride in their work. A TEST: IS YOUR STAFF SUFFERING FROM TERMINAL SERIOUSNESS? This is just a sampling of the benefits of having fun in your workplace. Hopefully now you are convinced you could use a “fun injection” in your own place of employment. Scan your workplace and take note: Help people belong to your organization and not just work there by giving them a way to solidify and build rapport. Do you regularly catch people laughing or smiling at work? ❑ YES ❑ NO GA Chapter HFMA • www.georgiahfma.org ❑ NO 19 Summer 2008 GEORGIA SCROLL a moment to give employees and customers an opportunity to see the fun in the event. THIRTEEN STEPS TO CREATING A FUN WORKPLACE: 1. Give up the notion that professionalism means being serious all the time. It’s possible to take yourself lightly and still be competent and productive. Start to promote the benefits of humor at work. 10. Commit to being fun and it will change your approach to work. Start slowly with a few activities and communicate your desire to create a more relaxed workplace. Don’t expect things to turn around overnight. 2. Define what fun is in your workplace and what it is not.. (e.g. harmful humor, off-color jokes, sexual humor, humor tarnishing the organization) 11. Put fun things and activities in the staff room. This allows people to take their mind off the seriousness of work for a short period, so they come back to work with a more positive and balanced perspective. 3. Organize a “Fun Committee” for dreaming up fun “stuff” to do during and after work. 4. Add fun to meetings. ■ Bring in fun things such as Nerf balls, a basketball and hoop, or party blowers. 12. Encourage staff to leave work behind at the end of the day. Employees should not be so consumed with work that it affects their family life and leisure activities. Find fun ways for employees to “unload” at the end of the day or week. Create a ritual like writing a “to do” list and posting it on the board. By doing this, you commit to not thinking about the things on the list until the next day. ■ Start a meeting with a humorous story or joke. 5. Collect and share your favorite cartoons and jokes. Create a Joke Board or a Humor Newsletter. Look for tools to disseminate fun and funny things daily. 13. Encourage employees to develop their own style of having fun. A nurse anesthetist at a hospital in Michigan often sings to his patients to help them relax prior to surgery. Patients have appreciated this so much that they have told family and friends about the experience. It is not uncommon now for the hospital staff to get requests for “The Singing Anesthesiologist” when they are scheduling their surgery. 6. Let customers know you are a fun company. Do something just for fun (organize fun customer events, dress for fun, share funny things with customers) and give employees tools to create a fun relationship with customers (stickers, candy for children, dog biscuits for dogs, humorous buttons with the company logo). This makes work more fun for employees and it strengthens the relationship with customers. Dick Snow of Ben and Jerry’s Ice Cream says, “We believe that we’re in the entertainment business and selling ice cream is just a part of what we do. In our stores the counter is our stage and the customers are our audience.” Disneyland has the same kind of approach. Employees are part of an entertainment experience, and they aren’t just doing a job. Remember that employees create fun in the workplace, not managers. It’s a manager’s job to orchestrate fun activities (and not get in the way of them). Jody Urquhart helps professionals create meaningful and fun work environments. For more information call us at (877) 750-1900 or see our website at www.idoinspire.com 7. Gather your co-workers for the “Joy of Work” hour. Everyone must talk about something good at work. Take turns telling stories about the things that make work a joy. Each person should contribute ideas on how to make work more fun. hines Those Office Mac at 6 s leaving the office A young executive wa CEO standing in front the nd fou he PM when piece of paper in his of a shredder with a CEO, "this is a very the d sai hand. "Listen," my tant document, and sensitive and impor s thing thi ke ma you n Ca t. secretary has lef work?" young executive. He "Certainly," said the inserted the paper, on, ne chi ma the turned ton. but rt sta the d sse and pre " said the CEO as his t "Excellent, excellent! ide the machine. "I jus ins ed ear paper disapp need one copy." 8. Have a fun recognition program. Fun is not a reward for performance, but can be a way to encourage employees to perform. For example, you could create “games” out of productive activity...who can motivate the most patients in a hospital to smile and say something funny to the head nurse. Playful and goal-oriented fun is best. 9. Respond to fun when it happens. Funny things occur all the time, but if you are obsessed with left-brain analytical thought, you might find it hard to stop and respond. Natural spontaneous humor is a blessing. Stop and take GA Chapter HFMA • www.georgiahfma.org 20 Summer 2008 GEORGIA SCROLL UnitedHealthcare Administrative Advisory Committee—A Channel to Make Your Issues Known By Susan Clark, CPA, FHFMA ■ New Welcome kit – what items should be included. UnitedHealthcare has created an administrative advisory committee as a forum for information exchange between UnitedHealth Group and the local medical community. The main purpose of the committee is to get feedback from Physicians and Hospitals regarding administrative topics such as web portals, contracts, fee schedules, data, etc. I want to solicit those of you in the provider community for input on any items/comments/feedback on these types of issues so that I may bring them before the committee. You can send your comments to me at [email protected]. Please put “UnitedHealthcare Committee” in the subject line. As President of Georgia HFMA, I am invited to participate on this committee. The committee meets quarterly to discuss issues and ways that UnitedHealthcare can make improvements. Some items discussed at our first meeting were: ■ Roll of Provider Advocates ■ Call center issues – for both Claim adjudication and pre-determination GA Chapter HFMA • www.georgiahfma.org 21 Summer 2008 GEORGIA SCROLL Outreach - Bridging the Gap in Knowledge Among Today’s Healthcare Leaders and the Healthcare Leaders of Tomorrow By Meghan Lynch We talk about getting the most out of our HFMA experience; what better way than to take advantage of two key components that has led many of us to the organization: Education and Networking. As an active member of the ’08 – ’09 Outreach TEAMS committee, my team and I have directed our focus in two primary areas to increase awareness of our organization. First, we are targeting the student and alumni population within many Georgia Colleges and Universities in order to attract new members of a younger generation. Our other initiative focuses on collaborating with professional healthcare organizations to bring education and awareness to a new level. Through collaboration, we as health care leaders can draw attention to some of the most critical issues facing our health care system and we can work together to find a solution. bers. This provides the students with a new way to network among industry professionals. As one of the fastest growing industries, health care is an avenue many students are now looking to become a part of. Simply put, as baby boomers age, the need for medical care is becoming greater and in turn, medical-related job opportunities have become seemingly endless. For someone just starting to enter the adult world, that translates into financial security. Granted, financial success may not be the only motivator for students to focus their studies on the growing health care industry. Many people, myself included, want to contribute to better health among our citizens but can’t seem to stomach the sight of needles. For those of us involved in the healthcare financial sector, we must realize that we too can make a difference. Topics recognized as shared concerns among the financial sector of the industry are Point of Service Collections, Government Reimbursement, and Bad Debt Collections. Georgia HFMA will be collaborating with Georgia AAHAM (American Association of Healthcare Administrative Management) on August 15, 2008, at DeKalb Medical Center in Decatur, Georgia, to co-sponsor an educational event targeted towards PFS professionals. The agenda includes the aforementioned topics, among others. A few of the speakers include our own Roxann Arnold, PFS Director of Emory Crawford Long, who will address POS Collections and also Robert Bolden, Director of Fiscal Services with GHA, who will discuss RACs. Also on the agenda are topics related to Medicaid, EDI, and Team-building efforts. As a call to action, we would like to invite both new and existing members of both organizations to attend this event. Together, we can proactively address these challenges and influence one another to improve the financial performance of our health care systems. Another way we are looking to address the market is by reaching out across all sectors of the industry. By tapping into those already involved in other health care organizations, we can share ideas and challenge one another to bring solutions to some of the most pressing concerns of today and tomorrow. By joining through co-sponsored educational events, we can share individual and unique perspectives related to our own business experiences. We can then benchmark our operations against those representing best practice standards. Recognizing that our health care systems are being threatened we must be proactive in bringing solutions to the table. By reaching out to the student and alumni population entering the healthcare finance sector, we can raise awareness of the emerging trends and issues that will affect this future generation of healthcare leaders. One way we are attempting to gain exposure is by the use of technology. By creating a MySpace and Facebook page devoted to the Georgia Chapter of HFMA, we have found a new medium to build awareness of the chapter and with hopes of attracting new members. On these Internet pages, we have given an overview of the organization, shared photos of our members and provided links to the website to draw additional traffic. A work-in-progress, the plan is to use these social networking sites to generate conversation among members and students (i.e., potential members) and provide real life, professional experiences in hopes of inspiring our youth. Once completed, the pages will host a link to prospective job opportunities, educational events, and contact information for key mem GA Chapter HFMA • www.georgiahfma.org By bridging the gap in knowledge among healthcare leaders and the future leaders of tomorrow, we can learn to become interdependent on each other. What makes the Georgia Chapter of HFMA unique is the people and their shared passion for being a part of this. As we challenge our conventional systems of thought and adapt to the changing needs of the health care industry, we can progressively improve the quality of our organizational performance. Meghan Lynch, Prestige Staffing, Outreach Committee Chairperson, Student Partnering 22 Summer 2008 spring institute 2008 GEORGIA SCROLL Paul Perrotti, Frank Powell and Rick Sheerin facilitate the Financial Executives Roundta ble Networking between sessions Jim Piper and Lamar Blount discuss important iss ues They said there was money under here Jerry Bridge helps everyon e reduce stress Could Karen Newton and Buford Fuddwhacker be the next “Dancing with the Stars” contestants? Kay Stanley and Elaine Dixon Leaders of the GA HFMA Kazoo Band Relaxing during a br eak GA Chapter HFMA • www.georgiahfma.org repares to Jamie Luce p session conduct her 23 Summer 2008 GEORGIA SCROLL spring institute 2008 Great Putt! Larry Kloock and Rob Kream give Terry Brown a pat on the back Eric Bergeon, host another great golf tournament with friends Nate Dondanville & Diana Lindsey A little to the left, Le e Kimberly Farmer, Best Female Shooter The SEC rivalary continues! Everyone enjoys the cookout at a new location Tiffany Dungan takes a shot in the skeet tournament GA Chapter HFMA • www.georgiahfma.org 24 Summer 2008 advertising in the Georgia Scroll GEORGIA SCROLL By advertising in the Georgia Scroll, you can reach over 2,000 healthcare professionals in various fields. If you have a product or service that you would like the healthcare financial industry to know about, please take advantage of this great opportunity. The 2008-2009 Scroll is published as a print magazine distributed by mail, and it is also posted on the Georgia HFMA website at www.georgiahfma.com. Having the Scroll available in hard copy and online on the Chapter website appeals to both readers who enjoy reading hard copy material away from their desks and those who prefer reading on-line. As an advertiser, you can now enjoy double exposure and extra benefit from your marketing dollar through the effective market penetration offered by the Scroll, capturing regional and national audiences. To place your ad, please contact the following Scroll TEAM members: Alan Cobb at [email protected] or (678) 969-7800 Kimberly Farmer at [email protected] or (678) 662-4266 The Georgia Scroll reserves the right to refuse any ad inconsistent with the overall mission of the Georgia Chapter. Inclusion of an ad in this news magazine does not infer endorsement by the Georgia Chapter of the Healthcare Financial Management Association. All ads submitted must be camera-ready. Payment should accompany the ad. Make checks payable to Georgia HFMA. and mail to: Alan Cobb, Hollis Cobb Associates, 6621 Bay Circle, Suite 180, Norcross, GA 30071-1218 Deadlines are: Fall 2008 September 5, 2008 Winter 2009 November 17, 2008 Spring 2009 March 16, 2009 Ad prices below are per issue. If an advertisement is purchased for 4 issues, the advertiser will receive a 10% discount, when paid in full upfront. Display Black & White B&W + 1 color 4 color Inside Cover Back Cover GA Chapter HFMA • www.georgiahfma.org Quarter Page $150 $200 $400 Half Page $200 $250 $500 25 Full Page $400 $500 $800 additional $50 additional $50 Summer 2008 GEORGIA SCROLL Attention: Revenue Cycle Managers By Bonnie Breland Employees are the most valuable asset you have in your organizations. The better educated they are, the more productive they are, and the happier they are to be a part of your team. The proven path for revenue cycle education in Georgia is the CPAR Program. Staff members who are looking to improve their skill set or advance their career continue to credit CPAR as a factor in their success. Tips for initiating positive change: Several years ago, past CPAR Chairpersons started planning to move the CPAR Program to an online, web-based program. With the rapid growth of technology today, that vision became a reality last year in 2007-08. The on-line testing allows Georgia HFMA to provide a longer testing cycle, more testing locations throughout the state, and immediate test results at your fingertips. CARE Information is only the first step. We must also learn to care about the education and knowledge we have and help your fellow peers to identify problems and how to handle those problems in your facilities. BE AWARE The first step towards becoming part of positive change is to be aware of what is happening in the health care world. Learn about issues and help educate your peers through advocacy training and educational information. SHARE We all have knowledge that we can share with the each other. Share what you know. Share your time by volunteering to help your peers study for these exams. You would be surprised how much of a difference it would make if everyone took the time to share a little of themselves! The CPAR Committee is happy to announce enhancements to the website this year. Changes include a lower exam fee and an improved practice test process. Online registration and testing, exam locations and proctors will be the same. The CPAR manual has been available on the website since May 10, 2008, with free CPAR coaching material and practice tests available since June 2008. In addition, the website designation has changed to HFMA Certifications, as the Certified Financial Counselor (CFC) Program is included this year. The CFC study guide will be available on the website on July 1, 2008, with CFC exams held in October 2008. For additional information, visit the Georgia HFMA website at http://www.georgiahfma.org or the CPAR website directly at www.hfmacpar.org. Bonnie Breland ACPAR, Joint Co-Chair CPAR Committee Phoebe Putney Memorial Hospital, Albany, Ga. The GEORGIA HFMA SUMMER INSTITUTE is JULY 23-25, 2008 at HILTON HEAD MARRIOTT RESORT & SPA, HILTON HEAD, SC We look forward to seeing you there! 888-511-5086 GA Chapter HFMA • www.georgiahfma.org 26 Summer 2008 GEORGIA SCROLL GEORGIA HFMA SUMMER INSTITUTE AGENDA JULY 23 – 25, 2008 REGISTRATION DESK OPEN (LEAMINGTON BALLROOM FOYERS) Wednesday, July 23 • 12:00 Noon to 5:00 p.m. Thursday, July 24 • 7:30 a.m. to 12:00 Noon Advanced CPAR Registration 30 minutes prior to sessions *Note: ACPAR Registration is located outside the session room. Chapter Activity Finance Leadership Revenue Cycle & Patient Access Professional Development CPAR/ACPAR TUESDAY, JULY 22, 2008 6:00 7:00 8:00 9:00 PM PM PM PM HFMA Board Meeting 6:00PM - 9:00PM (Dinner provided) WEDNESDAY, JULY 23, 2008 8:00 AM 8:30 AM 9:00 AM 9:30 AM 10:00 AM 10:15 AM 10:30 AM 11:00 AM 11:15 AM 11:30 AM 12:00 PM 12:15 PM 12:30 PM 1:00 PM 1:15 PM 1:30 PM 2:00 PM 2:30 PM 3:00 PM 3:15 PM 3:30 PM 4:00 PM 4:30 PM 5:00 PM 5:45 PM 6:15 PM 6:45 PM 7:00 PM 8:00 PM 9:00 PM 10:00 PM Session 1: “Point of Service Collections” 8:00AM - 10:00AM CPAR Break Session 2: “Legal Issues” 10:15AM-12:15PM Lunch on Your Own 12:15PM - 1:30PM Registration Desk Open Session 3: “Denial Management Strategies” 1:30PM - 3:30PM 12:00PM 5:00PM TEAMS’ Meetings 2:30PM-4:00PM Chairperson’s Mtg 4:00PM-5:00PM New Member Reception (Bullhead Deck) 5:45PM - 6:15PM Children’s Program *Reception in honor of GA HFMA Corporate Sponsors (Basshead Deck) 6:15PM - 6:45PM Dinner & Evening Entertainment (Basshead Deck) 6:45PM - 10:00PM THURSDAY, JULY 24, 2008 7:00 7:30 8:00 9:00 9:10 9:30 9:45 10:00 10:30 10:50 AM AM AM AM AM AM AM AM AM AM 11:05 AM 11:15 AM 11:30 AM 11:45 AM 12:00 PM 12:45 PM Continental Breakfast 7:00AM - 7:30AM Session 4 - General Assembly - Jody Urquhart - “The Nerve to Serve..Say Hello to Humor & Goodbye to Burnout” 7:30AM - 9:00AM Break Registration Desk Open 7:30AM Concurrent Sessions 9:10AM - 10:50AM 5 - A & A (Part 1) Draffin & Tucker 6 -“Recovery Audit Contractors (RAC)” - Laura Pait - 7-“Developing an Enterprise Charge Master” - Laura Outler & Ann Aschenbrenner 8 - “Planning for the Retirement That You Envision” - Mark Koppelmann & Adrian Powell - Smith Barney Break 12:00PM Concurrent Sessions 11:05AM-12:45PM GA Chapter HFMA • www.georgiahfma.org 9 - Financial Executives Roundtable 10 - “Breakthrough 11 - “Leveraging Strategies & Best Self-Service Practices in SelfKiosks for a Pay Mgmt”- Diane Streamlined Pt. Story, Stephen Experience Ross & Jessica Jane Gray & Kim Suchy Whitley 27 12 HFMA 101: “What is it?” Summer 2008 GEORGIA SCROLL GEORGIA HFMA SUMMER INSTITUTE AGENDA JULY 23 – 25, 2008 REGISTRATION DESK OPEN (LEAMINGTON BALLROOM FOYERS) Wednesday, July 23 • 12:00 Noon to 5:00 p.m. Thursday, July 24 • 7:30 a.m. to 12:00 Noon Advanced CPAR Registration 30 minutes prior to sessions *Note: ACPAR Registration is located outside the session room. Chapter Activity Revenue Cycle & Patient Access Finance Leadership Professional Development CPAR/ACPAR THURSDAY (CONT’D) 12:50 1:00 1:15 1:30 2:00 PM PM PM PM PM 2:30 3:00 3:30 4:00 4:30 5:00 5:30 6:00 6:30 7:00 PM PM PM PM PM PM PM PM PM PM Break Session 13: General Assembly - Keynote Address Robert Bolden - Georgia Legislative Update (15 minutes) & Maurice “Termite” Watkins “Termite: An Olympic Dream That Inspired The World” 1:00 PM - 3:00 PM Beach Games (Fun Games for the Children) 3:00 PM - 4:30 PM Reception 4:30 PM - 6:00 PM (Basshead Deck) Dinner on Your Own FRIDAY, JULY 25, 2008 7:00 AM 7:45 8:00 8:30 9:00 9:15 9:30 9:45 10:00 10:40 10:55 11:00 AM AM AM AM AM AM AM AM AM AM AM 11:30 12:00 12:30 12:35 PM PM PM PM Prayer Breakfast 7:00AM - 7:45AM Continental Breakfast 7:00AM - 7:45AM Session 14: General Assembly - Sonja Baro - “Healthcare Policy & the 2008 Election Implications for Healthcare & Information Technology” 7:45AM - 9:00AM Concurrent Sessions 9:00AM-10:40AM 15 A&A (Part 2) KPMG 17 16 - “The Value of Data “Maximizing to Healthcare” Initial Patient - Warner Head Contact” Elizabeth & John Richards Hanggi 18 - “HFMA 201: “Who is it?” Break Concurrent Sessions 10:55AM-12:35PM 19 “Credit Crisis in Healthcare” - KPMG 20 - Revenue Cycle Roundtable 21 - Certification Coaching Door Prizes & Adjournment (Must be present to win) Attention all Parents! Are you bringing your kids to the Summer Institute, but would like some grown-up time out on the town? Hilton Head Nannies has extended a special offer to Georgia HMFA Summer Institute Attendees. Hilton Head Nannies is a licensed agency and conduct background checks on all their staff. The special Georgia HFMA rate for a nanny is $18 an hour for three children from the same family (normal nanny rates are $20 an hour for one child, $5 for each additional child from the same family) approve this arrangement. For more information, visit the Hilton Head Nannies website at www.hiltonheadnannies.com. To arrange nanny services contact Jennie by phone at 843342-5673. Advance notice of 2 weeks is required. Credit card deposit is required for a reservation. Special arrangements for three children from more than one family can be made for an additional charge if the children are age compatible. Jennie at Vacation Nanny Services must GA Chapter HFMA • www.georgiahfma.org 28 Summer 2008 GEORGIA SCROLL Alabama Chapter of HFMA Presents The Region V Dixie Institute - February 17-20, 2009, Mobile, AL 2009 Sponsorship Program Gold: $10,000 As a Gold Sponsor you will receive the following: Main Sponsor of ALL Keynote Speakers, Entertainment and Luncheons Three (3) complimentary meeting registrations Exhibit Booth (double booth) Half Page ad in the Dixie Newsletter Special Signage and Promotion Opportunity to offer “goodies” in the Attendee Welcome Bag Silver: $5,000 As a Silver Sponsor you will receive the following: Sponsorship of ALL meeting breaks Two (2) complimentary meeting registrations Exhibit Booth Company Name Recognition Quarter Page ad in the Dixie Newsletter Bronze: $2,000 As a Bronze Sponsor you will receive the following: One (1) complimentary meeting registration Exhibit Booth Company Name Recognition Exhibit Space: $2500 (double booth) $1600 (single booth) Company Name Recognition One (1) complimentary meeting registration Register by July 31, 2008 to receive this special pricing. All prices will increase after this date. Commitments must be received and paid in full by October 1st to be included in Program Brochure. GA Chapter HFMA • www.georgiahfma.org 29 Summer 2008 GEORGIA SCROLL Yes, we commit to support the Dixie 2009 at the level indicated below: ❑ Gold $10,000 ❑ Silver $5,000 ❑ Bronze $2,000 Exhibit Space: (exhibit only) ❑ $2500 (double booth) ❑ $1600 (single booth) Please type or print Company name: Contact person: Phone: Address: City: State: Zip: E-Mail: Signature: Credit Card Type - Title: VISA Mastercard American Express (please circle one) Credit Card Number Exp. Date Signature Date V-Code (3 or 4 digit number on back of card) Billing Zip Code Make checks payable to Alabama Chapter HFMA and return to: Jeffrey H. Burkhardt, Ph.D., FHFMA Associate Professor Department of Health Services Administration, UAB Webb 558, 1530 3rd Avenue S. Birmingham, AL 35294-3361 Phone: (205) 934-1670 Fax: (205) 975-6608 Email: [email protected] GA Chapter HFMA • www.georgiahfma.org 30 Summer 2008 Data Integration, Inc. 600 Houze Way Suite D-7 Roswell, GA 30076
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