Sixth Edition

Winter Issue

February 2012

Greeting Maine Chapter of HFMA Members,

 

The results are in!  Thanks to those of you who took time out of your busy schedules to complete the Annual HFMA Chapter Survey for the Maine Chapter. Based on your responses over 57% of our members are either very satisfied or extremely satisfied overall with our Maine Chapter. While this exceeds our Chapter Balanced Scorecard goal of 55% we are continually looking for ways to improve. Members who responded indicated that they would like to see more diverse topics, more information on state reimbursement issues and preparing for healthcare reform. The survey responses have provided us with great feedback and brainstorming ideas as we begin to think about our educational programming in the coming year. Planning for next year's education programs begins in April so if you have any thoughts you would like to share with us feel free to contact any chapter officer. Thank you for helping make this such a great Chapter!

 

In the coming months we plan on offering two more excellent educational opportunities at various locations. On March 29th we will be offering an Accounting Update at the Augusta Country Club. We also will be offering a series of lunch and learn webinars for certification beginning in mid-March. Please consider one or more of these options as you plan your upcoming calendar.

 

Also in March, the Maine Chapter will be electing three new members to the Board of Directors as well as a new President, President-Elect, Vice President, Secretary and Treasurer for the 2012-2013 year. Prior to the election, information on the candidates will be made available.

 

Visit our Maine Chapter Website at http://www.mainehfma.org/ for further details on educational programming and becoming involved as a volunteer for the Chapter.

 

As always, if you have any questions or concerns about our Chapter, or if you would like to become more involved as a volunteer, please contact me.

 

 

Sincerely,

 

Lisa Trundy

President 2011-2012

Maine Chapter of HFMA

[email protected]

Phone: (207) 541-2263

  

Lisa T  

CFO Spotlight: Wayne Bennett, Chief Financial Officer, Franklin Community Health Center
 
Wayne Bennett

Wayne Bennett is the newly appointed chief financial officer at Franklin Community Health Network and Franklin Memorial Hospital.

 

Wayne is responsible for the management of the network's financial activities and oversees the functions of the accounting, revenue cycle, patient billing, patient registration, medical records, and materials management departments. He is a member of the senior management team, assisting with the development of key strategies to assure the overall future financial health and well-being of the organization.

 

Wayne came to Franklin after serving as the CFO for Mt. Ascutney in Windsor, Vermont. Before that he was the CFO at Mercy Health System, and was vice president of finance at Central Maine Healthcare.

 

When asked about the biggest challenges facing healthcare over the next five years, Wayne responds "[It] will be successfully navigating the transformation from volume to value.  Everyone agrees the current cost structure is unsustainable and there is great opportunity to improve quality in a cost-effective manner by focusing on managing the health of populations. Transformational change will happen when we change our focus from simple cost reduction to management of patient health across the continuum of care settings.  But we are presently operating within a payment system that rewards volume.  We must strike a balance between profit generated by volume, and new processes that reward delivering the best and most efficient care for a population.  The challenge will be ensuring that everyone in the organization understands the strategies and can integrate it into their daily routine."

 

And when looking at the challenges he foresees for Franklin over the next five years, Wayne says "One of the challenges for Franklin will be aligning physicians in the new model of care.  Improving clinical quality and lowering clinical cost will require a closer partnership between the hospital and its physician practices.  Systems must be established to provide information and data for the physician to make sound clinical decisions.  Employment agreements will evolve, with less emphasis on volume and more emphasis on delivering the best and most cost effective care. Physicians will play larger roles in governance and leadership."

 

Bennett holds a dual master's degree in business administration and health administration from the Georgia State University, Institute of Health Administration. He lives with his wife Kate and 17 year old son Sam, and they enjoy sailing, gardening and cooking.

 

Submitted by Jeffrey P. Provenzano, FHFMA 

The New HIPAA Privacy and Security Audit Program: Are You Ready?

 

 

Buried in Section 13411 of the Health Information Technology for Economic and Clinical Health Act ("HITECH"), which was passed as part of the American Recovery and Reinvestment Act of 2009, is a brief provision mandating that:

 

The Secretary [of the United States Department of Health and Human Services] shall provide for periodic audits to ensure that covered entities and business associates that are subject to the requirements of [the privacy, security and breach notification provisions of the HITECH Act]...and...[the HIPAA security and privacy standards], as such provisions are in effect as of the date of enactment of this Act, comply with such requirements.

 

As a result of this mandate, the Department of Health and Human Services' ("DHHS") Office of Civil Rights ("OCR") has established a new HIPAA Privacy and Security Audit Program to audit covered entities' and business associates' compliance with the requirements of HIPAA, as it has been amended by HITECH. DHHS has contracted with a federal contractor, KPMG LLP, to conduct the audits on behalf of the OCR.

 

Purpose of Audit Program:

 

The OCR views the new audit program as primarily a "compliance improvement activity," the purpose of which is to:

 

  • Examine mechanisms and actions taken by audited entities to address compliance deficiencies
  • Identify industry best practices
  • Discover risks and vulnerabilities that may not have come to light through OCR's complaint investigations and compliance reviews
  • Identify the most efficient types of corrective action
  • Develop technical assistance guidance

 

However, there is also the potential that an audit could trigger an independent investigation as the OCR has indicated that it may initiate separate compliance reviews in cases where "serious compliance issues" are found during an audit that could, in turn, lead to the imposition of civil penalties.

 

The OCR intends to share on its website (www.hhs.gov/ocr) best practices and guidance it gleans from conducting its audit program, but will not be publishing a list identifying audited covered entities or making available to the public its findings from individual audits that identify audited entities.

 

Scope of Audit:

 

A total of 150 covered entities will be selected for audit between November 2011 and December 2012. An initial 20 covered entities will be audited from November 2011 to May 2012 for the purpose of developing and testing audit protocols. The remaining 130 covered entities will be audited between May and December of 2012. Business associates will not be among the 150 entities audited during this phase of the audit program, but will be included in future audits as a regular part of the OCR's audit program.

 

Covered entities subject to audit include:

 

  • Organizational healthcare providers
  • Individual healthcare providers
  • Health plans
  • Healthcare clearinghouses

 

Covered Entity. A healthcare provider-whether an organization or an individual-is a HIPAA "covered entity" if the provider "transmits any health information in electronic form in connection with a transaction covered by" HIPAA. 45 C.F.R. �160.103. Individual healthcare providers selected for audit who do not transmit healthcare information electronically should carefully review how key HIPAA terms are defined at 45 C.F.R. �160.103-such as "transmit," "electronic media," and "transaction"-to determine whether they are HIPAA covered entities subject to audit. For example, certain types of transmissions, such as faxes, are excluded from the definition of "electronic media" because the information being faxed does not exist in electronic form prior to the transmission. Consequently, an individual healthcare provider who does not maintain health information in electronic format and does not submit claims electronically, may not be a HIPAA covered entity.

 

The Audit Process

           

Audit Notification Letter. Covered entities selected for audit will be sent an Audit Notification Letter by the OCR. A sample notification letter is available online at www.hhs.gov/ocr/privacy/hipaa/enforcement/ audit/sample-ocr_notification_ltr.pdf. The notification letter will explain the audit process, identify the audit contractor conducting the audit on behalf of the OCR, and, most importantly, request information and documentation regarding the covered entity's privacy and security compliance efforts.

 

Response to Document Request. The covered entity will only be given 10 business days to respond to the OCR's document request. Consequently, in view of the extremely short audit response time, it is imperative that covered entities already have in place all mandatory privacy and security policies required by the HIPAA privacy and security standards and by HITECH, including breach notification policies and procedures. If a covered entity isn't prepared at the time it receives an audit notification letter, it's too late.      

 

Site Visit. Thirty to ninety days following the receipt of the Audit Notification Letter, OCR's contractor will conduct a 3-10 day site visit of the covered entity. During the site visit, auditors will interview key personnel and observe the covered entity's processes and operations for HIPAA/HITECH compliance. Audited covered entities will be given the opportunity to discuss any concerns or issues identified by the auditor, as well as describe any corrective actions implemented by the covered entity to address any such concerns or issues.

 

Draft Audit Report. Twenty to thirty days following the site visit, the audit contractor will provide the covered entity a draft Final Audit Report. The draft audit report will describe how the audit was conducted, the auditor's findings (including a description of any best practices identified), as well as any actions being taken by the covered entity in response to the auditor's findings.

 

Review of Draft Audit Report. The covered entity will then be given just 10 business days to review and provide written comments on the draft audit report.

 

Final Audit Report. Following the covered entity's review of the draft audit report, the auditor will complete a Final Audit Report, presumably taking into account the covered entity's written comments, and submit it to the OCR within 30 days of the covered entity's written response.

 

Preparing for an Audit

 

As noted above, given the short audit response times for submitting requested documents and for implementing corrective actions to address issues identified by OCR's auditor, a covered entity needs to be prepared well in advance of an audit.

 

Updated HIPAA Policy and Document Inventory and Review. There are two important steps a covered entity should take in connection with such preparation. First, a covered entity should undertake a comprehensive inventory and review of its HIPAA/HITECH policies, procedures and forms. Such inventory and review are necessary to ensure (i) that a covered entity has in place all policies and procedures required by law-including policies and procedures that take into account the peculiarities of other state and federal laws governing the protection of especially sensitive healthcare information such as mental health information, substance abuse program information, and HIV-related information-and (ii) that such policies and procedures and forms have been appropriately updated to taken into recent changes in the law. Examples of policies, procedures, forms and other HIPAA-related documents a covered should have in place include:

 

  • Policy and Procedure on Uses and Disclosures of Protected Health Information (and, if applicable, addressing uses and disclosures of mental health information, substance abuse program information, and HIV information)
  • Policies and Procedures addressing the requirements of the HIPAA Security Standards
  • Policy and Procedure on Breach Notification (that also takes into account the additional requirements of Maine's breach notification statute)
  • Policy and Procedure on Patients' Right to Access Protected Health Information
  • Policy and Procedure on Patients' Right to Amend Protected Health Information
  • Policy and Procedure on Patients' Right to an Accounting of Disclosures of Their Protected Health Information
  • Policy and Procedure on Workforce HIPAA Training
  • Policy and Procedure on Sanctions and Disciplinary Action for Workforce Members who Violate HIPAA Privacy and Security Standards
  • Updated HIPAA Notice of Privacy Practices
  • Updated Authorization Forms for the Disclosure of Protected Health Information (that also take into account other state and federal legal requirements)
  • Updated HIPAA Security Risk Assessment
  • Updated HIPAA Business Associate Agreements (to reflect new HITECH requirements)

 

HIPAA Workforce Training. Second, a covered entity should ensure that all members of the covered entity's workforce have received updated HIPAA/HITECH training at some point within the last year. Covered entities must also have documentation that each workforce member has received such training, as such documentation is routinely requested by the OCR in connection with complaint investigations and is almost certainly documentation OCR will request from covered entities in connection with its new audit program.

 

A covered entity that undertakes the above steps should be well-prepared for an audit and, more importantly, can demonstrate its commitment to protecting the privacy and security of its patients' health information.

For Additional Information

 

Additional information on the OCR's Privacy and Security Audit Program is available at www.hhs.gov/ocr/privacy/hipaa/enforcement/audit/index.htm.

 

About the Author

 

Steven L. Johnson, Esq., is a health law attorney and partner/shareholder at the health law firm of Kozak & Gayer, P.A., located in Augusta, Maine, and is licensed to practice law in Maine, New Hampshire and Vermont. Mr. Johnson routinely advises healthcare organizations and providers on HIPAA/HITECH-related compliance issues, has prepared numerous HIPAA/HITECH-related policies and procedures and compliance documents for various types of healthcare organizations, and frequently conducts presentations and staff trainings on HIPAA/HITECH-related issues. Mr. Johnson is a member of the American Health Lawyers Association, and is currently serving as the Chair-Elect of the Health Law Section of the Maine State Bar Association. Mr. Johnson was recently recognized as a "Rising Star" in New England in the 2011 edition of New England SuperLawyers magazine. Steve can be contacted at (207)621-4390 or [email protected]

 

Utilizing MAC Denial Trends to Facilitate Process Improvement

By: Vicente

 

 

The Revenue Cycle is presented with daily challenges ranging from the daily pressure on cash, to managing operational improvements, to information technology initiatives. The staff is prepared and trained to handle these challenges while also completing the assigned tasks within the process to ensure that cash flow is not impacted. One of the key areas that staff continuously monitors and manages is denials. Given the potential negative impact that denials may cause in cash flow, denials remain on the top of management's priority list.

 

Medicare Administrative Contractors (MAC) share denial and rejection information regularly with the provider community through outreach sessions. A recent review of the most common Medicare denials from different MACs reveals that providers face similar issues and challenges since denial and rejection reasons reported are consistent across all regions.

 

The key to managing denials has always been to identify and understand the root cause that led to the denial. There are countless reasons why claims and charges are denied. For purpose of this article, the rejection reasons were grouped into three key denial reasons:

  • Eligibility
  • Coding/Coverage
  • Billing

Eligibility- The origin of most denials can be traced back to inaccurate and incomplete information obtained at the time of insurance verification. For example:

  • The Centers for Medicare & Medicaid Services (CMS) Common Working File (CWF) indicates the beneficiary's name and health insurance card number do not match.
  • CMS records indicate the beneficiary is not in file.
  • Claim date(s) of service are overlapping a Medicare Advantage Organization (MAO) plan enrollment period.
  • Claim submitted as Medicare primary and a Workers' Compensation insurance 15/E record exists at CWF. The claim should be billed to the primary insurer.
  • The service date(s) on this claim overlap a hospice election period and Condition Code 07 is not present.
  • CMS records indicate that the beneficiary is not entitled to Medicare coverage for the type of services billed on the claim. Therefore, no Medicare payment can be made.
  • Claim submitted as Medicare primary and a positive working elderly record exists at the CWF.
  • The beneficiary's entitlement for Medicare coverage was terminated prior to the first date for services provided on the claim.

As trends emerge among providers and within the facilities, providers should focus on identifying the root causes of the issues. We recommend the following course of action to enhance internal controls and mitigate future denials:

  • Verify eligibility data is available to staff upon registration and that all insurance information is confirmed through the registration process.
  • Review and refine as needed processes related to insurance verification for scheduled patients. Better performers conduct insurance verification for all scheduled patients prior to service.
  • Internally monitor and track eligibility denials to identify the point of registration.
  • Share historical and concurrent denial data with all registration points specifically decentralized registration.
  • Refine insurance eligibility processes based on denial trends for all account types.

Coding/Coverage- Coding and Coverage denials stems from rejections resulting from inaccurate diagnostic and procedural coding including:

  • Invalid Healthcare Common Procedure Coding System (HCPCS) code for a revenue code reported or HCPCS is not valid for the date on which the services were provided.
  • The principal diagnosis on this claim is V048 or V0382 and there is no condition code A6 present. Effective with dates of service 10/01/2003, diagnosis code V0481 is present and there is no condition code A6 present.
  • Inappropriate specification of bilateral procedure.
  • Multiple visits on the same day without an appropriate condition code.
  • A source of admission code is required on this claim.
  • Claims billed on or after 07/03/2006 bill type 12X, 13X, 22X, 23X, 34X, 74X, or 75X with revenue code 042X must have an Occurrence Code 29 present. If Occurrence Code 29 is present, then revenue code 042X must be present.
  • Inpatient acute care hospital claim with a discharge date on and after 04/01/2008 must contain a valid present on admission (POA) indicator.
  • Medicare payment cannot be made for these services because the claim does not indicate that the beneficiary had a three-day qualifying hospital stay (Occurrence Span Code 70) prior to admission to the SNF; or the hospital stay is prior to the beneficiary's Part A effective date.

As facilities continually analyze the reasons for denials, inevitably the facility will reach a point of diminishing returns and rather search for a solution to be proactive in preventing denials instead of retroactively correcting them. Subject to the staffing resources and expertise, we recommend the following best practices:

  • Review the Local Medical Revise Policies and National Coverage Determinations for Medicare with regard to the diagnoses that support medical necessity for these services.
  • Review services rejected as non-covered to verify that the denial is consistent with payer contracts and/or patient insurance coverage and is not due to inaccurate coding.
  • Audit CPT, modifier and diagnosis code rejections for specific sample data for the facility.

 

Billing- Rejections resulting from inconsistent/inaccurate data on the claim not captured through billing edits or not responding timely to a request for additional information. These denials include:

  • The operating physician is required or, if an operating Unique Physician Identification Number (UPIN) or National Provider Identifier (NPI) is present, the physician's last name and first name must be present. If any name is present, the UPIN or NPI must be present or NPP is an invalid UPIN.
  • Timely Filing
  • This claim is denied for payment because the provider failed to submit documentation requested by the intermediary within 45 days.
  • The requested non-medical information was not received timely.
  • This claim is an exact duplicate of a previously submitted claim where the following fields on the history and processing claim are the same
  • Beneficiary was an inpatient in a SNF at the time these services were rendered. Therapy services rendered to beneficiaries in a SNF must be billed by the SNF.

Providers can take additional steps through process improvement or staff education to prevent denials. Revenue Cycle staffers can implement these process improvements without putting additional pressure on timely processing:

  • Review bill edits and identification of what is not passing.
  • Implement 72 hour edit check with claim submissions and ADR processing.
  • Manage claim status/resolution lists to ensure clams are billed timely.
  • Track and trend timely filing denials to identify the reason why claims have not been billed timely. Track account service types and coordinate internally to identify process improvement opportunities.
  • Review and refine as needed internal processes related to SNF outpatients
  • Track UPIN and NPI denials and work internally to make updates to the physician master

 

An effective denial management strategy encompasses processes and action items that allow facilities to track denials, rejections and appeals internally. Coordination the functional areas within the Revenue Cycle is essential to identifying and assessing ongoing denials as an aggregate and percentage of denials category. Given the abundant information available through the MAC, keeping current with the most common denials impacting the industry provides the Revenue Cycle areas information that can be used to assess its internal operations. In addition, it allows providers to informally results their practices against their neighbors. Unfortunately, only with a detailed review will providers be able to stack up their internal policies and procedures against industry best practices.

The rejection reason codes outlined in the article are not uncommon and if one looks back in previous MAC-provided summaries, the same codes appear consistently over time. Based on these repetitive results, it is clear providers are still in need of effective management of their denials process. This can be accomplished through a precise focus on the process with technology enhancements. However, the optimal solution cannot be a one-size-fits-all approach. Facility management has to first assess where they compare, identify trends in their data and attack root causes vigorously. The facilities who strive to reduce the overall impact that these denials have, will be most effective in collecting every dollar that it is owed and on a more timely basis.

 

References

 

"Recommendations to Avoid Claim Denials", Provider Outreach & Education, Robert Aude, January 11, 2012, NHIC Corp.

 

"Top Billing Errors", Part A Top RTP Errors, January 11, 2012, Trailblazer Health Enterprises

 

"Medicare Part A News", Highmark Medicare Services, November 4, 2011

 

About the Author:

 

Vicente Farina has worked with BESLER Consulting's Revenue Cycle service line since joining the firm in 2001. Prior to joining BESLER, he worked for an accounts receivable outsourcing company and a regional Health Maintenance Organization. He earned his undergraduate and graduate degrees from Rutgers University. Vinny can be reached at (732) 392-8215 or [email protected]

HFMA issues new MAP Keys for Physician Practice Management

 

HFMA's MAP Keys are key performance indicators developed by industry leaders designed to measure efficiency of the revenue cycle in healthcare organizations. MAP Keys set clear and unbiased standards for revenue cycle performance excellence for the healthcare industry. HFMA MAP Keys eliminate confusing metrics and offer a consistent and standardized revenue cycle reporting and comparison across healthcare institutions and among various peer groups. MAP Keys help healthcare finance professionals to identify areas for improvement and to strengthen revenue cycle management within their organizations. To date, HFMA has released MAP Keys for Revenue Cycle Management covering patient access, revenue integrity, claims adjudication and claims management. Most recently, HFMA has released new MAP Keys for Physician Practice Management offering a number of standard indicators of financial performance for physician practices. Healthcare organizations are encouraged to use these indicators to track performance and to compare performance with their peers.

 

The new Physician Practice MAP Keys are:  

  • Practice Operating Margin - measures financial performance of a physician practice on an accrual basis.

Formula: Net Income from operations/Operating Revenue

  •  Practice Net Days in Accounts Receivable - calculates the average number of days it takes to collect payment on services rendered and measures revenue cycle effectiveness and efficiency.

Formula: Average monthly net patient service A/R / Average daily Net Patient Service Revenue

  • Practice Cash Collection Percentage: measures revenue cycle efficiency, supports valuation of current accounts receivable and predicts income.

 

Formula:Actual patient service cash collections /Net Patient Service Revenue 

  • Total Physician Compensation as a Percentage of Net Revenue - demonstrates ability to afford physician compensation in relation to revenue of the physician practice.

 Formula: Total Physician Salary/Net Patient Service Revenue

Formula:  Number of CPT (units of service) codes denied/ total number of CPT codes billed

Formula: Total point of service collections/Total patient cash collected

  • Total Charge Lag Days - measures charge capture workflow efficiency and identifies delays in cash payment.

Formula: Number of days from revenue recognition date (posted date) less date of service date (by CPT code)/ sum of CPT codes billed

Formula: Number of patient hours occupied (average weekly)/Number of patient hours available (average weekly)

 

 

MAP Keys listed above can be used by organizations to track performance over time or they can be used for benchmarking with other organizations. HFMA offers a MAP App tool that allows individual hospitals to benchmark against other entities in the industry or against a specific peer group selected by the organization. To learn more about this took, visit http://www.hfmamap.org/mapapp/how-it-works/

 

To view MAP Keys for Revenue Cycle Excellence, click here: http://www.hfmamap.org/mapkeys/definitions/

 

 

Submitted by Natasha Erb, CPA, CHFP

Former HealthSouth CFO Warns of the Dangers of an Ethics Meltdown

 

It was the mid-1990s and Aaron Beam, HealthSouth's chief financial officer and co-founder was flying high. The average guy who hadn't made more than $200,000 a year was now a millionaire buying a new luxury car every year, flying around the country in Gulf Streams and purchasing real estate for himself and his wife.

 

He had no idea that an otherwise normal day at the office would change his life, sending him to prison and setting him on a mission to warn others of the ethical dangers of wealth and success.

 

In the summer of 1996, HealthSouth, the country's largest provider of outpatient surgery and rehabilitative services, didn't make its earnings goals. Rather than report the company's shortfall, the company's then-CEO, Richard Scrushy, demanded the books be fixed, Beam told a room of controllers, accountants, chief financial officers and other healthcare managers during an ethics certification course offered by the Maine chapter of the Healthcare Financial Management Association on Monday.

 

"If you'd told me that day when we first cooked the books that when I walked outside the FBI was going to arrest me, I wouldn't have done it," Beam said. "You let yourself think that you're not going to get caught. It's foolish to think that way but you really let yourself think that you're not going to get caught."

 

And for a long time, Beam, Scrushy and a series of CFOs didn't get caught. When the fraud did come to light in 2003, it stunned the nation. Beam, who had retired from the company in 1997, and his successors, all spent time in jail for their roles in the fraud.

 

Scrushy was acquitted of criminal charges but in a civil trial was found guilty of defrauding shareholders. He has been ordered to pay $2.8 billion in restitution. Scrushy did go to jail, though for a charge not related to the accounting fraud. He is finishing his final year of a seven-year sentence for bribing former Alabama governor, Don Siegelman.

 

"I stand before you here today telling you that I'm a coward," Beam said in the soft cadence of his southern heritage. "I could not imagine being the one to stand up to (Scrushy) and cause his net worth to go down by $100 million. I did what a lot of people do, I took the easy way out."

 

Committing fraud, said the former CFO, had consequences he couldn't and didn't foresee. It nearly destroyed him emotionally, which is why he retired to everyone's surprise in 1997 at the age of 54, just a year after the fraud began.

 

"I was living a lie. It was terrible," Beam said. "I didn't want to be a whistleblower because I knew Richard would turn it on me. I knew he'd bring more lawyers, guns and money to the party than I would and I didn't want to battle the guy."

 

The accounting fraud also had unintended consequences for the company. "The damage that you do in the fraud is so massive that it's really hard to understand," he said.

 

The ripple effects of the accounting fraud included Medicare fraud, bank fraud, flimsy due diligence that resulted in bad acquisitions, diminishing employee morale and overpayment of income and property taxes.

 

"When you start a fraud like this," Beam told his audience in Augusta, "you never dream it's going to cause these things."

 

To avoid an ethics meltdown of the proportions that lead to the accounting fraud at HealthSouth, Beam advised that companies support their goals with values, create a culture that allows employees to speak up and report things safely, ensure that the board is strong, avoid conflicts of interest and have clear rules about conflicts of interest and be aware of the basics of economics and economic cycles.

 

After fulfilling his three-month sentence at a federal minimum-security prison, Beam started his own company mowing lawns because he couldn't get hired anywhere and he wrote a book and began talking at colleges and universities about his HealthSouth experiences.

"You need to put ethics first in everything you do," he tells his audiences. "If not, you can count on riding the slippery slope like I did. I never, never dreamed I would go to prison and that I would be a convicted felon... but I did. It can happen to you. Trust me."

 

Article based on live seminar coordinated by Anne Cloutier, CPA, VP Maine Chapter HFMA

 

Written by Stephanie Bouchard, Associate Editor

Reprinted with permission from Healthcare Finance News

http://www.healthcarefinancenews.com/news/former-healthsouth-cfo-warns-dangers-ethics-meltdown?topic=03

HMFA Certification: Are you certified?

 CHFP

Did you know that a growing number of organizations are required their leaders to be HFMA certified? The HFMA CHFP certification is designed for mid-level healthcare finance professionals who aspire to the executive level or for anyone desiring conformation of financial management expertise. Not only can earning the CHFP credential prepare you for increasingly responsible positions, but becoming certified can distinguish you as both a role model and a leader in the healthcare finance community.

  

The HFMA certification program has been completely restructured as of January 2011. Getting certified has become much easier! 

  • The two year membership requirement prior to taking the examination has been eliminated. Candidate need to have current HFMA membership only to qualify for the exam. 
  • Candidates now need to take one test, not two as was previously required.   
  • All materials are now available online for easy and convenient access. To make things even easier for our members, Maine Chapter of HFMA has purchased access to online materials which is available to anyone who is interested in getting certified. 
  • Maine Chapter of HFMA will also be offering a series of lunch and learn webinars on how to prepare for the certification examination. Lunch and learns are scheduled to begin mid-March and are free of charge. This is an excellent opportunity to get no-cost assistance with studying for the examination. 
  • Finally, Maine Chapter of HFMA is offering a $200 scholarship to the first 4 members who pass the examination. These scholarships are available each year on a first come first serve basis.

The Maine Chapter of HFMA board encourages you to take advantage of these educational opportunities and assistance with the HFMA certification process. It's a great career move and we are here to help you along in this process! Now is the time to get certified!

 

If you would like to learn more about the HFMA certification process, click here http://www.hfma.org/certification/ . If you would like to enroll in the Lunch and Learn program or would like to access online study materials, please contact Lisa Trundy at [email protected]

The Beacon has gone GREEN!!  Today's ME HFMA newsletter is the sixth edition of the e-Beacon, where Maine HFMA'ers get their news!
 
WE NEED YOU!! Our committee member numbers are dwindling and we sure could use some help!  Please contact  Ames Ryba at [email protected] or Natasha Erb at [email protected] to join the newsletter committee. 
 
Comments, questions and concerns are always welcome.  Have a suggestion please send to [email protected].
In This Issue
CFO Spotlight
New HIPAA
Utilizing MAC Denial Trends
MAP Keys for Physicians
Warning
HFMA Certifications
Upcoming Events
Impacts Satisfaction
Quick Links
Welcome New Members!

 

Geanette Treadway, Sr. Financial Analyst, Southern Maine Medical Center, Bidderford

 

Amos McCannell, Business Analyst, Eastern Maine Healthcare Systems, Brewer

 

William T Olsen, Jr., Team Leader, TD Bank, Portland

 

Ben Carr, Immunology Account Executive, Abbott Laboratories, Randolph

                          

Maribeth Irish, Chargemaster Analyst, St. Mary's Regional Medical Center, Lewiston

 

Brooke M Turner, Manager, Eastern Maine Healthcare Systems, Brewer

 

Wayne Bennett, CFO, Franklin Community Health Network, Farmington

 

Daniel Bennett, Chief Operating Officer, Waldo County General Hospital, Belfast

 

Thanks

To Our

Sponsors

GOLD SPONSORS

 

Baker Newman Noyes

 

BerryDunn

 

eHC Solutions

 

E-Management Associates, LLC

 

Emdeon

 

Maine Recovery Services

 

Medical Bureau/ROI

 

The Thomas Agency

 

 

SILVER SPONSORS

 

DECO

 

Martin's Point Health Care

 

Ritter Project Management

 

Vierill Dana, LLP

 

 

BRONZE SPONSORS

 

Morris Switzer

Upcoming Education Events

Save the Date: 

 

May 16-18, 2012 

 

 

HFMA Region 1 Annual Conference

 

Three Tracks:

 

Revenue Management

Pyment and Reimbursement

Value Based Healthcare

 

 

Early Bird Registration:

 

  Register on or before February 29, 2012 and save $50-$75

 

To view the conference schedule, click here:

 

Click Here 

 

 

Link to Early Bird Discount Info:

 

Click Here 

---------------------------------

 

 Accounting Update

 

March 29, 2012

 

990 & Accounting Update

 

Augusta Country Club 

-----------------------------------

More to come:

 

Certification Coaching Webinar Series

 

March 7

 

Register Here:

 

Click Here 

How the Hospital
Revenue Cycle Impact
Patient Satisfaction

Written by Rachel Fields , Becker's Hospital Review, December 19, 2011

 

Hospital leaders are increasingly prioritizing patient satisfaction, understanding that the experience of the patient impacts hospital finances, reputation and physician satisfaction. But one of the most crucial parts of the patient experience - the revenue cycle - is still neglected in favour of pushing customer satisfaction during the clinical encounter. Scott Morgan, chief strategy officer for Avadyne Health, discusses how the revenue cycle impacts patient experience - and what hospitals can do to improve their satisfaction ratings through interactions about money.

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MEET THE 2011-2012 ME HFMA BOARD OF DIRECTORS

 

PRESIDENT:

 

Lisa Trundy, FHFMA, CPA

Senior Manager, Berry Dunn

 

PRESIDENT-ELECT:

 

Melanie Meader, FHFMA, CPA

Controller, Franklin Memorial Hospital

 

VICE PRESIDENT:

 

Anne Cloutier, CPA

Senior Manager, Baker Newman Noyes

 

SECRETARY: 

 

Michael Whitten, CPA

Senior Manager, Berry Dunn

 

TREASURER:

 

Kathleen M. Carmichael, FHFMA, CPA

Financial Information Manager

 

PAST PRESIDENT:

 

Amy E. Atherton, CPA

Senior Reimbursement Analyst, Eastern Maine Healthcare Systems

 

 

 

Board of Directors

 

Natasha Erb, CHFP, CPA 

Assistant Controller, Franklin Memorial Hospital 

 

Andrea Duquette,

Senior Auditor, Berry Dunn

 

Mark Fisher

Managing Staff Accountant

State of Maine DAFS/DHHS

 

Michael A. Hendrix, FHFMA

Controller, Maine Coast Memorial Hospital 

 

Stephen J. Kelleher

Consultant

 

Eileen Moore, FHFMA

Director of Financial Planning, Franklin Memorial Hospital 

 

James F. Pacheco, FHFMA

Reimbursement Manager, Waldo County General Hospital 

 

Aimee Plowman, CHFP

SR Healthcare Consultant , Baker Newman Noyes

 

Raye Porter, CPA

Controller, Waldo County General Hospital 

 

Jeff Provenzano, FHFMA

CFO, Mayo Regional Hospital 

 

 

ME HFMA Newsletter Committee 

Ames Ryba, co-chair, 860-656-5102, aerb_3@live.com

 

Natasha Erb, co-chair, 207-779-2284,  [email protected] 

 

Jeff Provenzano, CFO Reporter, 
[email protected]

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May 2012