Nearterm News

Clinical-Financial Alignment Simplifies Revenue Cycle for Patients

noreply@blogger.com (Nearterm Houston) — Thu, 09 Apr 2015 13:40:00 +0000

According to Jeff Hurst, the senior vice president of finance at Florida Hospital, the revenue cycle trend hospitals should be moving towards is the integration of financial and clinical operations, in an effort to create a more consumer-friendly revenue cycle.

“Historically, the healthcare industry has done a good job advocating for patients in a clinical setting, and helping the patient understand what to expect during treatment. But the financial side of the healthcare industry has not kept pace with the clinical side,” Hurst, who directs all financial and clinical revenue cycle functions at Florida Hospital, told Healthcare Finance. “Our job from a revenue cycle standpoint is to help the patient navigate the financial intricacies of the healthcare system.”

For Hurst, this means simplifying the healthcare finance system for the patients through proactive “education and outreach” in order to increase patient understanding. Florida Hospital, a 2,247-bed, multi-site acute-care organization, has launched several initiatives in recent years to achieve this simplification. One major innovation includes increasing transparency surrounding out-of-pocket costs through price-estimate phone lines and online applications which allow patients to get estimates on their out-of-pocket responsibility based on their unique circumstances.

“Revenue cycle must learn to focus on continuous improvement of the patient experience,” said Hurst. “The patient experience has to extend beyond the clinical to the finance side of the business.”

As Nearterm sees it, this strategy is underway in most health systems. However, the strategy still has a long way to go in order for most to operationalize it. This is mostly due to the prioritization of spending in light of the cost of re-design and implementation.

Photo by Images_of_Money

Creating a Hospital Quality Management Cycle

noreply@blogger.com (Nearterm Houston) — Wed, 25 Mar 2015 16:05:00 +0000

According to Susan DeVore, president and CEO of Premier, Inc., a healthcare improvement company, today’s healthcare providers are being judged on more than the amount of payment for a procedure and the effectiveness of their billing and collection process. They’re also being increasingly evaluated based on their quality, creating a need for “total quality management.”

In a new op-ed published in the Wall Street Journal, Devore notes that, in today’s health-care industry, “the quality of care is just as important to a hospital’s revenue as making sure claims are paid properly.” Additionally, federal programs requiring hospitals to publicly report their outcomes, as well as rewards or penalties as a result of these outcomes, put pressure on hospitals to perform well. As a result, understanding how to measure performance is essential to a hospital’s success.

“Much like the revenue cycle process, hospitals need to be able to keep track of and manage the quality cycle of care to determine the most important areas of focus and consistently meet high-performance measures,” she writes. “If we take some of the best practices from the revenue cycle, we can implement a quality cycle management process that aligns and focuses firmly on the specific elements of performance that produce continuous quality improvement, and in turn, a healthier balance sheet.”

In the article, Devore notes that these “best practices” include “a clear cadence, metrics with targets, a firm culture of accountability and… deep executive engagement to generate change.”

“Yesterday’s revenue cycle management is today’s quality cycle management,” she says.

Nearterm sees RCM quality metrics as a subset of the overall mission that hospitals embrace which is to deliver quality care in a sustainable way. Quality cycle, in our opinion, is as much among the objectives of RCM as it is also among the objectives of Nursing Services, Supply, and other operational areas of care.

AMA President Urges Physicians to Prepare Billing Cycles for ICD-10 Implementation

noreply@blogger.com (Nearterm Houston) — Wed, 18 Mar 2015 18:19:00 +0000

In response to a letter to the Centers for Medicare & Medicaid Services (CMS), which expressed concern regarding the potential for an accumulation of millions of dollars in unpaid Medicare claims following the ICD-10 implementation, American Medical Association (AMA) President Robert M. Wah is urging physicians to prepare their billing cycles for the transition.

The letter, which was a joint effort from a hundred physician groups, including the AMA, expressed concern that contingency plans have not been established to prevent critical billing disruptions caused by the implementation of ICD-10, which goes in to effect October 1.

“By CMS’ own analysis, one of the most significant risks to moving to ICD-10 is the likelihood for claims processing and cash flow interruptions,” the letter states.

AMA President Wah told RevCycleIntelligence.com that the biggest concern regarding the transition to ICD-10 was demonstrated in CMS’s end-to-end testing, which found a decline in claims acceptance, from 97 percent to 81 percent, among the relatively small sample size tested.

“When this is expanded to all physicians and all claims, the results may be disastrous,” Wah said.

Wah also pointed to issues with previous HIPPA implementations, including NPI and Version 5010, which left some physicians unable to be paid by Medicare for several months.

“Some practices were at the point of being unable to make payroll for staff and needing to temporarily close the practice, or obtain lines of credit with financial institutions until processing was complete,” Wah states. “We are extremely concerned that physicians will face similar issues as a result of the switchover to ICD-10.”

To prepare for the transition, Wah is urging physicians to prepare for the federal mandate.

“Physicians will need to closely track various metrics for their claims including pending claims, rejected claims, days in accounts receivable and payments,” says Wah. “Any issues will need to be addressed and reworked as early as possible to prevent a backlog of unprocessed claims and lack of reimbursement.”

Nearterm can help you get your RCM in top shape in preparation for the ICD-10 compliance date of October 1. We offer coders, claims specialists, and billers to work onsite or remotely.

Read the entire article on RevCycleIntelligence.com

How Outsourcing RCM Supports Company Growth: A Client’s Perspective

noreply@blogger.com (Nearterm Houston) — Mon, 09 Mar 2015 14:20:00 +0000

Several years ago, Capital Women’s Care (CWC), an obstetrics and gynecology group in the Maryland, Virginia and Washington, D.C. areas, was facing a challenge with regards to their revenue cycle. According to Debbie Redd, CWC’s President and CEO, the practice’s revenue cycle was “not functioning to its full potential,” hindering the company's ability to grow.

In a recently-published article from Healthcare Finance News, Redd details how the practice overhauled their revenue cycle management system by streamlining the internal front-end financial processes and outsourcing back-end billing efforts.

According to Redd, the choice to outsource was a “practical alternative to keeping things in-house,” as it allowed the practice to “rely on an expert whose sole business is revenue cycle management” while freeing up time for the practice to “focus on expanding… and supporting providers in high-quality clinical care for patients.”

Overall, Redd concludes that outsourcing back-end processes both stabilized CWC’s financial operations and built a foundation of support for the company’s expansion.

"Before we began outsourcing our backend processes, our days in A/R were over 100," writes Redd. "Now we consistently see rates of less than 20. We also have about a 99 percent collection rate."

Additionally, Redd notes that the strong changes made to the front- and back-end of the revenue cycle make the organization “more attractive to new providers and potential partners.”

“Providers come to us seeking membership because they see how we effectively manage both the clinical and business sides of the practice. This has allowed us to expand our business and prepare for the coming changes in healthcare.”

Read the entire article on Healthcare Finance News.

Nearterm provides healthcare revenue cycle management (RCM) services for hospitals, medical clinics, and physician practices. Our RCM services are designed to provide clients with practical solutions and assist them toward strengthened financial positions.

The Damaging Effect Overstretched Revenue Cycle Management Resources have on Your Bottom Line

noreply@blogger.com (Nearterm Houston) — Fri, 20 Feb 2015 19:57:00 +0000

A recent Revenue Cycle Management (RCM) survey by NexGen Healthcare demonstrates the ways overstretched RCM resources can affect your bottom line.

According to the survey, which was conducted among practices across the nation and evaluated several high-level metrics, many medical practices are “falling short” of the best practices benchmark.

The survey found that the majority of practices, 77 percent, have between one and 10 people working in their billing offices. Only 7 percent said they had 25 or more employees working in a billing function. Additionally, only 15 percent of practices rated their ability to follow-up and resolve denials as 10 or “excellent”; 31 percent rated their abilities between 1-5.

According to Benjamin Colton and David Wofford of ECG Management Consultants, ineptitude and lack of technical knowledge may be contributed to the lack of qualified professionals within the RCM field.

“Unfortunately, revenue cycle management is often a thankless role with an unclear career path and therefore does not always attract top talent,” Colton & Wofford wrote in their article 6 Essential Elements for Physician Revenue Cycle Management. “Consequently, as physician practices are rapidly consolidated under hospital or health system ownership, the demand for people with the requisite skills is almost certain to exceed the supply and it will be common to find revenue cycle managers (and even directors) who struggle to see the way forward for their operation.”

According to the authors, the solution to this failure in RCM, which ultimately affects a hospital’s bottom line, is to outsource billing functions through a “sound, performance-driven contract that holds the vendor accountable.”

“Healthcare organizations that outsource portions of their revenue cycle operations typically do so to access advanced practice management capabilities more quickly or more economically than they could if they developed the operations on their own,” they write.

Nearterm provides interim management, executive search and project staffing for medical and healthcare organizations and hospitals nationwide. Our experienced and knowledgeable principal partners are actively involved in every RCM project we take on. Also, we are employee-owned and utilize an Employee Stock Ownership Plan (ESOP), giving each of our contractors the motivation to perform in an accountable manner.

Nearterm has been recognized by TAPC and HAAPC for outstanding contract/temporary service in the Technical/Professional category.

Health Information Management (HIM) to Surpass EHR Purchasing Amid Healthcare Reforms

noreply@blogger.com (Nearterm Houston) — Wed, 18 Feb 2015 16:01:00 +0000

According to a recently-released Frost and Sullivan report, health information management (HIM) and revenue cycle analytics are projected to surpass the electronic health records (EHR) purchasing market within the next few years, as hospitals adapt to meet the changes spurred by healthcare reform and the possible implementation of ICD-10.

"Hospitals understand they must establish new business models in order to survive under a dramatically transformed provider landscape," said Frost & Sullivan Connected Health Principal Analyst Nancy Fabozzi.

Read the entire article on Health IT Analytics.

Nearterm provides expert revenue cycle, financial management and health information management consulting for medical and healthcare organizations and hospitals. Contact us today to learn how Nearterm can help your business.

Revenue Cycle Industry to See Changes in 2015

noreply@blogger.com (Nearterm Houston) — Wed, 28 Jan 2015 17:17:00 +0000

The New Year will be a year of changes for professionals in hospital revenue cycle, notes a new article from Healthcare Finance News. The biggest changes impacting the industry include the move from fee-for-service to population-based payment systems, as well as the possible implementation of ICD-10.

According to the article, it will become critical for those at the department level of hospitals to understand foundational revenue cycle management, a task which will be left up to revenue cycle management directors. Additionally, the article notes that uncertainty regarding whether or not congress will implement ICD-10 in October 2015 will have a large impact on hospitals, primarily because of the revision's effect on coding procedures.

“[IDC-10] will be a bigger change on the hospital side because they now have to code based on procedure codes instead of revenue codes,” Laurie DeSantis, vice-president of operations for HCL, explained to the website. “The unknowns are especially large because the payers haven’t released their payment policies yet. It is hard to say that even when the coding is correct how the payers will react.”

Over the years, Nearterm has developed a strategy that provides coding expertise anywhere in the United States to deal with existing requirements, as well as the requirements imposed by the implementation of ICD-10.

Read the entire article on Healthcare Finance News.

Revenue Cycle Management Outsourcing Projected to Expand

noreply@blogger.com (Nearterm Houston) — Wed, 21 Jan 2015 21:22:00 +0000

Investment in revenue cycle management (RCM) outsourcing is set to expand at a compound annual growth rate of 7.2 percent through to 2019, according to a recent report from MicroMarket Monitor, a market research firm.

The report, which examines North America’s revenue cycle management market, was prepared through “extensive primary and secondary research.” The report’s findings are supported by previous reports which indicate that the RCM market is growing.

“RCM has become one of the most popular functions for healthcare providers to outsource, due to its critical importance and significant challenges associated with managing internal functionalities of hospitals and clinics, in an efficient and cost-effective manner,” the report notes. “The transformation of the U.S. healthcare facility is anticipated to ensure widespread adoption of these outsourced services.”

Consistent with this trend and as one of these outsourced RCM providers, Nearterm has experienced increased demand for our services, particularly for our nationwide Interim Management, Technicians (Coders, Billers and Collectors) and Healthcare Executive Search.

The entire report can be bought on the MicroMarket website.

noreply@blogger.com (Nearterm Houston) — Wed, 22 Oct 2014 19:51:00 +0000

CMS UPDATE FOR HIM PROFESSIONALS

Here is some great information and access to some useful resources via CMS:

Latest News

MLN Connects™ National Provider Call: Transitioning to ICD-10
Wednesday, November 5; 1:30-3pm ET
To Register: Visit MLN Connects™ Upcoming Calls. Space may be limited, register early.
HHS has issued a rule finalizing October 1, 2015 as the new compliance date for health care providers, health plans, and health care clearinghouses to transition to ICD-10. During this MLN Connects™ National Provider Call, CMS subject matter experts will discuss ICD-10 implementation issues, opportunities for testing, and resources. A question and answer session will follow the presentations.Register or visit the November 5 call web page for more information.
Agenda:

Final rule and national implementation
Medicare Fee-For-Service testing
Medicare Severity Diagnosis Related Grouper (MS-DRG) Conversion Project
Partial code freeze and annual code updates
Plans for National Coverage Determinations (NCDs) and Local Coverage Determinations (LCDs)
Home health conversions
Claims that span the implementation date

Target Audience: Medical coders, physicians, physician office staff, nurses and other non-physician practitioners, provider billing staff, health records staff, vendors, educators, system maintainers, laboratories, and all Medicare providers
Continuing education credit may be awarded for participation in certain MLN Connects Calls. Visit the Continuing Education Credit Information web page to learn more.

Deadline for ICD-10 Allows Health Care Industry Ample Time to Prepare For Change
The U.S. Department of Health and Human Services (HHS) has issued a rule finalizing Oct. 1, 2015 as the new compliance date for health care providers, health plans, and health care clearinghouses to transition to ICD-10. This new deadline gives providers, insurance companies, and others in the health care industry time to ramp up their operations to ensure their systems and business processes are ready to go on Oct. 1, 2015.
For more information read the rule or view the press release.
New Medscape Education Resources
CMS has released three new Medscape Education modules to help providers prepare for ICD-10. The new resources are available on the Provider Resources page. Continuing medical education (CME) and nursing continuing education (CE) credits are available to health care professionals who complete the learning modules, but anyone can take them and receive a certificate of completion. If you are a first-time visitor to Medscape, you will need to create a free account to access these resources.
• Video: ICD-10: Getting From Here to There -- Navigating the Road Ahead
• Video: ICD-10 and Clinical Documentation
• Expert Column: Preparing for ICD-10: Now Is the Time
Road to 10: CMS Online Resource for Small Practices
CMS has released “Road to 10,” an online resource built with the help of providers in small practices. This tool is designed to help small medical practices jumpstart their ICD-10 transition.
“Road to 10” includes specialty references and gives providers the capability to build ICD-10 action plans tailored for their practice needs.
Successful Results from CMS ICD-10 Acknowledgement Testing Week
In March 2014, the Centers for Medicare & Medicaid Services (CMS) conducted a successful ICD-10 testing week. Testers submitted more than 127,000 claims with ICD-10 codes to the Medicare Fee-for-service (FFS) claims systems and received electronic acknowledgements confirming that their claims were accepted. Read more about the results of the testing in this CMS eHealth blog.
CMS eHealth University
CMS eHealth University, a resource to help providers understand, implement, and successfully participate in ICD-10 and other CMS eHealth programs, features a full curriculum of materials and information, all in one location. The education modules are organized by level, from beginner to advanced, and simplify complex information in a variety of formats, including fact sheets, guides, videos, checklists, webinar recordings, and more.
Visit eHealth University website to find resources to help you prepare for the compliance date.
CMS/WEDI Implementation Success Initiative
The Workgroup for Electronic Data Interchange (WEDI) is partnering with CMS and other public and private organizations to develop the ICD-10 Implementation Success Initiative. The first phase of the Initiative, a searchable database of ICD-10 issues, is open to the public to submit questions. WEDI, CMS, and industry partners will update the database with information and resources to help health care organizations who submit issues understand how the new codes and standards will affect reporting of diagnoses and inpatient procedures.
The goal of this initiative is to ensure a successful ICD-10 transition for all stakeholders, including health care providers, payers, clearinghouses, and vendors.
Stay up to date on ICD-10!
Sign up for CMS ICD-10 Email Updates and follow us on Twitter.

J.J. WATT QUOTE

noreply@blogger.com (Nearterm Houston) — Fri, 10 Oct 2014 21:47:00 +0000

I typically ignore the myriad of quotes and quips that saturate social media these days but this one caught my eye:

"SUCCESS ISN'T OWNED, IT'S LEASED. AND THE RENT IS DUE EVERY DAY"

Wouldn't it be great if everyone embraced this wisdom? It applies to our personal lives as well as our professional lives. So if you are a Revenue Cycle Leader, HIM Director, Hospital CFO or some other key role player, be sure to pay your rent :)

Hope you enjoyed reading this as much as I enjoyed sharing it. We at Nearterm practice it every day!

Jim Matthews
Principal; Nearterm Corporation
(281) 646-1330

AHIMA 2014 Convention - iPad Winner

noreply@blogger.com (Nearterm Houston) — Wed, 08 Oct 2014 14:02:00 +0000

Nearterm would like to congratulate our iPad winner Diane Brooks, Compliance Auditor/Educator at Central California Faculty Medical Group.

Diane was shocked and super excited. She said she did not own an iPad and had been looking at getting one. She also said she had never won anything at the shows before so this made an impact with her.

Congratulations Diane!

Nearterm at the AHIMA 2014

noreply@blogger.com (Nearterm Houston) — Thu, 02 Oct 2014 18:10:00 +0000

Thank you to everyone who came to the Nearterm booth at the AHIMA 2014 in San Diego. You made our show a great success.

OUTSOURCE HOSPITAL CODING OVERSEAS?

noreply@blogger.com (Nearterm Houston) — Fri, 12 Sep 2014 15:06:00 +0000

IMPORTANT CONSIDERATIONS RELATED TO OVERSEAS CODING OUTSOURCE PLANS

AHIMA published this article recently. It provides practical insight for your consideration when contemplating outsourcing hospital coding overseas. Here is a link; http://library.ahima.org/xpedio/groups/public/documents/ahima/bok1_050329.hcsp?dDocName=bok1_050329
Most industries depend on foreign resources either directly or indirectly. Healthcare is no different. Many facilities are outsourcing coding and other functions overseas. However, most HIM Leaders we have talked with about outsourcing coding overseas are reticent about it for a variety of reasons. If you are an HIM decision maker, we would welcome your opinion on this topic.

CMS OFFERS A DEAL

noreply@blogger.com (Nearterm Houston) — Mon, 08 Sep 2014 21:50:00 +0000

CMS OFFERS AN INCENTIVE TO SETTLE DISPUTED INPATIENT MEDICARE CLAIMS

CMS and hospitals have historically been challenged to reach agreement on Medicare claims that have been suspended. The volume has increased dramatically resulting in processing backlogs and impasse. Here is a link to a recent CMS publication explaining the new "offering" to pay backlogged claims at a discount if hospitals will accept the discounted rate as payment in full.

http://www.cms.gov/Research-Statistics-Data-and-Systems/Monitoring-Programs/Medicare-FFS-Compliance-Programs/Medical-Review/InpatientHospitalReviews.html

If you are a Hospital CFO and/or Revenue Cycle Leader in a Medicare provider organization, this article may be of interest. Among other services, Nearterm works with hospitals to assist with Medicare billing and collection activities. Most of our work is done at the patient account level but this offering by CMS may be an opportunity to remedy appeals through an administrative discount.

Obviously, the decision to further discount revenue that is already marginal is formidable. Meantime, if you have a Medicare backlog give us a call. We have AR Specialists that can go to work immediately helping you prepare for the CMS deal or moreover helping you avoid the discount deal by resolving your claims at their full negotiated value.

Jim Matthews; Principal, Nearterm Corporation

(281) 646-1330

www.nearterm.com

Revenue Cycle DRP

noreply@blogger.com (Nearterm Houston) — Fri, 29 Aug 2014 16:13:00 +0000

REVENUE CYCLE DISASTER RECOVERY PLANNING (DRP) IS CRITICAL

Most hospitals have highly detailed disaster plans that are mostly focused on direct patient care issues and that is absolutely the appropriate focus. However, we as revenue cycle professionals advocate the reminder that cash flow is a critical when disaster strikes. The following wikipedia link articulates DRP issues fairly well - http://en.wikipedia.org/wiki/Disaster_recovery_plan

Here are a few questions to think about as you review your revenue cycle disaster plan:

What is the increased volume capacity of the hospital and how would sudden increased volume caused by a disaster and perhaps sustained for several weeks impact registration, coding, billing and collections? For example, if you are accustomed to X OP/ED visits and Y census, what happens if volumes increase to hospital capacity? Is it a 25% increase, 40% or more? If your system is down and staff can't get to work, what is the plan?
How quickly can EHR's, subsidiary AR ledgers, patient account histories and other data be accessed and what would the process be to do it?
Is there a resource in the revenue cycle operation that is well versed in securing funds from various agencies that are involved in disaster relief?

Generally, 99% of hospital employees live in the immediate area surrounding the facility. They are therefore in the effected area and most are either dealing with personal trauma or in other cases they are patients. But the work of financial and revenue cycle professionals must continue in order to maintain patient services and to support the viability of the hospital. This includes management and technicians as well.

The contemporary and increasing practice of using remote hospital resources for certain functions is an option to consider, not only during disaster conditions but routinely. This option delivers an experienced labor pool and/or leadership team when the need arises.

Nearterm is in the business of providing interim resources to healthcare providers as part of the business model. Nearterm has clients routinely accessing this model as part of their routine non-disaster operation but it is easily applied when providers face disaster management challenges. Resources might include senior financial leaders, department heads, HIM Directors, Patient Financial Service Managers, Coding Managers, Collectors, Billers, call center personnel and more.

We are always interested in sharing solutions developed by hospitals and colleagues. Please feel free to share your experience by responding to this blog. If you would like to hear more about how we can be of assistance or simply get acquainted, let's talk.

Jim Matthews; Nearterm Corporation

(281) 646-1330

jmatthews@nearterm.com

REVENUE CYCLE EMPLOYEE DRESS CODE

noreply@blogger.com (Nearterm Houston) — Thu, 28 Aug 2014 20:25:00 +0000

HOSPITAL DRESS CODE IS CHANGING

Eric Chester has written a very interesting article on the topic of dress code.

http://ericchester.com/2014/07/16/casual-friday-or-casual-everyday/

I found this article and many others written by Mr. Chester to be very informative and practical. If you are a healthcare leader in a provider organization, you know that our industry has unique dress code protocol. Some is related to occupation at a facility, some driven by public business acumen and certainly culture and location influence dress code policy.

Because our business is revenue cycle services, we visit many hospitals every week. It is our observation that revenue cycle employee dress code policy seems to be all over the map. In any case, it is important to adapt and we hope this article provides you with food for thought as it did for us.

Jim Matthews; Principal

Nearterm Corporation

(281) 646-1330

jmatthews @nearterm.com

Hospital Collection Practices

noreply@blogger.com (Nearterm Houston) — Tue, 26 Aug 2014 16:16:00 +0000

COLLETION LAWS THAT MAY PROVIDE POLICY GUIDANCE

This is a very practical look at the laws that guide hospital collection practices. Are your policies and procedures compliant? (see below)

http://www.consumer.ftc.gov/articles/0149-debt-collection

If you have comments to share with colleagues about how you have designed collection protocols that are compliant and advantageous from a collection standpoint, please post them here.

Thanks, Jim Matthews; Principal (281) 646-1330

www.nearterm.com

AHIMA 2014 Conference, San Diego, CA

noreply@blogger.com (Nearterm Houston) — Mon, 25 Aug 2014 20:54:00 +0000

The AHIMA Convention is not only a great opportunity to access cutting edge education and thought leadership, it is also a great way to meet new healthcare industry friends and strengthen existing relationships. I hope you will stop by the exhibit hall and come see us at BOOTH 1041. We would love to meet you. Be sure to enter the drawing for an iPad 2!

Check it out at the AHIMA website http://www.ahima.org/convention

TxHIMA 2014 Conference

noreply@blogger.com (Nearterm Houston) — Thu, 12 Jun 2014 13:38:00 +0000

Thank you to everyone who visited Nearterm's HIM Team at TxHIMA. Congratulations to Betty Janak, RHIA for winning the gift card drawing.

ANI: the 2014 HFMA National Institute - Booth 333

noreply@blogger.com (Nearterm Houston) — Thu, 29 May 2014 21:25:00 +0000

Booth #333

Enter to win iPad

SCAN YOUR BADGE AND BE ENTERED INTO THE DRAWING

WINNER SELECTED LAST DAY OF SHOW,

NEED NOT BE PRESENT TO WIN

http://www.hfmaconference.org/

ICD 10 DELAY VOTE TOMORROW

noreply@blogger.com (Nearterm Houston) — Wed, 26 Mar 2014 18:51:00 +0000

Very interesting vote tomorrow........

CONGRESS TO VOTE ON ICD-10 DELAY TOMORROW, YOUR ACTION NEEDED TODAY TO STOP BILL

A new bill has been quietly introduced into the US House and Senate that features a section calling for the delay of ICD-10-CM/PCS implementation until 2015. This bill is expected to go to the House floor tomorrow, Thursday, March 27 for a vote.

The bill, which would adjust the Sustainable Growth Rate (SGR) and amend the Social Security Act to extend Medicare payments to physicians and change other provisions of the Medicare and Medicaid programs, also includes a seven line section that would delay ICD-10 to October 1, 2015.

This bill was negotiated at the leadership level in the House and Senate, and it is expected that there will be no debate before calling the bill to vote.

Call Congress Now to Request Removal of Delay Provision

Again, this bill is expected to go to the House floor tomorrow for a vote. AHIMA urges members and other stakeholders to contact their representatives in Congress today and ask them to take the ICD-10 provision out of the SGR bill.

Go to our website now and use your zip code to look up phone numbers for your representatives and senators in Congress. http://capwiz.com/ahima/callalert/index.tt?alertid=63161891

Phone Script Available Below for Use in Contacting Your Legislator:

"Hello Representative XX/Senator XX, my name is XXX and I am a concerned member in your district, as well as a healthcare professional. I am calling to voice my opposition to the language in the SGR patch that would delay ICD-10 implementation until October, 2015. CMS estimates that a 1 year delay could cost between $1 billion to $6.6 billion. This is approximately 10-30% of what has already been invested by providers, payers, vendors and academic programs in your district. Without ICD-10, the return on investment in EHRs and health data exchange will be greatly diminished. I urge you, Representative XX/ Senator XX to oppose the ICD-10 delay and let Speaker Boehner and Senate Majority Leader Reid know that a delay in ICD-10 will substantially increase total implementation costs in your district as well as delay the positive impact for patient care."

Get more details at the Journal of AHIMA website.
http://journal.ahima.org/2014/03/26/congress-voting-tomorrow-on-icd-10-delay-ahima-calls-on-members-to-take-action/

wwww.nearterm.com

noreply@blogger.com (Nearterm Houston) — Fri, 04 Oct 2013 19:21:00 +0000

THERE'S A CODE FOR THAT!

I found this coding article very entertaining and also provocative. If you are an HIM professional, you are probably already familiar with some of this but the perspective reflected in this blog is amusing nonetheless. If you have similar or new perspectives, please share with us at www.nearterm.com .

Burn Due to Water Skis on Fire? - There's an ICD-10 Code For That

Struck by a Turtle? Walked Into a Lamppost? Hurt While Crocheting? Burn Due to Water Skis on Fire? – There’s a Code for that.
Don’t you hate those burns you get when your water skis catch on fire? Speaking of burning water skis, will your practice sink or swim through the ICD-10 transition? ICD-10 is a massive change and the impact cannot be understated for physicians and the financial health of their practices. GroupOne was there for our clients through 5010, for meaningful use and when they transitioned to paperless EHR systems. GroupOne’s RCM clients will not have to face the ICD-10 challenge alone.
In addition to providing ICD-10 training sessions for its providers, GroupOne’s partner practices will also have access to ICD-10 trained certified coders and reimbursement experts, who will monitor coding and documentation for proper ICD-10 compliance.
Furthermore, GroupOne will also provide its clients with access to clinical interface terminology technology. The tool interfaces the standard ICD-9-CM / ICD-10 driven terminology in the EHR search with an improved 260,000+ term search that expresses clinical intent while at the same time providing the correct coding for the intent. The tool solves the problem of forcing clinicians to remember and use the often awkward and cumbersome ICD-9/ ICD-10 coding language when documenting in an EHR. A client survey shows the 93% of users are more satisfied with EHR when this tool is utilized. The tool also aids with Meaningful Use Compliance and is already mapped to ICD-10. This tool greatly simplifies the transition to ICD-10 for clinicians eliminating much of the need to learn a completely new coding terminology.
Excerpts from an earlier Wall Street Journal article are included below. Some may find this interesting / amusing. ICD-10 is a good reason for medical practice to partner with a professional revenue cycle management (RCM) firm like GroupOne Health Source.

By ANNA WILDE MATHEWS - Wall Street Journal
Today, hospitals and doctors use a system of about 18,000 codes to describe medical services in bills they send to insurers. Apparently, that doesn't allow for quite enough nuance.
A Code for What Ails You
Search for diagnoses codes from the International Classification of Diseases, 10th Revision, by typing in a keyword. We've provided a few to get you started.
A new federally mandated version will expand the number to around 140,000—adding codes that describe precisely what bone was broken, or which artery is receiving a stent.
It will also have a code for recording that a patient's injury occurred in a chicken coop. (See code.)
Indeed, health plans may never again wonder where a patient got hurt. There are codes for injuries in opera houses (see code), art galleries (see code), squash courts (see code) and nine locations in and around a mobile home (see codes), from the bathroom to the bedroom.
Health insurers, doctors and hospitals are bracing for chaos as they prepare to adopt a new federally mandated format for medical billing. Anna Wilde Mathews has details on Lunch Break.
Some doctors aren't sure they need quite that much detail. "Really? Bathroom versus bedroom?" says Brian Bachelder, a family physician in Akron, Ohio. "What difference does it make?"
The federal agencies that developed the system—generally known as ICD-10, for International Classification of Diseases, 10th Revision—say the codes will provide a more exact and up-to-date accounting of diagnoses and hospital inpatient procedures, which could improve payment strategies and care guidelines. "It's for accuracy of data and quality of care," says Pat Brooks, senior technical adviser at the Centers for Medicare and Medicaid Services.
Billing experts who translate doctors' work into codes are gearing up to start using the new system in two years. They say the new detail is welcome in many cases. But a few aspects are also causing some head scratching.
W61.11XA: A code for injuries related to macaws.
Some codes could seem downright insulting: R46.1 is "bizarre personal appearance (see code)," while R46.0 is "very low level of personal hygiene (see code)."
It's not clear how many klutzes want to notify their insurers that a doctor visit was a W22.02XA, "walked into lamppost, initial encounter" (or, for that matter, a W22.02XD, "walked into lamppost, subsequent encounter").
Why are there codes for injuries received while sewing, ironing, playing a brass instrument, crocheting, doing handcrafts, or knitting—but not while shopping, wonders Rhonda Buckholtz, who does ICD-10 training for the American Academy of Professional Coders, a credentialing organization.
Code V91.07XA, which involves a "burn due to water-skis on fire (see codes)," is another mystery she ponders: "Is it work-related?" she asks. "Is it a trick skier jumping through hoops of fire? How does it happen?"
Much of the new system is based on a World Health Organization code set in use in many countries for more than a decade. Still, the American version, developed by the Centers for Disease Control and Prevention and the Centers for Medicare and Medicaid Services, is considerably more fine-grained.
Y93.J4: A code for injuries received while playing brass instruments.
The WHO, for instance, didn't see the need for 72 codes about injuries tied to birds. But American doctors whose patients run afoul of a duck (see codes), macaw (see codes), parrot (see codes), goose (see codes), turkey (see codes) or chicken (see codes) will be able to select from nine codes for each animal, notes George Alex, an official at the Advisory Board Co., a health-care research firm.
There are 312 animal codes in all, he says, compared to nine in the international version. There are separate codes for "bitten by turtle" and "struck by turtle." (See codes.)
U.S. hospitals and insurers are bracing for possible hiccups when the move to ICD-10 happens on Oct. 1, 2013 (delayed until Oct 1, 2014), even though they've known it was coming since early 2009.
"You have millions of transactions flowing in the health-care system and this is an opportunity to mess them all up," says Jeremy Delinsky, chief technology officer for athenahealth Inc.
Medicare officials say they believe many big insurers and hospital systems are making preparations, but there may be some issues with smaller ones that won't be ready.
With the move to ICD-10, the one code for suturing an artery will become 195 codes, designating every single artery, among other variables, according to OptumInsight, a unit of UnitedHealth Group Inc. A single code for a badly healed fracture could now translate to 2,595 different codes, the firm calculates. Each signals information including what bone was broken, as well as which side of the body it was on.
Some companies hope to grab business from the shift. One medical-coding website operator, Find A Code LLC, has created a series of YouTube videos with the tagline, "Yeah, there's a code for that." Snow White biting the poisoned apple, the firm says, may be a case of T78.04, "anaphylactic shock due to fruits and vegetables (see codes)." On April 1, the company posted a document with the secret "X-codes" to describe medical conditions stemming from encounters with aliens.
Other coding cognoscenti spot possible hidden messages in the real codes. The abbreviation some use for the new system itself, I10, is also a code for high blood pressure. Several codes involving drainage devices end in "00Z." Then there are two of the codes describing sex-change operations that end in N0K1 and M0J0. "You could see it ripple through the room as people said, 'nookie and mojo!'" says Kathryn DeVault, who has been teaching ICD-10 classes for the American Health Information Management Association. "Was it purposeful? We don't know."

AHIMA 2013 Conference

noreply@blogger.com (Nearterm Houston) — Fri, 20 Sep 2013 16:19:00 +0000

The AHIMA Convention is not only a great opportunity to access cutting edge education and thought leadership, it is also a great way to meet new healthcare industry friends and strengthen existing relationships. I hope you will stop by the exhibit hall and come see us at BOOTH 834. We would love to meet you and we are giving away an iPad 2!

Check it out at the AHIMA website http://www.ahima.org/convention

HEALTHCARE CAREER TIP

noreply@blogger.com (Nearterm Houston) — Thu, 12 Sep 2013 16:38:00 +0000

Here is a quote from Mark Twain that you may find inspirational as you build your career, your life and your reputation;

"YOU CANNOT BUILD YOUR REPUTATION ON WHAT YOU ARE GOING TO DO"

Next time you have a moment of introspection about your image, consider that reputation is defined as the general estimation in which a person is held by the public. Take inventory of your progress in terms of what you have done, not what you are going to do. This exercise may give you guidance about renewed goals or changes you want to make as you build your reputation.

At Nearterm, we have the expertise to assist you in your efforts to enhance your career and to help you achieve a strong reputation for your facility. We recognize that like people, businesses also have a reputation. Business reputation is critical in the competitive environment we occupy. The reputation of your revenue cycle team is based on performance, not what you have planned. If you would like to talk about how to achieve what we refer to as "REPUTATION EXCELLENCE" for your healthcare revenue cycle operation or your healthcare financial operation, please give us a call.

Jim Matthews

Principal

CODER INFORMATION

noreply@blogger.com (Nearterm Houston) — Thu, 29 Aug 2013 14:47:00 +0000

Coding professionals may find this site useful. It is the "official" source for up to date information.

http://www.cms.gov/Medicare/Coding/ICD10/Latest_News.html

Please feel free to contact us for all of your HIM resource needs!

Jim Matthews
jmatthews@nearterm.com

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CODER INFORMATION