Billing Operations Management Seminar — Course Description
Monday, July 14, 2008
8:15 am – 9:15 am
HSAs, HRAs, HDHPs: How to Survive the Coming High-Deductible Environment
Daniel J. Marino, MBA, MHA
The growth of Health Savings Accounts (HSAs), Health Reimbursement Arrangements (HRAs) and other high-deductible health plans (HDHPs) has created a whole new class of patients—individuals who have insurance but who function in critical respects like self-pay. To accommodate these patients without losing money, radiology practices and imaging centers need to make a number of key changes to both operations and strategy. This presentation will provide detailed information on how to adapt revenue cycle processes to the coming high-deductible environment and create a price-driven growth strategy.
9:15 am – 10:15 am
What Makes a Good Billing Service?
Barbara J. Grant, CPA, MST
The quality of the billing process can make or break a radiology practice. Therefore, the decision of whether to outsource billing services or maintain an in-house billing department is never an easy one. What are the advantages and disadvantages of outsourcing your billing? How should you go about identifying qualified billing companies, judging their performance and comparing the cost of outsourcing to an in-house department? What key provisions should be in a billing contract? In this session, radiology business managers will learn the answers to these questions.
10:45 am – 11:45 am
CONCURRENT SESSIONS
Corporate Integrity Agreement: What it is and How to Avoid it
Heather Zimmerman, Esq.
In light of the heightened government interest on controlling imaging costs and scrutiny of leasing and similar arrangements, it is important to understand the legal authority and theories on which the government can bring an enforcement action, including the
False Claims Act, the Anti-Kickback Statute and Corporate Integrity Agreements. This session will enhance understanding of government enforcement actions and provide tips on how to avoid becoming the target by implementing an effective compliance program.
Bridging the Technology Gap
Nicole L. Palmer, CPA
Billing software and its capabilities have been changing rapidly over the last several years. Just keeping up to date with what functionality is available can be difficult and time consuming. This session is designed to provide a process whereby the participant can review the practice’s billing operation to assess technology needs, potential add-ons or software upgrades that could allow for more efficient billing processes.
Selecting a Billing Service – More Than Just Price
Patricia Kroken, FACMPE, CRA
The decision to select (or change) a billing service is one of the more critical business decisions facing a practice. Too often, an emphasis strictly on "best price" ends up costing the group in terms of performance and revenue. Ideally the billing decision will be made only once and a long-term partnership established, since there is risk each time a change occurs.
1:00 pm – 2:00 pm
CONCURRENT SESSIONS
Motivation, Quality, and Output: Bringing it All Together
Joseph A. Seale, CMA, CFE
We all want our organization to produce quality work; however, we also want to perform as cost effectively as possible. Many times these two objectives seem to be at odds with one another, but it doesn’t have to be that way. Learn how to use 21st century tools to tackle problems intelligently without making rookie mistakes.
Managing Denials From Registration Through the Appeal Process
Dorothy Steed, CPC-H, CCS-P, RCC
This session will discuss ten tips for either avoiding denials or managing claims/line items that have been denied. Subject matter will include the registration process through billing, meeting medical necessity, working remittance advices, when and how to appeal, and creating tools to assist in determining weakness in the operational flow.
Record Retention – Do’s and Don’ts
Steven C. Bennett, JD
As we shift to making electronic medical records the standard, it raises questions regarding compliance with current laws and regulations. For example, where should you retain your records and for how long? How often should your program be audited to ensure compliance? How and when should you destroy records? Who should have access to them? This session will address these and many other compliance questions related to online health record keeping.
2:15 pm – 3:15 pm
GENERAL SESSION
The Radiology Billing Self Audit: Steps Every Billing Office Should Be Performing
Shannon J. Doyle
Audits are different from the standard billing practices of double checks and internal controls. The impetus behind this presentation is that state-of-the-art billing companies should be performing their own audits on a continual basis. These audits should cover the gamut of the billing functions: charge collection and input, coding, manual and EDS billing mechanics, payment receipt and posting, A/R management and collection agency procedures.
3:30 pm – 4:30 pm
GENERAL SESSION
Effectively Collecting Self Pay Balances
David F. Jakielo, CHBME
As patient deductibles increase, effectively collecting self-pay balances is becoming a more important part of a practice’s everyday operations. This session will examine various techniques to ensure that you maximize the collection of self-pay balances without alienating your patient. Discover proper communication tools, precollection strategies, and ways to connect with the patient as well as what you must avoid relating to the collection process.
Tuesday, July 15, 2008
8:30 am – 9:30 am
GENERAL SESSION
Detecting the Silent PPO
Michael R. Lowe, Esq.
In this session you will be shown how to expose any silent PPOs in your practice. You will be able to recognize silent PPO transactions and identify techniques used to prevent the detection of silent PPOs. Also included in the discussion will be the negative impact of silent PPOs on the revenue cycle, the reasons why silent PPOs persist and how to combat them.
9:30 am – 10:30 am
GENERAL SESSION
Training Employees to be Excellent Customer Service Representatives
David F. Jakielo, CHBME
This session will cover the essential tools and techniques everyone in your organization needs that will enable them to provide excellent customer service. Techniques will be applicable to everyone you come in contact with who effects your business. The tools will help all your team members deliver excellent customer service to patients, referring doctors, fellow employees, vendors etc. Your ability to provide excellent service to both internal and external customers is a key element to any successful company.
11:00 am – 12:00 pm
GENERAL SESSION
2008: Update on New Medicare Rules & Impending Changes
Thomas W. Greeson, JD
The Stark Law and Medicare rules applicable to IDTFs and diagnostic imaging arrangements with referring physicians were changed significantly as of 2008 and are predicted to undergo additional revisions before the year's end. This program will address the changes to the IDTF performance standards (including the space sharing prohibition), explain the newly expanded Anti-Markup Rule and its effect on technical and professional service agreements, highlight the provisions of the Stark Phase III rule pertinent to imaging service providers, and discuss additional Stark Law revisions that may be implemented this year by CMS.
1:00 pm – 2:00 pm
CONCURRENT SESSIONS
Responding to a Client’s Audit Request
Claudia A. Murray
What do you do when your client asks you to open the door for an audit, especially when the auditor is a competitor? A billing company's reaction and response to an internal or external audit can be critical to their relationship with their client.
Compliance Responsibilities for Practices that Outsource
Robert B. Burleigh, CHBME
Outsourcing your billing delegates some of the most compliance-sensitive operational tasks such as coding, overpayments, etc. A practice's ongoing compliance responsibilities cannot be contracted away or delegated as any violation could lead to sanctions against the practice first and perhaps the billing service later. This session will cover key oversight responsibilities, practical ways to fulfill those duties and ways to collaborate with the billing company without compromising the integrity of either organization's compliance program.
So You’re Being Audited…Now What?
Jeff Howard
This session will discuss how to document the services performed, ensure that each service performed is documented appropriately, submit the documentation when requested and ensure all is documented appropriately, and how to add "overviews" if needed for clarification.
2:30 pm – 3:30 pm
CONCURRENT SESSIONS
The Link Between Compliance and Good Business: Working with the Hospital to Reduce Denials
Patricia Kroken, FACMPE, CRA
Most organizations are aware of the need for a strong compliance effort—and of the importance of denials management. However, many radiology practices underestimate the power of their information when it comes to driving change in terms of hospital processes. How can a group's denial patterns be used to change hospital admitting procedures for example? Case study examples will illustrate how several radiology practices have been able to get the attention of hospital administration.
CPCPA: Client-by-Client Profitability Analysis
Chris W. Kellogg
Most service companies know who they have as winner clients, and most recognize which might be breakeven clients. Few believe they also have money losing clients, yet your money losing clients may be the single most dramatic force acting to lessen your effectiveness and destroy profitability. This session describes Chris’ findings from over 23 years in the business of analyzing physician billing companies, and details a method he developed to identify low revenue producing clients and then, methodically, work to eliminate them from your roster.
Evaluation of Outsourced Practice Management Services
Nicole A. Palmer, CPA and Barbara F. Rubel, MBA
Practice management and billing services are increasingly a "hand-in glove" relationship. An entity’s ability to effectively negotiate, e.g. managed care contracts, has a direct influence on that group’s revenue. As more payers deny payment to non-credentialed providers, effective and efficient credentialing is imperative. The goal of this session is to help attendees understand the key areas they need to focus on in evaluating the effectiveness of their practice management services.
3:45 pm – 4:45 pm
GENERAL SESSION
Preventing Whistle blower Actions
Eartha Jean Johnson, JD, SPHR
There are many ethical and legal reasons that compel organizations to develop a formal whistle blower policy. What can you do to assure that your company effectively handles whistle blowing actions? This session will focus on measures companies and organizations can take to address, reduce and even prevent whistle blower actions.
