Accountable Care Organizations (ACOs): Are They a Savior or a Snake? Seize the Power of Change: Five Proven Ways to Overcome Negativity, Improve Productivity and Ignite People Benefits of Certified Compliance Technician (CCT ) Certification 5010 Conversion Challenges ANI 2012 Behavioral Interviews: Three Steps to Great Answers Changing Your Attitude by Keeping Your Sense of Humor Can External Call Centers Benefit Hospitalsâ€™ Access Departments?
- Certified Patient Account Technician
- Certified Clinic Account Technician AAHAM certifications can give you a powerful competitive advantage with employers. Certifications demonstrate that you have mastered the common body of knowledge for you profession. AAHAM Study Manuals will help assist you in preparing for AAHAM certification programs. These manuals are the gateway to studying for and passing these exams. The manuals include review questions and study tips. Log on to www.aaham.org for more information and to order your Exam Study Manual today!
table of contents
features 8 Accountable Care Organizations (ACOs): Are They a Savior or a Snake? By Rob Borchert 10 Seize the Power of Change: Five Proven Ways to Overcome Negativity, Improve Productivity and Ignite People By Kathy B. Dempsey, CSP,
12 Benefits of Certified Compliance Technician (CCT ) Certification By Maya Mohan, CPAM, FHFMA
14 5010 Conversion Challenges By Dean Mitts
15 ANI 2012
26 Behavioral Interviews Three Steps to Great Answers By Deborah Walker
28 Changing Your Attitude by Keeping Your Sense of Humor By Jan McInnis, Comedian
30 Can External Call Centers Benefit Hospitalsâ€™ Access Departments? By Steve Chrapla, CHFP
departments 2 Letter from the Executive Director 4 Letter from the National President 6 Washington Wire
By Paul A. Miller, PLC
32 Meet A Committee Chair: Michael (Mike) Dobbs, CPAM, Chapter Development Chair 33 Professional Certification Corner By Elizabeth Baptist, CPAM
34 From the Desk of the Certification Director By Maria LeDoux, CAE
35 Technical Certification Corner By Brenda Chambers, CPAM
36 From the Desk of the Membership Director By Moayad Zahralddin
41 National Calendar/The JHAM Network
28 Summer 2012
42 Did You Know?
By Moayad Zahralddin 1
letter from the executive director AAHAM National Office Staff
11240 Waples Mill Road, Suite 200, Fairfax, VA 22030 Executive Director Sharon R. Galler, CMP (703) 281-4043, ext. 204 email@example.com Membership Director Moayad Zahralddin (703) 281-4043, ext. 202 firstname.lastname@example.org
Sharon R. Galler
elcome to our special pre-ANI issue, can you believe we are less than two months away? We are all busy gearing up for our ANI, “Changes in Latitudes, Changes in Attitudes”, October 17-19, in beautiful Bonita Springs, Florida at the luxurious Hyatt regency Coconut Point hotel. We know funds are tight and have tried to make the ANI as economical as possible. We include most of your meals and have a jam packed list of speakers and sessions. Earn over 30 CEUs all at one place and all at one time. You will also meet exhibitors that offer you solutions to your at work challenges. We also have fun networking opportunities to help you build integral relationships and help give you the edge in today’s competitive economy and job force. This year the “Jimmy Buffet” theme will be everywhere and will add to the fun and excitement. Wear your shorts, flowered shirts and flip flops to the banquet and get into the “Margaritaville” mood! We hope you find this issue of the Journal informative and timely. Robert Borchert’s cover article about Accountable Care Organizations (ACOs) is very interesting. ANI keynote speaker, Jan McInnis wrote a funny article about changing your attitude by finding humor in everyday things and Kathy Dempsey’s article on the changing to improve productivity keeps personal growth in the forefront. Dean Mitts’ article on 5010 conversion challenges and Steve Chrapla’s article on external call centers are both very current topics and on target. Be sure to read Deborah Walkers article on interview tips as well as Maya Mohan’s article on the many benefits of the AAHAM CCT certification. Be sure to check out my blog on our website for some ANI tips, networking ideas and other news. A big AAHAM thank you to our advertisers, exhibitors and sponsors, we couldn’t do it without you! Warm regards, Sharon
Certification Director Maria LeDoux, CAE (703) 281-4043, ext. 201 email@example.com Finance Manager Christine Antal (703) 281-4043, ext. 216 firstname.lastname@example.org CEU & Technical Amanda Leibert Certification (703) 281-4043, ext. 211 Manager email@example.com Manager of Danielle Burns Meetings & Events (703) 281-4043, ext. 209 firstname.lastname@example.org Art Direction Christopher R. Izzo & Graphic Design CRI Design (401) 821-1849 email@example.com
AAHAM National Executive Officers
President Christine Stottlemyer, CPAM Director Patient Accounting Memorial Hospital PO Box 15118 York, PA 17405 Ph: (717)849-5431 firstname.lastname@example.org Chair of the Board Laurie Shoaf, CPAM Vice President Corporate Compliance, Inpatient Solutions NEXTGEN Healthcare 5511 Ridingate Cour Greensboro, NC 27455 Ph: (512) 904-4729 email@example.com First Vice President Victoria DiTomaso, CPAM System Director, CBO Lee Memorial Health System PO Box 150107 Cape Coral, FL 33915 Ph: (239)242-6011 firstname.lastname@example.org Second Vice President John Currier, CPAM, CCT Executive Director, Revenue Cycle Management Gibson Area Hospital and Health Services 1120 North Melvin Street Gibson City, IL 60936 Ph: (217)784-2613 email@example.com Treasurer Lori Sickelbaugh, CPAM Director Patient Business Services Wake Forest Baptist Health Lexington Medical Center PO Box 1817 Lexington, NC 27293-1817 Ph: (336)238-4510 firstname.lastname@example.org Secretary Kathy Sandora, CPAM CDR Associates, LLC 212 Hummingbird Hill Cranberry Township, PA 16066 Ph: (443) 904-4361 email@example.com Legal Counsel
George Colman, Esquire Stephenson, Acquisto, & Colman 303 North Glenoaks Blvd. #700 Burbank, CA 91502 Ph: (818)559-4477 gcolman@sacfi rm.com
The Journal of Healthcare Administrative Management
letter from the national president
Deadlines & Submission Guidelines The Journal welcomes submissions from AAHAM members. Submission deadlines are as follows:
can’t believe we are finally in the middle of summer. What an up and down couple of months with the weather and other natural disasters. One thing, however, that remains consistent (consistently good that is), is our National organization, good and strong! We continue to offer personal growth opportunities in terms of educational and certification webinars. And, many of our chapters are holding regional conferences and programs and celebrating monumental milestones. We will be recognizing these chapters in a variety of ways. Stay tuned! Your Executive Board and Committee Chairs just had a leadership retreat in July where much planning and brainstorming took place. I look forward to sharing some of the information and ideas with you over the next few months. One thing I am going to change right now, however, is my use of the words “leadership retreat.” Retreat is defined by Webster’s in the following manner: “to withdraw or to draw back.” We are all about moving forward, so this will officially be the last time I refer to any of our meetings as a “retreat!” If anyone has any suggestions I would love to hear them. Should I get any suggestions, I will know you are reading your Journal! Information has been going out at a steady pace regarding the ANI being held in Bonita Springs, Florida, October 17-19. We have two really phenomenal keynote speakers as well as the always popular, Paul Miller. You have received the email blasts, and you probably received your beautiful brochure. What are you waiting for? Sign up now! Registrations are coming in quickly. The educational and networking opportunities are in plentiful. And, we have a few surprises in store for you as well. You won’t want to miss this year’s event. Don’t forget the Bill Spare National Recognition award. Is there someone in your chapter who has made a difference in our organization? Now would be the time to recognize and nominate them for this very prestigious award which will be presented at the ANI. And speaking of recognizing, don’t forget your staff members. October 15-20 is Patient Account Management (PAM) Week. I know several organizations hold celebrations every day of the week, but tokens of appreciation are also nice. Those can be found on the AAHAM website. Since it’s summer, I’ll keep my letter short. However, like my last letter, I’ll conclude by encouraging you to take an active role with AAHAM. Be on the cutting edge; help shape the future of the healthcare industry. Make the commitment today! Become certified! Join me at the ANI!
Journal Issue Fall 2012
Submission Deadline September 28, 2012
Send submissions to: Executive Director, AAHAM 11240 Waples Mill Road, Suite 200 Fairfax, VA 22030 firstname.lastname@example.org Please send a copy of your submission on a CD n (preferably IBM compatible), or e-mail it to: Sharon@aaham.org. n Leave a one-inch margin on the top, bottom, and sides. n Use upper- and lower-case letters as you would in typing any correspondence. n Indent the first line of each paragraph five spaces. Include a cover page with the following information: n Author’s name, (degrees, certifications) Place of employment Position Address Phone/Fax number AAHAM Chapter Affiliation (if any) n Any article submitted for reprint in the Journal must be accompanied by written permission to reproduce from the original source. n Do not use abbreviations or italics. n All photos become the property of AAHAM, unless you specifically request that they be returned. Each picture should be accompanied by a listing of all individuals in the picture (left to right). Black and white pictures reproduce better than color. n All articles are subject to editing by AAHAM. AAHAM reserves the right to hold articles for future Journal issues when space is limited. n Articles referring to or endorsing specific products or services will not be considered. The Journal is published quarterly by the American Association of Healthcare Administrative Management, 11240 Waples Mill Road, Ste. 200, Fairfax, VA 22030. Opinions expressed in this publication represent the viewpoint of each author, and do not necessarily reflect the policy of AAHAM. Advertisements do not necessarily imply sponsorship by AAHAM. Subscriptions are included with AAHAM membership. Reprints are available from the National Office in portable document format (PDF) for a $75 fee per article. Prepayment is required. © Copyright 2012 by the American Association of Healthcare Administrative Management.
Best regards, Chris
The Journal of Healthcare Administrative Management
Professional Certification Webinar Series Available Now On CD ROM AAHAM and top CPAMs & CCAMs present a four part Webinar Study program for the AAHAM Professional Exams: Access • Billing • Credit & Collections • Accounts Receivable Management The entire 4 part recorded CD ROM series costs $350.00. Individual parts can be purchased separately for $125.00 each.
❏ Yes, I want all 4! ❍ 4 Part Series on CD ROM: $350.00 Member rate
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❏ Enclosed is my check. Please make payable to AAHAM. ❏ Please charge my credit card: ❍ AMEX ❍ MasterCard ❍ VISA Card Number: ________________________________________________________ Name on Card: ___________________________________ Exp. Date: ___________ Signature: ___________________________________________________________
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Individual Sections: Please check which section(s) you want:
❍ Part 1 Access ❍ Part 2 Billing ❍ Part 3 Credit & Collections ❍ Part 4 Accounts Receivable Management
Address: ______________________________________________________________ City: __________________________________ State: ________ Zip: ___________ CONTACT INFORMATION Name: __________________________________ Phone: ___________________ Email Address: _______________________________________________________
Email, fax or mail this registration form along with your payment to: AAHAM CPAM/CCAM Study Session CD ROMs,11240 Waples Mill Road Suite 200, Fairfax VA 22030 Fax: 703.359.7562 • Email: email@example.com • Questions? Please call 703.281.4043 x202
washington wire 100 Days and Counting Paul A. Miller, PLC, Lobbyist
uly 30, marked the 100 day mark until we go to the polls and vote to see which party will control Congress for the next two years and the White House for the next four years. With the way things have been going in Washington the past several years, you might think it doesn’t matter who’s in charge because nothing ever gets done. On some level you would be right, but on a more practical level you could not be more wrong. This election cycle will be a defining moment for the direction of the country. It has been a bitter two-year’s since the Patient Protection & Affordable Care Act (PPACA) was passed and signed into law by President Obama. During this process our politics has gone from mean and nasty to downright ugly and destructive. In the short term, this ugliness is going to continue up through the elections. This year’s elections will be about direction. For the Democrats it will be about pushing forward with implementation of the PPACA. For the Republicans, it will mean a continued push to repeal the PPACA and implement it with a more market based approach. Both may seem non newsworthy, but I can assure you, healthcare will be at the forefront for both sides in the next Congress and why AAHAM needs to continue to be out front on these issues. It is an ugly process right now, but I do see potential for a light at the end of the tunnel. I say this because we are at the proverbial wall right now and there is no kicking the can any further. What does this mean? Well, for one thing, it means 2013 is going to be a very busy legislative year. We have a huge backlog of issues that have been piling up. Congress and the President will have to begin wheeling and dealing to get things done. For the President, it is critical for his legacy. Even with the passage of the PPACA and the killing of 6
Osama Bin Laden, the President needs more to secure his place in history. If the Republicans are able to capture the Senate, they will be forced to prove to the American people that they are able to govern and this means getting things done. None of this will be easy. Before we can get to 2013, we need to go through what is about to become a nuclear election cycle we have not seen before. This year’s elections could go down in history as the meanest and most expensive in history. There will be bruised egos on both sides and those feelings do not disappear overnight. I expect partisan wrangling to take place in the new Congress, as it always does. I also expect that both sides will see the American people will no longer continue to give them a pass by holding things up. We have seen an angry electorate and we have seen just how powerful they can be when they organize and vote. No elected official will want to spend the next two years trying to defend an obstructionist mentality when people continue to struggle to find jobs; when people struggle to stay in their homes; when people struggle to put food on the table for their family; and when states are forced to make tough choices due to escalating budget deficits. Voters simply won’t take anymore of this “do nothing” mentality we have going on in Washington right now. I believe voters, already pushed to the brink, will decide to simply throw them all out and start over if things don’t change. I think for any politician, the prospects of this happening may force them into a corner and force them to take those tough votes or at a minimum, standup and be the leaders we expect them to be. Either way, I see 2013 as the beginning of an opportunity to get some things done. Don’t get me wrong. I am not saying both sides will join hands and forget all the back stabbing that has taken place over the
past several years, but I don think you have smart leaders on both sides who will try and cut deals to get some things done, if for no other reason than to protect their own jobs and ambitions. I see 2013 as that year. I learned early in this profession that you never over promise and if you do promise something you better be able to deliver. So, I feel very comfortable saying today that if you were expecting healthcare to fall into the background now that the Supreme Court has ruled on the PPACA, you would be wrong. I can say confidently that healthcare will once again be front and center in the next Congress. If the Republicans are able to capture the White House, the first thing Mitt Romney has said, is he would repeal “Obamacare.” This would be easier said than done. If, on the other hand, the Republican’s fail to capture the White House, but take control of both the House and the Senate (which I believe to be a more likely scenario) then you can expect continued votes to either do away with the PPACA or attempts to alter it significantly. This becomes easier in the House as Republicans should still have a sizable margin to pass such legislation. It would be harder to do in the Senate because the Republicans would need the help of some Democrats to get the sixty votes needed to make any such vote veto proof. Again, easier said than done. If however, we continue with the status quo of President Obama occupying the White House, Speaker Boehner and the Republicans controlling the House and Majority Leader Reid and the Democrats holding an even slimmer majority in the Senate then we may have to revisit how productive 2013 will be. A lot of pundits thought once the Supreme Court ruled, everything would sort Continued on page 7 The Journal of Healthcare Administrative Management
washington wire continued from page 6
itself out on the healthcare front. Far from it. I think the Supreme Court’s ruling only sets us up for another long battle of how to curb skyrocketing healthcare costs. You didn’t think the debate over the PPACA would go away that easily did you? Both sides, including the President, admit changes need to be made to the PPACA. Therefore, we can expect more healthcare hearings, more healthcare votes, and probably even more healthcare lawsuits challenging states decisions to implement or not implement certain pieces of the PPACA. This is why it is going to be critical to work with both sides of the aisle heading into 2013 on healthcare related issues critical to AAHAM members. Let’s look at some of the areas where we are likely to see party line battles in the next Congress. First, look at Medicaid. The Supreme Court’s ruling the expansion of Medicaid is optional and not a mandate, puts this issue at the forefront of issues to be resolved in the next Congress. States already strapped for revenue, have to decide if they will expand the program to cover more or change their program to cover less. As a politician, this is one issue that is always risky. On one side of the spectrum, you have had several Republican Governors come out against expanding Medicaid and others on the Democratic side who have decided to follow the President’s lead and will expand their programs. For those who oppose the PPACA because of its cost you more, you will be happy to hear that not requiring states to expand Medicaid will save taxpayers $84 billion over the next decade. The bad news here is the Congressional Budget Office expects there will be 3 million fewer people getting benefits due to the Supreme Court’s ruling. This means someone will have to pick up their healthcare costs if they cannot afford to on their own. If states won’t cover the cost, the responsibility will fall on the Federal government, which could mean another fierce battle in Congress. Now let’s move onto the government exchanges, which the PPACA requires states to implement. Again, you have quite a few Governors saying they don’t care what the Summer 2012
Supreme Court ruling is, they refuse to setup insurance exchanges in their states. Oklahoma is one state that has said it has no plans to help sign people up for benefits under the PPACA. Oklahoma has a history of bucking Washington on issues like this and they appear to be ready to do it on this issue as well. Oklahoma has an independent streak; it doesn’t make residents comply with car insurance laws, so there is no way they are going to force residents to buy health insurance. Oklahoma isn’t alone; there are quite a few other states that have taken similar stands. What does this all mean then? Well, if states refuse to set up the exchanges, it will force the Federal government to step in and create the exchanges for them. It will also mean taxpayers will have to cover those costs. So, as you can see there are still a lot of unknowns with the PPACA and don’t expect those unknowns to change anytime soon. I predict we will have even more unknowns as the timelines approach for other pieces of the PPACA to be implemented. These are a couple of the big items I expect to be on the agenda in 2013. These are the ones that will continue to keep the partisan bickering alive and well. I do think there are opportunities for real bi-partisanship. One of those issues which has bi-partisan support is changing the Telephone Consumer Protection Act (TCPA). This change is critical for so many reasons we discussed
during Legislative Day, but it is a revenue raiser. Our deficits are continuing to grow and sequestration is getting ready to kick in next year. Congress and the Administration are looking for ways to generate extra revenue to help get us out of this fiscal mess. One way to do that would be to support AAHAM and a bi-partisan group in changing the TCPA. Something as simple and as bi-partisan as this, would generate billions of dollars each year for the Federal government. I won’t tell you this change will solve all our problems, but this issue is one of many that would help us generate the added revenue the government needs immediately. Things will move fast next year and AAHAM needs to be ready. We have some big tasks yet to complete and the biggest right now is making changes to the TCPA. With your continued support we will see success. Get your walking shoes ready as we will need you out in Washington in the Spring to participate in Legislative Day. We can’t rely on our elected officials to do the right thing, they will still need a nudge or kick in the pants from you. Healthcare will be on the agenda in 2013 and we have no time to take a break just because it’s an election year. Are you ready? Hear Mr. Miller at the AAHAM ANI closing session. He can be reached at pmiller@ mwcapitol.com
Accountable Care Organizations (ACOs): Are They a
Savior Snake? or a
By Rob Borchert President Best Practice Associates, LLC Member of the AAHAM Virginia chapter
e all hear about Accountable Care Organizations (ACOs) today. They are becoming a code that many of us ignore, don’t believe it will impact us or we are in an ACO and awaiting outcomes to show success and sustainability. The concept of the ACO is one that has lead to much discussion since its initial presentation by the Federal Government. The original/initial intent of an ACO was to formulate cost containment through the inter-relationships of physicians and hospitals. As this relationship was established and cost containment practices were put into place, there would be a financial benefit (from the Shared Medicare Fund) once the reduction of costs was presented and verified. The modifications from the first government presentation to become an ACO and abide by the complicated reporting and adhering to the quantity of quality measures now makes it more appealing to the healthcare community to strongly consider forming an ACO. There is less reporting requirements and down to thirty-two quality measures. The expectation is there will be a very high increase in the formation of ACOs over the next two years. In April 2012, CMS picked twenty–seven ACO participants for the shared-savings program. This is the initial list: • Accountable Care Coalition of Caldwell County, LLC 8
• Accountable Care Coalition of Coastal Georgia • Accountable Care Coalition of Eastern North Carolina, LLC • Accountable Care Coalition of Greater Athens Georgia • Accountable Care Coalition of Mount Kisco, LLC • Accountable Care Coalition of the Mississippi Gulf Coast, LLC • Accountable Care Coalition of the North Country, LLC • Accountable Care Coalition of Southeast Wisconsin, LLC • Accountable Care Coalition of Texas, Inc. • AHS ACO, LLC • AppleCare Medical ACO, LLC • Arizona Connected Care, LLC • Chinese Community Accountable Care Organization • CIPA Western New York IPA, doing business as Catholic Medical Partners • Coastal Carolina Quality Care, Inc. • Crystal Run Healthcare ACO, LLC • Florida Physicians Trust, LLC • Hackensack Physician-Hospital Alliance ACO, LLC • Jackson Purchase Medical Associates, PSC • Jordan Community ACO • North Country ACO • Optimus Healthcare Partners, LLC • Physicians of Cape Cod ACO • Premier ACO Physician Network • Primary Partners, LLC • RGV ACO Health Providers, LLC • West Florida ACO, LLC
These healthcare entities were the first ACOs officially approved by CMS. They represent over 10,000 physicians, 10 hospitals and 12 smaller physician-led entities who will serve over an estimated 375,000 Medicare beneficiaries. Now this seems like the meaningful intent of the ACO model. What we need to be aware of is the “history repeat itself ” model of third party insurance companies becoming strongly involved in this ACO model. I say that “tongue in cheek”, since it is already happening. The major players are looking to the ACO model to play a growing role as health plans try to rein in costs and direct quality and clinical goals. They also see opportunities in managing care for Medicare and Medicaid dual eligibles. Here are some real examples: • Aetna: Look for more expansion in the health plan’s ACO business which currently has nine contracts including Carilion Clinic (Roanoke, Virginia), Sharp Community Medical Group (San Diego, California) and Cleveland Clinic (Cleveland, Ohio) and six letters of intent. This relationship even goes beyond the Medicare population. Effective July 1, Aetna has been awarded the administrative services contract for Maine’s 33,000 employees and their dependents. It plans to develop a statewide ACO network for this membership • CIGNA: They acquired HealthSpring, a Medicare plan in 2011, and is preparing an ACO model to include dual eligibles. It is also expanding its participation in accountable care organizations with 17 iniThe Journal of Healthcare Administrative Management
tiatives underway in 15 states. • Humana: Like CIGNA, Humana intends to be a major player in the dual-eligibles market. Its strategy is to take state-bystate approach to opportunities. Humana has focused on developing a nationwide footprint for its Medicare Advantage and faces little competition in many of its markets. This is an excellent partnering opportunity when discussing future plans with an ACO. • United Health Group: They have stated employers are very focused on value-based benefit design for employees and its consumer based health plans have done well in that marketplace with about 15% of its membership in value-based products. The company has several pilots in place around bundled payments in its commercial and Medicare business. The focus is on aligning the bundles with the right clinical programs and the right incentives. This is the new insight into the ACO model for non-Medicare members. In addition, United Health sees the dual eligibles market as a major opportunity. • WellPoint: WellPoint has several ACO pilot and medical home programs that involve more than 100,000 members and more than $240 million in shared savings. The medical home program in Colorado posted an 18% decrease in acute inpatient admission over the first 2 years and a 15% reduction in emergency room visits. In the first year of its ACO partnership with the Dartmouth-Hitchcock Medical Center in New Hampshire, inpatient admissions and avoidable ER visits declined. Everyone major insurance company is becoming a strong player in this new model and this could change the fact of healthcare access as we know it. If the major insurance companies focus on their strongest markets and offer very attractive plans to employers and other members with restricted service at only “in-network” facilities, what will happen to competition; what will happen to those of us who do not have that plan, what will happen to the smaller insurers in that Summer 2012
market? Only the future will tell us. As this ACO model develops across the various geographic areas of this country, there are some questions that will need to be addressed. We recognize the intent of cost savings and in some cases have already achieved some demonstrative savings but there are other potential concerns that may need to be addressed moving forward: 1. Anti-trust: The question of joint negotiation of contracts between physicians as well as between hospitals; and addressing what about physicians who may work at different hospitals that are not part of the ACO? 2. Stark/anti-kickback: Will this law have any effect on the ACOs approach to reward physicians if quality is maintained and cost savings achieved? 3. Tax-exempt providers: In the ACO environment, if clinically integrated, is the sharing of the cost savings a violation of any current tax laws?
4. State Insurance regulation: If ACOs become their own insurer for services rendered and assume the financial risk under the reimbursement structure, will they have the financial capability to assume that risk is they experience a high volume of very expensive care patients? 5. Medical malpractice: ACO structure / practices/procedures may prevent costs from decreasing due to “defensive medicine”. 6. Health benefit (insurance exchanges): How will these state exchanges fit into the ACO structure is they are a third party owned ACO? Only the future will tell, but I hope this reflection on ACOs have been helpful for both existing ACOs and for those who are contemplating being involve with an ACO. n Mr. Borchert can be reached at 315.345.5208 and firstname.lastname@example.org 9
Power Change: Seize the
Five Proven Ways to Overcome Negativity, Improve Productivity and Ignite People By Kathy B. Dempsey, CSP, President of Keep Shedding Inc.
hy do 75% of all change efforts fail? Largely because people feel left out of the process and lack the motivation, skills and knowledge to adapt to the new systems, processes and procedures. According to Gallup’s calculations, actively disengaged employees cost the American economy up to $350 billion per year in lost productivity. No organization thrives unless their people learn how to “shed.” To stay competitive, employers must arm their teams with the necessary skills and positive attitudes. Negativity, like an infectious virus, siphons precious energy and productivity. Discover how you can seize the power of change in your organization by utilizing these five ways to overcome negativity, improve productivity and ignite your people to shed. 1. Help them attach to something new. Humans have a natural tendency to attach to familiar people, processes and products. Remember back when you were a child and someone took away your lollipop. You probably screamed and cried and thought your life as a four year old had come to an end. Minutes later, in the heat of your temper tantrum, someone handed you a cuddly teddy bear and immediately your eyes lit up and you stopped crying. The lollipop? Who cares? Life was good! You were now attached to your new bear. This strategy works similar for work teams. 10
How can you get people excited about the change (the cuddly new teddy bear) so they shed their attachment to their current lollipop quickly? Help them attach to what they will gain from the change? Time? Efficiency? A new skill? Watch resistance to change evaporate as you uncover ways to help people attach to something new. 2. Shrink the change. Dan & Chip Heath discuss this in their book, Switch: How to Change Things When Change is Hard. Too much, too fast or too big of a change will overwhelm and paralyze a workforce. If the proposed change is perceived as insurmountable, people will shut down and give up before you even get out of the gate. Shrink the change down to bitesize digestible pieces by providing a more achievable goal. If your target is to improve productivity by 50% this year, consider a more realistic goal of 5% monthly. To keep peak motivation, don’t forget to publically recognize and celebrate short term wins. Momentum is vital for sustainable results. 3. Give the goal with choices. My mom was not in executive leadership but she knew the value of this strategy extremely well. Her goal? A clean house. Choices? “Kathy, do you want to take out the trash or do the dishes?” I didn’t want to do either but somehow I was more motivated because I had a choice in my household chores. Likewise, employees’ motivation soars if they are given more control over a situation. Peter Bragman, from Harvard Busi-
ness Review, offers another slant on this tip. Give the desired outcome, and then suggest the path. Allow people to reject the path as long as they chose an alternate route to the same destination. 4. Eliminate the fear. While working at a healthcare system years ago, the CEO announced to all 4000 employees that they were going through tremendous change. He said anyone who came up with an innovative idea to save time or money, even if it changed or eliminated their job, would have a place to work somewhere in the system. The CEO eliminated the employees’ fear of losing their jobs. 95% of people say fear is the #1 barrier holding them back at work and in life. You might not be able to guarantee 100% job security, but how can you build strategies that eliminate as much fear as possible? 5. Create a sense of urgency. Spark motivation for change with open and honest communication. Talk about what’s happening in your industry and with your competition. Discuss the trends, the facts, and the consequences for team members and the organization if change doesn’t occur. Without cooperation or buy-in your change efforts will fail. By stimulating people to talk and think, you’ll propel them to move out of denial or anger. Urgency provides the fire to ignite teams to get on board with the exciting possibilities. n Ms. Dempsey, CSP can be reached at www. KeepShedding.com The Journal of Healthcare Administrative Management
Certified Compliance Technician
By Maya Mohan, CPAM, FHFMA Executive Vice President of Operations, AGS Health , Member and President of the Chennai chapter
have been working in the United States healthcare Industry for the past twenty years. There have been so many changes throughout these years. Of all the changes that I have seen, Compliance is something that has taken huge precedence over many other issues. Technological advancements further increase the need for heavy-duty compliance despite all the additional regulatory requirements. A decade ago, we did not have Comprehensive Error Rate Testing (CERT) or Recovery Audit Contractor (RAC) conducting stringent audits on reimbursements made. Now mistakes can be very costly. The civil monetary penalties imposed can range anywhere between $2000 and $100,000. That said, when we hire new staff, it is mandatory for them to be compliant with all the regulations applicable to us. After all, all violations would warrant penalties whether committed by a junior employee or by the CEO! I have been a member of AAHAM for the past eight years. It has been a very interesting journey. Through these years, I have been training and conducting AAHAM’s technical and professional certifications across various billing companies. AAHAM has been offering Technical 12
certification exams since 1992. Technical certifications test the basic knowledge required to work in the “front end” of hospitals and clinics. I always wanted (and needed) certification that would test the compliance knowledge of my staff. Certified Compliance Technician (CCT) fits the bill perfectly. It tests the examinees on various acts and laws and “must know” information for all the staff working in healthcare billing offices, hospitals and clinics. The AAHAM CCT exam covers various topics like fraud, abuse, compliance guidance given by Office of Inspector General (OIG), Health Insurance Portability and Accountability Act (HIPAA), Clinical Laboratory Improvement Amendments (CLIA), Operation Restore Trust (ORT), Anti-Kickback statute, Physician Incentive Payments, Health Care Quality Improvement Program (HCQIP), task forces of FBI that takes care of healthcare fraud, Department of Justice (DOJ), Civil Monetary Penalties and provider self-disclosure. The course curriculum does not stop with only the acts and statutes. It also gets into realtime examples, tools and best practices that are followed by other organizations. When a person prepares for the AAHAM CCT certification, they receive diverse exposure to the industry. They get to learn the “dos and don’ts” and also the penalties they will be liable to pay if they cross the line. This profound understanding of the laws and the industry would result in less numbers of compliance violations in organizations.
After all, compliance awareness is inversely proportional to the number of compliance violations! Any hospital, clinic or a pharmacy would be comfortable to work with a billing office which has demonstrated a higher degree of compliance awareness and training by achieving an AAHAM CCT designation. CCT adds value to the organization as well as to the individual who takes the exam. It, first of all, enriches the resume of the person. Any healthcare organization would be happy to hire a person with such a certification compared to someone without it or who has to be trained from the beginning. It shows them the way to be model citizens in the industry. Some companies use certifications to promote employees into leadership roles. CCT is a good continuous learning initiative. It helps in benchmarking staff based on their competence and compliance orientation. I have tried this in my organization and it has worked well. Are you interested in certifying yourself and your staff too? The AAHAM CCT exams are held in conjunction with the other technical certification exams; February, May, August and November. All you need is just one year of healthcare billing experience. Log on to www.aaham.org to register or find out more. Many local AAHAM chapters including the Chennai chapter offer coaching sessions to help you, visit www. aahamchennai.org .to know more. n Ms. Mohan can be reached at email@example.com and firstname.lastname@example.org The Journal of Healthcare Administrative Management
5010 Conversion Challenges By Dean Mitts Site Director, Frisco National Insurance Center, Conifer Health Solutions, Member of the Texas Bluebonnet chapter
e all knew the federal mandate requiring clearinghouses and providers to upgrade their current HIPAA 4010 transaction standards to the new 5010 standards was coming on January, 1, 2012. Now, both Providers and Payers are experiencing challenges with the new changes. Providers spent many hours updating and testing their claims creation processes to accommodate the new 5010 billing requirements. Payers were doing the same on their side to convert from 4010 to 5010 processing formats. Some Payers are still running “dual processing” until they finalize their conversions. Now we are working the problems from all angles as they surface. Are you experiencing more payer rejections in your EDI departments? Is your billing team seeing more rebill request than normal? Are you calling on claims and finding an increased number of claims not on file? These are just a few questions many Revenue Cycle Operators are verifying in their operations on a regular basis. It’s a good thing you are. You’re most likely seeing some inflated numbers. When you drill down to the root cause, you may find that in the first few months of 2012, it’s very possible 14
they are related to the 5010 changes. As you start “working the problem,” you may have realized if the claim goes directly from your Billing Editor to one clearinghouse and then to the payer, it is been much easier and timelier to get a permanent solution in place. However if you have to work your way through the “maze of intermediaries” it becomes very problematic. The biggest 5010 challenge you may be experiencing is a result of the lack of single thread responsibility and contacts through the flow of claims from the claim editor to the payer. In most cases there are one or more claim intermediaries between the claims editor and the payer. Each entity has a person/team that was responsible for 5010 changes with the next entity in the delivery chain but the same person/team is not involved in the 5010 changes with the next entity in the chain. In the majority of the claim intermediary organizations, there is a team responsible for incoming claims/837s and a different team responsible for outgoing claims/837s and in most cases these teams, are not tuned into what specific changes the other team has made or what 5010 type issues the other is experiencing or having reported to them. This lack of a single cohesive 5010 inbound/outbound team at each intermediary has caused significant delays in getting 5010 claim issues correctly communicated, in the
hands of the correct resolution party and of course in getting the issue completely resolved. The next biggest 5010 challenge, which most providers have not yet encountered but will shortly, is with the processing of payer v5010 835s. Most payer 835s come through a single entity and because these entities 5010 plan was to focus on 837s, there has been minimal testing on the v5010 835s. This could have a negative impact on the 04.01.2012 compliance enforcement date. As changes continue to take shape in healthcare, we will all continue modify our processes to meet the needs of the business. Adaptability is a required characteristic of a good Revenue Cycle leader. The transition from 4010 to v5010 is just another challenge we as providers, payers and clearinghouses will need to overcome in our evolving healthcare industry. Nevertheless, it is important that we keep in mind the two key factors that are driving the 5010 upgrade, which are the governments’ and industries’ shared goal of providing higher quality, lower cost health care; and the need for a comprehensive electronic data exchange environment for the expanded ICD-10-CM and PCS code set transition mandated for compliance by October 1, 2013. n Mr. Mitts can be reached at 214.387.6764 and Dean.Mitts@ConiferHealth.com The Journal of Healthcare Administrative Management
Speakers & Schedule
October 17-19, 2012 Hyatt Regency Coconut Point Bonita Springs, Florida
American Association of Healthcare Administrative Management
Jan McInnis Learning doesn’t have to be boring! Professional speaker, Jan McInnis has spent the last fifteen plus years as a speaker, comedian, trainer and comedy writer. She has won numerous awards and has spoken to hundreds of organizations, including the Mayo Clinic, the Health Information Association, the Association of Women’s Health, Obstetric & Neonatal Nurses, Aventis Pharmaceuticals and many more. Jan has a knack for finding humorous analysis in the typical challenges of the work day. She has been featured in the “Wall Street Journal” as one of the top business comedians. She goes by the nickname, “The Work Lady” because she spent her extensive pre-comedy career as a corporate marketing executive. Jan knows change. Not only has she worked with organizations involved in major change, she made one herself when she left her marketing career and headed into the uncertain world of entertainment. The tips and tools she used in her journey will help you deal with change, whether it’s on the job or in your personal life, and laughing all the way! View her video at www.theworklady.com, her blog at www.comedywritingblog.com or become a Facebook fan at www.janfans.com.
Christina Thielst, MHA, FACHE is Vice President at Tower Strategies. Her firsthand experience with the challenges and barriers to effective communications and collaboration have shaped her vision for social media technologies, in her book “Social Media in Healthcare: Connect, Communicate, Collaborate.” Leveraging almost thirty years experience on the front lines of healthcare delivery as a hospital administrator and consultant; she helps guide large, complex healthcare institutions as they positively transform their patient experience, as perceived by the patient. Christina understands how technology can enhance experiences and integrate seamlessly across the continuum of interactions. As a highly respected thought leader and published writer she envisions the application of new and emerging technologies that providers can leverage as solutions to patient care and workplace challenges. Links to most of her published work, including her book Social Media in Healthcare: Connect Communicate Collaborate can be found on her personal weblog. http://thielst.typepad.com. Christina received a Bachelor’s degree in Social Science/Management from Louisiana State University and a Masters of Health Administration from Tulane University, School of Public Health and Tropical Medicine. She is a Fellow in the American College of Healthcare Executives and a member of Health Care Executives of Southern California, Health Information Management Systems Society, American Telemedicine Association and the National Rural Health Resource Center’s HIT/Telehealth Key Informant Group.
Paul Miller, PLC Paul is a founding partner in the Government Affairs firm, Miller/Wenhold Capitol Strategies, LLC. He has vast experience in the lobbying profession and introduced the first lobbying certificate program designed to help lobbyists keep pace with the profession and its standards. He led the successful fight to bring changes to the electronic filing system for lobbyists to comply and meet their obligations under federal law and allows the general public an opportunity to view lobbying reports online in real time. Paul was also instrumental in shaping the debate on lobbying reform in 2006 and 2007. He has been a tireless champion in the fight to protect 16
every citizen’s right to petition their government through lobbying activities. Paul has traveled abroad to talk and meet with foreign leaders about their efforts to implement lobbying rules and regulations and has appeared on many national news programs discussing ethics and transparency issues. Paul is the co-founder of the Virginia Small Business Partnership; a statewide policy group focused on the needs of small businesses. Paul currently serves on his alma mater’s Deans Advisory Board at the University of Wisconsin Whitewater and was named to the Board of Directors of the Fairfax Partnership for Youth. The Journal of Healthcare Administrative Management
General Session Speakers
New Altitudes are achieved with these featured speakers:
Rhonda Bankester, RN, CPUR, CMAS, ICQCI Ms. Bankester is Vice President, Clinical Revenue Cycle Services, at Conifer HIM/ Clinical Revenue Cycle Services. Ms. Bankester leads a national team of revenue cycle clinicians performing retrospective review of clinical denials and appeals and precertification activities. She also leads a team of credentialed coders focused on timely, accurate and quality coding to ensure optimal revenue cycle performance. Prior to joining the company, she managed case managers and utilization review nurses in the managed care industry.
Virginia Berney, CPAM, CCAM Ms. Berney is Program Head for the Medical Billing and Coding Department and an instructor at Anthem College in Minnesota. Her career has included running both operations and the billing office for an urgent care facility and as a Coding Educator Analyst. Virginia has been an active member of the AAHAM Gopher chapter and has held numerous board positions.
Douglas J. Bilbrey Mr. Bilbrey is Executive Vice President of Sales and Marketing at the SSI Group. Previously, he worked as the Applications Development Manager, as well as a Senior Systems Analyst.
Kelley Blair Ms. Blair is Vice President of Professional Services for Craneware, Inc. She helps hospitals manage revenue cycle strategy projects by providing operations insights, best practices, performance improvement methods and measurement tools. Ms. Blair has more than 13 years of revenue cycle operations management and performance improvement experience and is also a certified Six Sigma Black Belt and experience using Lean and Focus PDCA improvement methodologies in complex integrated health systems. She holds a master’s degree in Organizational Leadership with a focus on strategic management. Summer 2012
Catherine Colyer, Esquire
Linda Fotheringill, Esquire
Ms. Colyer is Corporate Counsel; Compliance Officer/Privacy Officer for Alliance Collection Agencies, Inc. and Healthcare Business Services, Inc. She represents healthcare providers and focuses on regulatory compliance. She received a Bachelor’s Degree in English and in Political Science, with honors, from the University of Wisconsin-Madison. She graduated from the University Of Virginia School Of Law and began working in healthcare law in Washington, D.C., and has also worked as a healthcare consultant.
Ms. Fotheringill is a founding member of Washington & West, LLC, and is a nationally recognized expert on Denial and Appeals Management. Linda assists hospitals across the country, overturning denials. She has represented clients in insurance contract disputes and medical malpractice litigation. Ms. Fotheringill began her career as a hospital-based Physician Assistant in the areas of general surgery, oncology, neurosurgery and trauma. She also had fourteen years of experience in the insurance industry as a claims representative.
Angelica Del Villar, CPAT
Lea Fourkiller, Esquire
Ms. Del Villar is the Registration Lead Representative for the Emergency Registration Department at Presbyterian Intercommunity Hospital. She has over twenty years experience working in the front end healthcare field. She led staff as they transitioned into a successful point of service department for the organization.
Ms. Fourkiller is Vice President and Chief Compliance Officer for Conifer Health Solutions Inc. She is responsible for leading the valuesbased ethics and compliance program for the company’s more than 3,500 employees. Prior, Ms. Fourkiller served as a Regional Compliance Director, where she oversaw the compliance programs at thirteen hospitals, as well as the Compliance Officer for a multi hospital system. Ms. Fourkiller earned her Juris Doctorate from the University of Tulsa/College of Law and is a member of the Oklahoma Bar Association.
Margaret Dowling Ms. Dowling is a Senior Revenue Cycle Consultant for PNC Healthcare. Her areas of expertise include automated cash posting, healthcare collections, cash reconciliation, streamlining healthcare collection business processes, EOB conversion and denial and contract management. She graduated with honors from Bryn Mawr College and holds an MBA in Finance from the University of Mississippi. She is an AFPCertified Treasury Professional.
Christine Fontaine, CHFP, CPAM Ms. Fontaine is the Vice President of Revenue Cycle Solutions for OptumInsight. Previously, Christine was the Director of Revenue Cycle Operations for a large University medical system. Christine has been in the healthcare finance field for over twenty years, in both physician and hospital business offices. She has held several management positions and directed all facets of Revenue Cycle Operations in her experience in healthcare.
James S. Gandolfo Mr. Gandolfo is Vice President Senior Consultant Treasury Consulting Group, PNC. He provides support to both industry and PNC’s Treasury Management professionals related to comprehensive solutions for commercial payments, receivables and information management. Previously he was with PNC Global Investment Servicing. His experience also includes a long tenure as President and CEO of a registered brokerdealer. Jim has is BS degree in both political science and history from Radford University. He holds a variety of FINRA licenses, including Series 6, 7, 24 and 63. Jim is chairman of the American Bankers Association’s HSA Council and a member of the board of directors of the HSA Coalition.
General Session Speakers Continued John B. Garver, III, Esquire Mr. Garver is a partner with the law firm of Robinson Bradshaw & Hinson, P.A. His practice includes work in joint ventures, healthcare and insurance law. In the healthcare law area, he regularly advises clients on compliance and regulatory issues, including the federal Anti-Kickback and Stark laws. He has a broad transactional healthcare practice, including assisting hospitals and health systems, physicians and their practices, dialysis providers and dental practices in acquisitions, affiliations, joint ventures and ownership transfers.
Brent Grimes Mr. Grimes is the Administrative Director of Patient Financial Services for INTEGRIS Health. He has over sixteen years experience in the healthcare field. He has worked in nursing home administration, pharmaceutical sales, home health, hospice, DME and revenue cycle management. Grimes currently works with the Administration, CFO’s and Revenue Cycle Leadership at INTEGRIS Health, as well as serves on several committees and community boards to improve the health and services to the communities that INTEGRIS serves.
Nicole Guido Ms. Guido is the Regional Vice President of Sales for Adreima. Nicole began her career as a Registration Clerk in an Emergency Department. She now has over twenty years of experience as a Revenue Cycle professional, which include twelve years working at the Director level, for providers. The last several years Nicole has assisted Revenue Cycle professionals with consulting, software solutions, and outsourcing services. Nicole is active in HFMA both at the local and regional levels.
Susan Gutjhar, BS, RHIT, CCS, CPC Susan is the Health Information Technology Director for Sparta Community Hospital. Her current duties include direction of the HIM, Reimbursement, and Utilization Review Departments which includes implementation of the EMR in the hospital and numerous physician clinics. Susan is also the Compliance Officer, Privacy 18
Officer, and a Six Sigma Black Belt. She is a member of AHIMA and AAPC. Susan is also adjunct faculty for Southwestern Illinois College where she is currently teaching ICD-10 Anatomy and Physiology classes. She holds a BS in Organizational Leadership
revenue cycle. Prior, he served in similar positions for the last twentytwo years. Mr. Hovan holds a BS from Clarion University in Pennsylvania and a MBA from Indiana Wesleyan University. He is an active member of Tennessee HFMA.
Dan Hobbs, CPAM
Ms. Hutchens is an associate at Robinson, Bradshaw & Hinson, PA. Jennifer practices in the area of corporate and commercial law, with an emphasis on joint ventures and mergers and acquisitions. As a member of the firm’s health law practice group, she consults with healthcare clients on regulatory and compliance matters at both the federal and state level, including the federal Anti-Kickback and Stark laws and HIPAA privacy and security. Her transactional healthcare work includes negotiating provider joint ventures and hospital acquisitions and preparing physician recruitment, employment, and service contracts for physician practices and hospitals.
Mr. Hobbs is a Senior Consultant for QHR. He conducts assessments and implements best practices in the areas of patient financial services and patient access management. He has nearly three decades of healthcare experience and has worked with hospitals of various sizes to improve cash and accounts receivable performance, reduce bad debt, reduce denials and improve the quality of front-end processes. Mr. Hobbs also conducts seminars and workshops for hospitals on a variety of financial management topics.
Steven Honeywell, MBA, CCAM, CPAM Mr. Honeywell is the Senior Director of Professional Fee Billing for the University of Pennsylvania Health System. He has twenty-six years experience in physician billing, the majority of which has been in an executive level position at UPHS responsible for running the centralized Physician Billing Office that service over 1,000 physicians (Primary Care and Specialists). Steven is an active participant in several professional organizations that include the Board of Directors for the Philadelphia Chapter of AAHAM, the Advisory Group for the Faculty Practice Solutions Center (part of the Association of Academic Medical Centers), PNC Healthcare Advisory Board and a leader of the Academic Practice Plan Associate Directors organization. Steven holds an undergraduate degree in Public Health from Rutgers University and a MBA in Healthcare Administration from LaSalle University.
Stephen Hovan Mr. Hovan is Executive Director of Patient Fiscal Services for the University of Tennessee Medical Center. Mr. Hovan oversees the revenue cycle operations for the hospital and has assisted in transforming the
Jennifer Hutchens, Esquire
Cynamin Kinard, CPAR Ms. Kinard is the Director of Patient Financial Services at Gwinnett Hospital System for nineteen years. Her responsibilities have expanded to include Patient Accounts. Cynamin spent her entire career in Patient Access, where she was Director for six years. She has her bachelor’s degree in Business Administration from Shorter College. She is a past president of the Georgia Access Management Association (GAMA) and received the Marian Blankenship Distinguished Service Award from the National Association of Healthcare Access Management (NAHAM). She is also active in Georgia HFMA
Steve Levin Mr. Levin is the CEO of Connance, Inc. He is a hospital revenue cycle expert focused on developing consumer-centric business offices. He has worked for more than a decade in healthcare revenue cycle and is a frequent presenter at events on improving self-pay performance and the issues of charity eligibility. Mr. Levin has also authored numerous industry articles, and is a graduate of Dartmouth College and Harvard Business School. The Journal of Healthcare Administrative Management
General Session Speakers Continued Mark Mathia, MBA Mr. Mathia is the CEO of Tiburon Financial, LLC. Mark has over twenty three years of experience in the collection industry. Mark has his undergraduate degree in Business Communications from Dana College and his MBA from Bellevue University. Mark has been a mentor to many and has shared his insights and been published in periodicals such as New Man Magazine and the Inside ARM Newsletter. Mark has created and leads an internal leadership development program at Tiburon and is a prolific blogger and communicator.
J. Kevin McKechnie Mr. McKechnie serves concurrently as Executive Director of the American Bankers Insurance Association and Executive Director of the American Bankers Association HSA Council, representing each group before Congress and the federal government. Mr. McKechnie is a nationally recognized expert in insurance generally and health insurance in particular. He won the 2011 Public Policy Leadership Award from the Institute for Healthcare Consumerism. Mr. McKechnie is also a principle in HSA Holdings, an organization of global healthcare financing experts, providing healthcare financing expertise to several governments around the world. Previously, Mr. McKechnie was Government Relations Representative for the Affinity Services Division of a large insurance services organization.
Michelle Moore, CPAT
bilitation. She has over twenty-eight years of healthcare experience including Registration, Accounts Receivable, Collections and Managing the Revenue Cycle process. Ms. Price is an active member of AAHAM and HFMA.
Glen Reiner, RN Mr. Reiner is the Vice President for Clinical Operations at Adreima. Previously, Glen spent seven years as the Assistant Director of Nursing for a large healthcare corporation. He has spent over sixteen years as a Registered Nurse, with many of these years specializing in Nurse Management. He has extensive knowledge of healthcare coding, billing, reimbursement, denials and RAC/ MIC audits.
Mike Reppart, CHFP Mr. Reppart is the Director of Business Services at Hendrick Medical Center. He oversees basic business office functions, the eligibility and charity programs, along with the hospital’s revenue budgeting and charge management activities. Mike is a graduate of Lubbock Christian University and holds a Master’s degree in Public Administration from Texas Tech University. With over thirty years’ experience on the healthcare management scene, Mike has experience in a variety of areas. From his beginnings as a Medicare Reimbursement Auditor to his current position, he has compiled a broad base of knowledge related to Revenue Cycle and Account Receivable Management.
Ms. Moore is the Registration Supervisor for the Emergency Registration Department at Presbyterian Intercommunity Hospital. She has over twenty-two years of experience in Admitting/Registration functions with fourteen years in a leadership role. She has been with PIH for seven years working with the Emergency Registration staff. She has a Bachelor’s Degree in Organizational Leadership from Azusa Pacific University.
Nancy Price, CPAM
Mr. Seviour is the Vice President of Revenue Cycle Consulting for Array Services Inc. He has over thirty-nine years of health-
Ms. Price is the Director of Patient Financial Services at Bacharach Institute for RehaSummer 2012
Mr. Sammartano is CEO of Blue Marsh Holdings, LLC. He is a results oriented healthcare executive with over twenty years of hands-on experience. He has served as an Officer for two healthcare systems. Previously, Mr. Sammartano successfully managed all aspects of revenue cycle management for 56 acute care hospitals in sixteen states.
care industry experience. He is a member of AAHAM, HFMA and MGMA. Chuck served as Director of Business Office Operations for large health system for many years and has consulted at over 150 hospitals during his extensive career. Chuck is an experienced trainer and speaker and has served as a healthcare consultant for a major accounting firm specializing in revenue cycle, patient access, credit and collection, HIPAA and EMTALA.
Lyman G. Sornberger Mr. Sornberger is the Executive Director of Revenue Cycle Management for the Cleveland Clinic Health System. He is responsible for the Revenue Cycle Management for all eleven Cleveland Clinic Health Systems and 1800 Foundation Physicians. His responsibilities include CCHS Patient Access Services, Health Information Management and Billing. In total there are 1900 employees under his direction with a model that is both centrally and decentrally dispersed. Previously, he was with a university medical center for twenty-two years as a leader in their revenue cycle management.
Tanja Twist Ms. Twist is the Director of Patient Financial Services for Methodist Hospital, a 460 bed acute care facility in Southern California. Ms. Twist has over twenty years of healthcare management experience, including admitting manager for a large hospital and the manager of operations for a large cardiovascular medical group. Ms. Twist is an active member of AAHAM and is the President of the AAHAM Western Region chapter.
George V. Vancore, Jr. Mr. Vancore is an IT Systems Integrator/ Business Architect at Florida Blue. George is responsible for the successful technical and business integration of regulatory mandates and compliance programs throughout the enterprise. This includes healthcare related federal, state and Blue Card regulatory mandates and compliance programs. George holds an undergraduate degree in Computer Science with a minor in Mathematics. 19
General Session Speakers Continued Judy Veazie, CPAM, CCT Ms. Veazie has over thirty years of experience in healthcare and has consulted extensively on the Revenue Cycle including HIM, accounts receivable, admitting and charge master management. In addition to managing her role in Revenue Cycle Management, she has been the Editor for Aspen Press for the past nine years, editing “The Biller” publication and writing a monthly column in “The Healthcare Collector.” Judy is an active AAHAM member and past President and Board Chair of the Evergreen chapter of AAHAM. Judy has extensive teaching experience as an instructor for Edmonds Community College and Lower Columbia College, with a concentration in Medical Office Practice and HIM curriculum for Distance Education. She graduated from Marylhurst University with a BS in Business and Management.
Gerard (Jerry) Vitti Mr. Vitti is President, CEO and Co-founder of Healthcare Financial, Inc. Mr. Vitti has over twenty-five years of healthcare entrepreneurial and business operations expe-
rience in complex and ever-changing environments. He is a nationally recognized expert, speaker and author on receivables management, Medicaid and SSI enrollment, hospital revenue maximization and healthcare reform. Jerry is Past-President of the Massachusetts/Rhode Island chapter of HFMA and also a board member of the Massachusetts Health Council, member of the Massachusetts Association of Patient Account Management and a founding board member of the Long Term Care Finance Association.
Amanda Waesch, Esquire Ms. Waesch is a Healthcare Attorney at Brennan, Manna & Diamond, LLC. She focuses on advising healthcare providers including hospitals and physicians, on billing and reimbursement appeals and strategies, regulatory compliance, contracting and general corporate matters. She has personally handled Medicare appeals for hospitals, physicians, podiatrists, chiropractors, ambulatory surgery centers, independent diagnostic testing facilities, and ambulance companies at all levels of the appeals process throughout various states. Ms. Waesch also advises providers on managed care contracting issues, employment contracts, joint venture structural analyses and credentialing and privileging matters.
James (Jim) Whicker, CPAM Jim is the Principal Technology Consultant in Health IT Strategy & Policy at Kaiser Permanente. He is responsible for coordinating and facilitating the development of administrative simplification transaction standards, code sets and operating rules. Prior, he was with Intermountain Healthcare where he was responsible for implementing HIPAA Transactions and Code Sets and other related processes. He currently participates with X12 in developing standards for Administrative Transactions and active in HL7 with the attachments work group. Jim chaired the Claim Adjustment Reason Code, Claim Status Reason Code, and Health Care Decision Reason 20
Code committee on behalf of the American Hospital Association and continues as a voting member. He was elected as a Commissioner with the Electronic Healthcare Network Accreditation Commission (EHNAC) and has served as various chair and board positions with the Workgroup for Electronic Data Interchange (WEDI) on behalf of AAHAM and now Kaiser Permanente. Jim is an active AAHAM member, as well as a Certified Patient Account Manager. He has served in various local and national positions and is currently the National EDI Liaison for over fifteen years. Jim received his B.A. in Finance from Utah State University.
Michael Wilmoth, Esquire Mr. Wilmoth is a principal and Chief Development Officer for Advanced Patient Advocacy. Michael has worked for more than fifteen years helping patients access the resources that cover the cost of care. His background as a litigator, regulatory specialist and lobbyist has helped influence state and federal health policy. His more recent focus has been on developing programs and creating public-private partnerships that streamline the enrollment process for Medicaid applicants.
Shawn Yates Mr. Yates is the Director of Consulting Services for Experian Healthcare. He is responsible for developing custom solutions using advanced data and analytics for healthcare systems that positively impacts the entire revenue cycle process from registration to the back end collections operations. Mr. Yates has more than fifteen years of healthcare revenue cycle management experience. He previously worked for a healthcare system managing the hospital self-pay receivables and collections operations. He has worked for a national outsourcing collections company, partnering with thousands of healthcare clients across the country helping them to manage their insurance and self-pay receivables processes. Shawn holds a Bachelor of Science degree from Virginia Tech and is currently a board member for AccountsRecovery.net. The Journal of Healthcare Administrative Management
Professional Certification – Get your CEUs!
Industry professionals on average, enjoy higher salaries and wages than non-certified individuals. Remember, continuing education units (CEUs) are necessary to maintain your AAHAM certifications. Earn two (2) AAHAM CEUs per each educational hour attended. The AAHAM ANI offers the solutions you need to succeed, no matter what your challenge or experience level. With the ANI’s five distinct learning tracks and over 30 sessions, the ANI offers unparalleled education and training to meet every individual’s needs.
Schedule of Events (tentative)
Tuesday, October 16, 2012 6:00pm – 8:00pm
Registration Wednesday, October 17, 2012 7:30am – 5:30pm
1:45pm – 4:15pm
Opening Keynote Session & Awards Ceremony Keynote Speaker: Christina Thielst, MHA, FACHE “Social Media in Healthcare; the Good, the Bad & the Ugly.” Made possible with the support of Financial Credit Services/Medmax
8:00am – 11:45am
Virginia Berney, CPAM, CCAM, Program Head, Medical Billing & Coding Department, Anthem College
This session will help prepare you for AAHAM certification exams in a fun, relaxed and informative format. The workforce has become very competitive; employers are now looking at certification in addition to education and experience. Whether you are already signed up for an exam or just contemplating sitting, this interactive, preparatory session is for you. 12:00pm – 1:30pm
CPAM/CCAM Luncheon and Certification Awards Presentation All CPAM/CCAM certified members are invited to join us as we recognize our newly certified professional members and bestow special achievement awards. This luncheon is open to CPAMs and CCAMs only. Summer 2012
7:30am – 4:30pm
Registration Continental Breakfast in the Exhibit Hall
Made possible with the support of NHI Billing Services
Certification Coaching Session “Enhancing Career Opportunities through Certification”
Thursday, Thursday, October October 18, 18, 2012 2012
8:00am – 9:00am
Board of Directors Meeting
9:00am – 11:00am
hibitors at the opening event of the ANI. Enjoy delicious appetizers and entertainment as you tour our exhibit booths and learn about the latest products and services available to our industry.
Financial Solutions The growth of social networking has been dramatic and the applications are quickly finding their way into healthcare. This riveting session highlights how healthcare organizations are leveraging social media tools to connect, communicate and collaborate with their patients, physicians, employees and the communityat-large. Ms. Thielst will explore how social media can contribute to meaningful use and offers advice for managing the risks that threaten the value of these powerful tools. Learn how to recognize the value of social media and mobile computing tools in healthcare environments. Ms. Thielst will help you identify the risks of these tools and solutions to minimize loss and damage to your organization’s reputation and why these new technologies can’t be ignored. 5:00pm – 6:00pm
Start your day off right with delicious pastries and coffee while you visit with our exhibitors. 9:15am – 10:45am
KEYNOTE SESSION “Finding the Funny in Change” Jan McInnis, Professional Speaker
Jan will give share useful ideas on handling life’s curveballs using humor. From changing rules and regulations budget cuts and longer work hours, there’s a lot of change coming at you. All of this change causes fear, tension and miscommunication. Jan will share practical tips to help you deal with this change using humor. She will show you how to diffuse tension instantly, how to kick off tough conversations and how to facilitate communications. You’ll walk away laughing and learning as you discover the steps you can take to conquer and even embrace, change.
First Timer & New Member Reception All new members and first-time ANI attendees are invited to join the AAHAM Board of Directors at a special networking reception in your honor. 6:00pm – 7:00pm
Welcome Reception in Exhibit Hall Join your friends, colleagues and ANI ex21
Tentative Schedule Continued 11:00am – 12:30pm
CONCURRENT SESSIONS MANAGEMENT /REVENUE CYCLE TRACK
“An EMR for the Revenue Cycle: Documenting the Business Side of Care at University of Tennessee Medical Center”
Stephen Hovan, Executive Director, Patient Fiscal Services
This session will discuss opportunities to improve the hospital’s bottom line by creating an EMR for the revenue cycle. Attendees will hear how the University of Tennessee has used documentation of revenue cycle activity to reduce denials, increase POS collections, improve patient and physician satisfaction and enhance workflow between departments. Outcomes will be shared, as well as processes and methods.
and bill auditing processes, data gathering and ultimately, gross revenue, have been attained. Hendrick Medical Center has designed a revenue integrity program with charge capture as its centerpiece and supported it with auto-updating tools which have helped to support an automated workflow. LEADERSHIP /PROFESSIONAL DEVELOPMENT
“The Past, Present & Future of Healthcare Reform” Gerard (Jerry) Vitti, President & CEO, Healthcare Financial, Inc.
“Creating an In-House Compliance Team: Basic Principles for Getting the Job Done”
This session will show how Massachusetts has paved the way for National Healthcare Reform. By looking at reform trends and the state of Massachusetts as the “benchmark” for national model and plans-indevelopment, Mr. Vitti will dissect and breakdown what has been working, what needs to be done and where we are likely headed on the path to nation-wide healthcare reform implementation. Attendees will gain a thorough comprehension of healthcare coverage, reimbursement and state policy tactics.
Lea Fourkiller, Esquire, Chief Compliance Officer, Conifer Health Solutions
This session will explain how to effectively establish a compliance program that supports the goals of a hospital’s revenue cycle process, protects the financial and reputational welfare, and maintains an organization’s compliance with the law. ACCESS /QUALITY MANAGEMENT TRACK
“How Hendrick Medical Center of Abilene Made Charge Capture the Centerpiece of Revenue Integrity Program”
Mike Reppart, CHFP, Director of Business Services, Hendrick Medical Center Kelley Blair, Vice President of Professional Services, Craneware, Inc.
This case study presentation will demonstrate how a properly orchestrated revenue integrity program including improvements in coding, pricing, charge 22
“RACing” Up the Costs For Providers: How You Can Protect Yourself from RAC Audits and Avoid Large Overpayments” Amanda Waesch, Esquire, Healthcare Attorney, Brennan, Manna & Diamond, LLC
This session is designed to provide a brief overview of the RAC program, as well as an update of the recently amended RAC Statement of Work and Proposed Rule regarding Medicaid RACs. This session will also provide “best practices” to assist providers in mitigating against and handling RAC and payor audits by developing offensive and defensive strategies. Learn about RAC statistics and current activities as well as hear an overview of actual cases and outcomes.
12:30pm – 2:00pm
Buffet Luncheon in the Exhibit Hall Enjoy a delicious buffet luncheon while you visit and learn from our exhibitors.
2:00pm - 3:00pm
CONCURRENT SESSIONS MANAGEMENT /REVENUE CYCLE TRACK
“Getting Collections Right in a Challenging Self-Pay Environment” Brent Grimes, Administrative Director of Patient Account Services, INTEGRIS Health Shawn Yates, Director of Consulting Services for Experian Healthcare
INTEGRIS Health will provide real world examples of challenges it has faced and how utilizing these new collections strategies have helped the healthcare system overcome a challenging healthcare environment resulting in a decrease in bad debt and an increase in cash recoveries. COMPLIANCE TRACK
“A Practical Approach to Identifying HIPAA Breaches” Catherine Colyer, Esquire, Corporate Counsel, Compliance Officer and Privacy Officer, Alliance Collection Agencies, Inc. and Healthcare Business Services, Inc.
This session focuses on how to capture and report information related to a suspected HIPAA violation. Learn about specific tasks for providers regarding training of staff, how to properly document a suspected violation, how to assess whether business partners with whom the provider works are effectively capturing and reporting the necessary information to the provider, and how to design and execute an internal HIPAA breach risk assessment. The session culminates with a practical “to do” list which is relevant to both providers and their business partners.
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Tentative Schedule Continued ACCESS /QUALITY MANAGEMENT TRACK
“Managing Your Front End Process” Chuck Seviour, Vice President, Revenue Cycle, Array Services Group
This session will focus on managing your Front End Process and offers a participative, informative, real-life approach to bringing Point of Service strategies in-line with the current economic and legislative environment. By changing our paradigm about how we think of POS activities, we are able to improve patient satisfaction, begin to change the way patients utilize healthcare services and protect the financial stability of our healthcare organizations. LEADERSHIP /PROFESSIONAL DEVELOPMENT TRACK
“Maximizing Employee Orientation and Training Outcomes” Judy Veazie, CPAM, CCT, Peace Health Corporate System Service Center
This presentation will provide managers with tools to lock in their investment in staff and guarantee their new staff is ready and equipped to perform. It also provides tools to solve the traditional training puzzles and gaps inherent in the training cycle from “new hire” to “ready to go solo.”
agement services, adapted for healthcare transactions, and some are new technology solutions. 3:15pm – 4:15pm
CONCURRENT SESSIONS MANAGEMENT/REVENUE CYCLE TRACK
“Creating a Collaborative Culture: Improving Revenue Cycle Performance Through Accountability” Cynamin Kinard, CPAR, Director, Patient Financial Services, Gwinnett Hospital System Christine Fontaine, CHFP, CPAM, Vice President, Revenue Cycle Solutions, OptumInsight
This case study presentation will show how Gwinnett’s management team used staff engagement, accountability and positive motivation to quickly turn around their revenue cycle operations. Their strategy resulted in rapid, sustainable results while improving employee morale and satisfaction. This session will provide attendees with tools, processes and insight on how to align staff with revenue cycle goals, and have fun in the process!
“Considerations and Strategies for Healthcare Provider Contract Compliance Self-Audits” John B. Garver, III, Esquire, Partner, Robinson, Bradshaw & Hinson, P.A. Jennifer Hutchens, Esquire, Associate, Robinson, Bradshaw & Hinson, P.A.
The creation and faithful use of contract compliance self-audit procedures helps prevent the unwitting creation of liability, which could include exclusion from federal health programs. This session will provide simple and clear guidance to help attendees understand and spot issues. It will explain how to implement a contract self-audit in order to ensure your organization is operating to minimize the risk of surprise in this area. Attendees will learn the pros and cons of a self-disclosure, should the self-audit turn up problems. Gain an understanding of how self-audit and potential disclosure are relevant to organizations, to enable you either to lead or to alert others in order to prevent unanticipated loss due to unintentionally faulty compliance structures.
“How Big is Your Spreadsheet? Automating Data Can Reduce Your Reliance On Manual Processes and Improve Efficiency” Steven Honeywell, MBA, CCAM, CPAM, Senior Director of Professional Fee Billing, University of Pennsylvania Health System Margaret Dowling, Senior Vice President, Pro-duct Management, PNC Healthcare
Even if your patient billing system does not have a fully automated cash reconciliation module, this session will offer information on a number of tools to help begin the process of general ledger automation. Some of these automation solutions are traditional bank cash manSummer 2012
Tentative Schedule Continued ACCESS /QUALITY MANAGEMENT TRACK
“How to Implement an Effective Clinical Denials Strategy”
Rhonda Bankester, RN, CPUR, CMAS, ICQCI, Vice President, Clinical Revenue Cycle Services, Conifer Health Solutions
Ensuring a health system is properly reimbursed for its services is vital for an effective revenue management cycle. This session will provide effective approaches for establishing denial prevention and recovery processes that lead to enhanced profitability and reduction of case management workload and a decrease of insurance denials. Conifer will share their best resources available to support a hospital case management team and how they can impact your bottom-line revenue cycle management efforts. LEADERSHIP /PROFESSIONAL DEVELOPMENT TRACK
“Igniting Story & Building Teams”
Mark Mathia, MBA, CEO, Tiburon Financial, LLC
This session will enable leaders at every level to understand and implement strategies that enhance teamwork and unify vision through the use of story building techniques. Story is one of the best ways to clearly assess weaknesses and rally teammates around a vision worth striving for. SPECIALTY TRACK
“Consumer Driven Healthcare, High Deductible Health Plans History, Present and Future. Impact on Patient Responsibility and Financing” James S. Gandolfo, Vice President Senior Consultant Treasury Consulting Group, PNC J. Kevin McKechnie, Executive Director, American Bankers Insurance Association & Executive Director of ABA’s HAS Council
This session details the evolution of “Consumer Driven Healthcare”, the regulatory and legislative events that created Health Savings accounts in 24
particular. The speakers will clarify the difference between the plans and their financing accounts with respect to their impact on patient responsibility and corresponding financial impact to providers. 6:00pm – 7:00pm
President’s Reception All attendees are invited to join AAHAM President, Christine Stottlemyer, CPAM, for a networking reception before the banquet festivities begin. 7:00 pm – 11:00pm
Annual Awards Banquet Enjoy a delicious dinner; awards presentations and dancing. Friday, October 19, 2012 8:45am – 3:00pm
Registration 9:00am – 10:00am
Continental Breakfast in the Exhibit Hall Start your day off right with delicious pastries and coffee while you visit with our exhibitors. 10:15am – 11:45am
CONCURRENT SESSIONS MANAGEMENT /REVENUE CYCLE TRACK
“What’s Your Magic Number? Solve Your Hospital’s Accounts Receivable Challenges”
Dan Hobbs, CPAM, Senior Consultant, QHR
In this session learn how to improve your revenue cycle process outcomes by improving your process from the start. The patient’s access point is the first chance you have to improve patient satisfaction. The same access point is also your first chance to increase efficiency and reduce errors that affect your revenue cycle outcomes. COMPLIANCE TRACK
“The Tale of 5010 and
The Little Red Hen” Douglas Bilbrey, Executive Vice President, The SSI Group, Inc.
The Little Red Hen is a folk tale that emphasizes the virtues of the work ethic and personal initiative. Prior to 5010 deadlines, SSI used this tale in a cautionary way to encourage providers to take part in the necessary preparation for the 5010 transition and protect their revenue streams. In this session, Mr. Bilbrey will share lessons learned from the 5010 preparation experience and how to apply them towards ICD-10 preparation. He will also discuss the benefits of using a test harness to insulate the productionenvironment from potential interruptions and to analyze the impact of ICD-10 edits on business processes. ACCESS /QUALITY MANAGEMENT TRACK
“Improving POS Collections in Emergency Department: It is possible!” Michelle Moore, CPAT, Registration Supervisor, Emergency Department, Presbyterian Intercommunity Hospital Angelica Del Villar, CPAT, Registration Lead Supervisor, Emergency Department, Presbyterian Intercommunity Hospital
Point of Service Collections is challenging in any area of a hospital; the Emergency Department arguably being the most challenging due to the nature of the care and setting. However, reaching a successful POS process and outcome is possible, even in a fast paced Emergency Room. This session will provide a case study of the Emergency Room Registration Department at Presbyterian Intercommunity Hospital and how they accomplished increasing the POS Collections by more than 55%. Learn the methods you can use that were implemented in the progressive success for the collection process, scripting, best practice steps and expectations, monthly goals and rewards/recognition ideas for staff. LEADERSHIP /PROFESSIONAL DEVELOPMENT TRACK
“Can’t Get There From
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Tentative Schedule Continued Here, Oh Yes We Can!” Nancy Price, CPAM, Director, Patient Financial Services, Bacharach Institute for Rehabilitation
This session will show you step-by-step guidelines for changing processes in the workplace so employees can work smarter not harder. Guidelines will include how to get started, how to get employees on board, what questions to ask, how to make processes more efficient and how to complete the change with a written procedure to transform to a “leaner” way of thinking. SPECIALTY TRACK
“How to Improve Your Physician Documentation Improvement Program with Limited Resources” Linda Fotheringill, Esquire, Principal, Washington & West, LLC
This presentation will provide concepts and tools to assist in effective physician education & compliance to ensure best practice physician documentation. The cost of fighting a denial erodes already slim margins; therefore denial prevention is essential for economic sustainability. The key to denial prevention is Physician compliance and Physician documentation improvement. 12:00pm – 1:30pm
Buffet Luncheon in Exhibit Hall Enjoy a delicious buffet luncheon while you visit and learn from our exhibitors. 1:30pm – 2:30pm
correctly can positively impact a hospitals financial bottom line. Knowing how to structure an integrated, effective process is key to achieving to the best outcomes. ACCESS /QUALITY MANAGEMENT TRACK
“Reengineering Patient Access- A Case Study”
Mark Sammartano, CEO, Blue Marsh Holdings, LLC
The case study session presents the implementation of centralized registration in coordination with implementation of a central scheduling model. The scope of the presentation is based on a scientific approach to resource development and allocation using quantitative measures. LEADERSHIP /PROFESSIONAL
Development Track “Maximizing Enrollment in the Shadow of PPACA” Michael Wilmoth, Esquire, Principal, Chief Development Officer, Advanced Patient Advocacy, LLC
This session will discuss how federal insurance reform is a game changer for provider- based eligibility/enrollment programs. Learn how you can optimize Medicaid cash flow by integrating best practice strategies to ensure a successful transition. SPECIALTY TRACK
“Where Patient Clinical and Financial Experiences Meet: The Hidden Opportunity”
Steve Levin, Chief Executive Officer, Connance, Inc.
MANAGEMENT /REVENUE CYCLE TRACK
This session will discuss how patient loyalty is influenced by how patients are treated during the billing process, post-care and the opportunity it creates. Consumer research shows that patient’s experience with the hospital billing office impacts their clinical and hospital perceptions. There is a major opportunity to improve the total patient experience by improving the billing processes.
“Retrospective Denials Management”
Glen Reiner, RN, Vice President Clinical Operations, Adreima Nicole Guido, Regional Vice President of Sales, Adreima
This session will show how effective denials management is critical to overall revenue cycle management and done Summer 2012
2:45pm – 3:45pm
ICD-10 Panel Discussion Join top experts in the field as they discuss the challenging world of ICD-10 and hear how facilities like yours are preparing for the transition. The panelists represent key individuals from a large health system; medium size hospital, critical access hospital and an insurance company will discuss how they have progressed with the preparations for ICD 10 implementation, the pitfalls and what they have learned along the way. PANELISTS : Susan Gutjhar, BS, RHIT, CCS, CPC, Sparta Community Hospital Lyman G. Sornberger, Executive Director, Revenue Cycle Management, Cleveland Clinic Health Systems Tanja Twist, Director of Patient Financial Services for Methodist Hospital George V. Vancore, IT Systems Integrator Business Architect, Delivery Systems, Florida Blue MODERATOR : James (Jim) Whicker, CPAM, Principal Technology Consultant, Kaiser Permanente 3:45pm – 4:00pm
Refreshment Break and Raffle Drawings 4:00pm – 5:00pm
Closing Keynote Session “Washington Update” Paul Miller, PLC, Miller/Wenhold Capitol Strategies, LLC
Join Paul Miller, AAHAM’s “Man in Washington” for an informative session on the upcoming 2012 elections and a Washington status recap.
Three Steps to Great Answers
By Deborah Walker Certified Career Management Coach Alpha Advantage
ome of the most challenging interview questions are found in behavioral interviews which are designed to test your abilities in three ways: 1. Determine how well you work under pressure 2. Find out how well you work with others 3. Establish whether you can resolve conflicts
Sample Interview Questions To test your stress-coping skills you may get a question like: “Tell me about the most stressful situation you’ve encountered in your current position.” To find out how well you work with others you might be asked: “Tell me about a time when you strongly disagreed with your team?”; “Tell me about a time when you thought your boss was wrong? How did you handle it?” Finally, employers want staff members who can resolve conflicts to gain win-win results for all parties. To discover your conflict-resolution 26
skills you might be asked: “Tell me about a time when you had difficulty resolving a customer conflict?”
There are three steps to preparing for a behavioral interview. 1. Behavioral questions ask you about specific events. Take inventory of the stressful or difficult situations you’ve encountered at work. Think back to times when you didn’t agree with your boss, or when your peers drove you crazy, or when customers made unrealistic demands. 2. If the workplace doesn’t provide much to choose from, expand your thought process to include other circumstances where you work or must cooperate with others, like community activities, neighborhood associations, or church functions. For instance, planning a school fundraiser, participating on a neighborhood committee or participating on a professional association board. Any of these situations are ripe with opportunities for conflict and cooperation, where something must be accomplished for the betterment of the group. 3. Once you’ve thought of several situations, plan how you will present them in a positive light. For situations you didn’t handle well (like
your boss yelled at you and you ran off crying) present them in terms of what you learned, like this: “Yes, I learned an important lesson about following directions and asking questions for clarification when. . . “ For situations that did turn out well, present them based on what was accomplished, like this: “Yes, I had to deal with a really angry customer just last week. But when I calmly asked a few questions I was able to get to the heart of her issue. I was able to fix the problem, and she was happy with us again.” With the right interview preparation, you can turn nightmare behavioral questions into opportunities to sell yourself. You’ll be seen as an employee who is able to stay calm under pressure, work well with others to promote corporate goals, and retain key customers, contributing to revenue growth. In other words, the type of person all employers would want to hire. n Deborah Walker, Certified Career Management Coach Read more career tips and see sample resumes at: www.AlphaAdvantage. com, email: Deb@Alphaadvantage.com, 360-260-4965, Twitter: http://twitter.com/ DebWalkerCCMC The Journal of Healthcare Administrative Management
Changing Attitude Your
by Keeping Your Sense of Humor By Jan McInnis, Comedian Comedy Writer and Professional Speaker
y friend Mary has a great sense of humor. She recently got to ride in an ambulance courtesy of a heart problem, and as she was lying there looking around, she saw the word “GRIP” written on each of the ambulance door handles. Except that on one side the “G” was obscured, so you could only see the last three letters. And as she points out, “RIP is really not what you want to read as you’re headed to the hospital!” Not only is that hilarious, butlet’s face it, wouldn’t most of us be looking around the ambulance for humor. We’d be freaking out and begging them not to put a needle in us, (okay, maybe that’s just me and my needle phobia). She found humor in a nonhumorous situation. This may not have made her heart problem any better, but it may have made the ride a tiny bit better. We are challenged with non-humorous situations daily, even if you don’t think you have a great sense of humor, at least you can try to find the lighter side of things, so you can do as Mary and make the situation a tiny bit better. No one gets mad at you for trying to joke around (unless you are a comedian in a comedy club and people paid money to laugh, then they get upset if you’re not funny. But usually, people appreciate that you’re trying to liven things up. A lot of things have potential for being funny, if you just pay attention. I stopped by the store to pick up a few things I need28
ed to do my laundry, and I asked the clerk where the bleach was. She sent me down the cosmetics aisle! It took me a minute before I realized, hey lady; it’s for my whites, not my mustache! I guess I could have been insulted (I don’t have a mustache), but I chose to laugh it off. I think the mustache is her issue, not mine. I don’t think we use humor enough in our communications. I looked up the word communications in Wikipedia, the online encyclopedia, and it says that all organisms communicate. Even fungus communicates. I’m thinking, what does fungus say, Jan just cleaned her bathroom, let’s multiply? But as humans, I think we’re the only organism that can put humor into our communications on purpose, and we don’t do it enough. It’s nice to see some companies are encouraging humor in the workplace. I read an article in Southwest Airlines magazine that they ask candidates during the job interview to tell a joke. That may be a little extreme, but wouldn’t it be better to teach your employees to goof around and even let them know as early as the job interview that it is okay to have fun with people? People who use humor are the ones we remember. Last Halloween, when I arrived at the car rental counter at the airport, I saw that the agent was dressed up as the devil, complete with horns, a pitchfork and tail. When she handed me the paperwork, I stated loudly, but I can’t sign a contract with the devil! She was great and immediately played along. We both cracked up and had a “no I can’t, yes you can” banter for a few min-
utes, which entertained everyone in line and made the rental process much better. Humor also livens up the boring things in life. I once sat through a hospital awards ceremony in which they gave out 292 service awards. That’s two hundred and ninety-two service awards! By the time I got onstage, I said, “you know, I earned my five year pin just sitting here through this ceremony!” You can also get people’s attention, in a good way, with humor. If you want people to show up at a meeting, you could demand they attend the sexual harassment training seminar. People would go, but they might not be happy about it. Or you could have some fun with it; “come to the sexual harassment training seminar. We’ll show you why a pat on the back is cheap, and a pat anywhere else costs millions!” Okay, that might get you in a little bit of trouble, but you get my point. You can also make things more interesting with humor; things such as your introduction. How many times do we introduce ourselves with the same old boring information about our name, our job, and our companies? I challenge you at the conference this year to ask funnier questions when you meet people so that you learn something different that’s also memorable. I love the show on Animal Planet, Fatal Attraction, in which people have exotic pets like alligators and lions. Wouldn’t it be cool to find out that your new friend Bob is living with a real cougar? You would actually remember him the next time you ran into him! At my program last week, we found out the godThe Journal of Healthcare Administrative Management
mother of one of the attendees is Madonna’s mother! You’d never find that out if you didn’t ask a funnier question. If we’ve learned anything from social networks like Facebook, LinkedIn, Twitter, and LinkedFace (okay, I made that last one up), it’s that what people really want is a sense of community, and one of the best ways to create that sense of community is to use humor. In keeping with your conferSummer 2012
ence theme on change, I’ll be talking about ways to use humor when you’re dealing with change, but I challenge you to start looking for the humor now so that you can begin reaping the benefits immediately. And the next time you’re faced with a big challenge down the road, you’ll be able to find something funny about it, and that will make the situation a tiny bit better. n
Jan McInnis will be sharing her keynote “Finding the Funny in Change” at the AAHAM ANI. She is the author of “Finding the Funny FAST; How to Create Quick Humor to Connect with Clients, Coworkers. Ms. McInnis can be reached at 800.492.9394 and Jan@TheWorkLady.com
External Call Centers
Benefit Hospitals’ Access Departments? By Steve Chrapla, CHFP Director Third Party Solutions, Avadyne Health Member of the Texas Bluebonnet chapter
ealthcare reform places additional challenges to providers. The Patient Protection and Affordable Care Act, as it is currently written, establishes compliance requirements related to financial screening impacting patient billing and potential financial assistance. Experts have stated that such screenings, to meet these requirements, need to be done on the front end of the revenue cycle. This will place additional responsibilities and challenges on hospital’s Access areas. Providers will need to find ways to be more efficient and provide quality service for less cost. In addition there is, for lack of a better phrase, the “consumerism impact” on healthcare delivery that is requiring providers to take a more patient centric approach. This means enhancing the patient’s overall experience and increasing the level of satisfaction the patient has with their healthcare provider. These tasks will require the complete involvement and cooperation of all clinical and administrative departments within a healthcare organization. For Patient Access Departments, their primary objectives will need to include; • A more patient centric approach to all interactions • Increased patient’s satisfaction with the provider • Reduction of net operating expenses 30
• Increased level of financial and clinical screening • Established clear financial and clinical expectations for the patients • Reduced level of re-work in post-treatment revenue cycle functions • Reduced payer denials • Increased cash collections Is it time we re-think how Access departments have approached work flow and process? Revenue Cycle executives have long discovered the benefits of critical outsourced functions used in the back end of the Revenue Cycle. Can some of these resources serve the Access areas? Consider external call center operations a resource in achieving the objectives facing the Access Departments. Current pre-access processes require extensive telephone interactions that, while are often redundant, require staff with specific communication skills with expertise in discussing financial responsibilities. The process requires accessibility for patients that volumes often create cost efficiency challenges. Staff interpersonal skills are essential to successful patient interactions but often not available or developed with access department personnel. The latest technologies are often cost prohibitive or even beyond the resource capabilities usually found in Access Departments. Some of the functions within Patient Access that would benefit from a call center operation would include; • Patient scheduling • Medical necessity screening • Pre-registration • Pre-certification of services
• Eligibility and benefits verification • Financial screening and counseling • Pre-service collections These pre-access functions can have a significant financial impact on a facility. Controlling denied claims alone can increase net revenues by over 2%. The reduction in re-work within the business office can also be impacted by over 60%. A properly structured call center operation can provide the following benefits; • Increased patient and physician satisfaction • Standardized processes for all service areas and locations • Timely efficient scheduling • Expedited registration • Improved financial metrics/lower costs and increased reimbursements • Reduction in payer denials • Expanded hours of operations • Skilled staff specialized in patient communications • Financial counseling specialists • Staffing complement with cross training to meet variable volume demands • Technology including Interactive Voice Response (IVRs), call recording and predictive dialing • Presumptive charity screening technology with hospital specific criteria • Management knowledgeable in high-volume call operations Gap Analysis: Definition of ‘Gap Analysis’ 1) The process through which a company compares
Continued on page 31
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its actual performance to its expected performance to determine whether it is meeting expectations and using its resources effectively. Gap analysis seeks to answer the questions “where are we?” (current state) and “where do we want to be?” (target state).
As with the development of any operational process the identification and monitoring of key metrics is critical. Here are some best practices and metrics an effective pre-access call center would achieve.
Scheduling • 100% of non-emergent patients are scheduled • All cases are scheduled at a minimum of twelve hours in advance of service • All surgeries are verified against inpatient only list • Collection of all information prior to surgery in accordance with clinical criteria • Medical necessity is validated to prevent Advanced Beneficiary Notification (ABNs) • “OK to delay” criteria is established with physicians
Re-Registration • 95% of all scheduled patients are pre-registered • 100% of all pre-registered patients have insurance eligibility and benefits verified • Identify specific service lines requiring verbal verification beyond electronic veriSummer 2012
fication and obtain 100% • 100% pre-certification on all required patients • 98% Patient demographic data quality
Patient/Guarantor Communications • All non-covered services are explained to every patient impacted • 95% of all out of pocket costs are requested from patient/or as guided by patients prior payment history • 80% of POS collection potential achieved • 100% of patients with outstanding AR will be counseled • Charity care guidelines explained to 100% of applicable patients
Call Center Operations • 80% of calls answered within twenty seconds • 50 second average call hold time • <5% abandoned call rate • 98% complete resolution in one call While the benefits may be overwhelming, the success of moving to an external call center model have many factors to consider, as well as understanding important stake holders. It is critical you understand the barriers to success. The physicians may feel they are less involved over their patient’s treatment or will be left out of critical communications with their patients. Management may feel a loss of control or that an outsourced service may have an adverse
public relations impact. Hospital clinical departments may feel they are losing control and will be negatively impacted. Most importantly will the marketplace or patients view this negatively and that they are dealing with individuals that are not interested in them. As you develop the project plan for such a venture it is important to keep these points in mind. Begin with by performing an analysis of your current operations and determine the current and future financial impact you are experiencing. A GAP analysis (comparing actual performance to expected performance) will allow you to identify the potential of your Access Departments as well as impact of future revenues as the result of enhanced patient experiences. Process design with key stakeholders will be important to achieve buy-in and ensure the most appropriate processes are being developed. Develop implementation plans and always over communicate to minimize misinformation. It is also important to indentify your external partner and bring them into the planning process as early as possible. This ensures a high commitment level and the development of a true partnership environment. Access Departments like all operational areas within hospitals will need to consider solutions to challenges that may differ from approaches in the past. n Mr. Chrapla can be reached at 847.395.7655 and email@example.com 31
meet a committee chair
Michael (Mike) Dobbs, CPAM Chapter Development Chair
Q. Where do you work and what do you do? A. I am the Director of Business Services at Marshalltown Medical & Surgical Center in Marshalltown, Iowa Q. How many years have you been a National Member? A. 25 years Q. How did you get where you are today professionally? A. I graduated from college with a degree in Psychology and took a job with the State of Iowa in the Child Support Recovery Unit. Experiences from that job helped me land a credit manager position at an Iowa hospital. Q. What made you decide to become certified? A. I remember thinking that trying to gain certification would look good in the eyes of my supervisor. Also, I knew it would be great way to learn some key principals that I would use in patient accounting. Q. What advice do you have for members that want to move up in their current healthcare careers? 32
A. Get certified! Also, don’t get caught taking a narrow approach to everyday issues. Ask questions and really try and learn a process from beginning to end.
A. I would have to say now it is my iPad Q. Celebrity crush? A. Michelle Monaghan
Q. What are your children(s) names, ages and occupations (if applicable)? A. My daughter, Megan is 25, and works for Principal Financial Group in Des Moines. My son Ben is 23 and works for JB Hunt. He and his wife Mallory live in Chicago.
Q. I still can’t quite get the hang of.... A. Playing video games competitively with my son.....It’s very frustrating!
Q. What was the last book you read? A. “To Heaven and Back” Q. What is your favorite movie? A. Serenity Q. What is your indulgence? A. M&Ms Q. What was your first job? A. Cheesemaker Q. Where did you spend your last vacation? A. Padre Island area in Southern Texas Q. What do you never leave home without when you travel?
Q. What is your favorite way to celebrate after you’ve completed a demanding project? A. Hang out on my deck with friends Q. Name something about you that most people don’t know. A. I once trained shot put with a Olympic medalist and former world record holder, Al Feuerbach. Q. What do you know now that you wish you’d known when you were younger? A. Not to worry about things you can’t control Q. The world would be a better place if only… A. I could take my dog to work with me every day! n
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professional certification corner
Elizabeth Baptist, CPAM Professional Certification Chair
Certification Essay Questions
n AAHAM’s Professional Certification exams, you will find plenty of examples of what most people call “essay questions.” We are occasionally asked why we have these types of questions on our exams. There are several reasons. First, an essay is a good way to assess communication skills and writing ability. Both of these are important for someone who holds a management position. Second, an essay displays the depth of knowledge of the subject material, or lack of it. Again, this is important for someone in a leadership role. And finally, an essay can demonstrate critical thinking skills, also important for leaders. I often tell people to think of it this way- Suppose your boss emailed you to ask what it means to outsource first party collections and what you think about it. How would you answer them? You would want your email reply to demonstrate your knowledge of the topic, and show thoughtful reasons for your opinion. You can’t do either of those things if you can’t write a good answer to an essay question. So what makes a good answer to an essay question? Before you can even begin to write an answer, you must do a few things first. You need to read the question carefully, to make sure you understand what is being asked. You may need to supply a list; you Summer 2012
may need to write a paragraph; you may need to compare and contrast two alternatives. If you don’t understand the question, you will be unable to write a correct answer. Next, you begin to think about the structure of your answer. If a question asks you to list three advantages of outsourcing your first party collections, you can probably use bullet points. However, it is important to have an introduction and conclusion as well. Here is an example of how to answer the above question: Outsourcing first party collection, or early out, has numerous advantages: 1. Collection agencies have specialized staff 2. Collection agencies have technology specifically designed for collecting money 3. Outsourcing typically increases the percentage of cash collected, even after their fees are taken into account The advantages of outsourcing should be carefully compared to any disadvantages when evaluating whether or not to do so. For some questions you will need to write a longer paragraph or two. Here is an example of how to answer a question asking you to explain the Family Medical Leave Act (FMLA): The FMLA, or the Family Medical Leave Act, is a Federal law meant to protect the jobs
of people who need extended time off for a specified condition of themselves or a family member. A condition can include childbirth or the adoption of a child, personal illness or that of a family member, or certain situation arising due to active military duty. To be eligible for FMLA, a person must have been employed for at least twelve months and worked 1250 hours or more in the last year. FMLA can extend twelve weeks for medical conditions and twentysix weeks to care for a service member. The twelve weeks need not be taken consecutively. When a person returns from FMLA, he or she must be given the same job or one similar in duties, benefits and wages. A few other important and useful things to remember when answering an essay question, do not just restate the same points to hide the fact you do not have other points to write about. Make sure to proofread your answer, because even though spelling and grammar are not scored, you may have written something that might not really make sense. And finally, do not obsess over your answer. Imagine yourself just jotting off a little bit longer than usual email to your boss. Remember, I am more than happy to help you with certification questions. Contact me at firstname.lastname@example.org. n 33
from the desk of the certification director Professional Certification Exams are coming up…. Maria LeDoux, CAE
he dates for the fall professional exams are approaching fast; the week of October 22-27, 2012, is right around the corner and will be here in no time! AAHAM has made substantial investments over the past few years in improving the materials available to assist you in preparing for all of our exams. The CPAM/ CCAM Exam Study Manual is the only study manual written by AAHAM for AAHAM’s Professional Exams, it was designed specifically to assist you in studying for AAHAM’s certification programs. The manual
has a wealth of helpful information for those studying for the CPAM and CCAM exams and for those who do coaching; it is also a great reference and training book for facilities. The manual chapters match each section of the exams; Patient Access, Billing, Credit & Collections and Revenue Cycle Management. The material is targeted and geared toward exam questions and features knowledge checks along the way to help you gauge your progress. AAHAM is conducting the popular four part Professional Exam Training We-
Join AAHAM For Valuable Educational and Career Support. Increase your professionalism, improve your skills and enhance your knowledge What are the Benefits AAHAM Membership? • Eligibility for Certification Designations • Exclusive invitation and pricing to the AAHAM’s Annual National Institute (ANI) • Invitation to an active scholarship and awards program
Enhance Your Career - network with your peers via the: • Join your local AAHAM Chapter, there are 35 local AAHAM chapters across the nation to choose from • Membership Directory, available on-line at www.aaham.org helps you keep in touch with other members and vendors both locally and nationwide • Job Bank to assist you in searching and posting that special job • Unlimited networking and information exchange through our web site and chapter interaction • Web site access to state and metro area hospital associations nationwide • AAHAM Member List Serve • Social Media Groups
Stay Informed - keep on top of the latest regulations and guidelines affecting patient accounting matters through AAHAM’s publications: • • • •
Legislative Currents The Journal of Healthcare Administrative Management National News eNews watch
Discounts on Products and Services • Seminar, meeting, and product discounts offered by the chapters and the National organization • Affinity discounts on credit cards, hotels, moving services and rental cars • And so much more!
For more information visit: www.aaham.org 34
binars again this summer. Those who take this intensive study series have been shown to have a higher pass rate than those who do not. The webinars cover the four parts of the exam - Patient Access, Billing, Credit & Collections and Revenue Cycle Management. If you are unable to attend the live sessions or missed one along the way, CDROMs of the entire series are also available. Another helpful preparation tool is the online CPAM practice exam, available for purchase on the AAHAM website. You can use this to help you identify the sections you are strong and/or weak in and to help you target your studying. There are twenty questions covering each of the four exam sections for a total of eighty questions. Local Chapters are a great resource and many offer training opportunities. AAHAM has published a coaching kit to accompany the study manual; your chapter’s trainers will be able to use this to assist in help with chapter training sessions. Be sure to contact your local chapter to find out what options they have available to help you prepare for your exam. Finally, you can attend the coaching session offered at this year’s ANI, being held October 17-19, 2012, at The Hyatt Regency, Coconut Point in sunny Bonita Springs, Florida. The coaching session is a great professional exam preparation tool and a great way to refresh and refocus your studies just a week before the exams are scheduled. Be sure to take advantage of this opportunity as well. Keep in mind the time and effort involved with preparing for your certification exams can be seem intimidating, but if the exams were not demanding, they would have no value. After all, if it were easy, everyone would be doing it! Good luck and happy studying! n The Journal of Healthcare Administrative Management
technical certification corner Continual Improvements in Technical Certification
ummer is here and the 100+ degree weather in most areas is proof of that. It makes for lazy and hot summer days. Speaking of hot, the certification committee has been hot on making changes to improve the certification process. We are excited about the ideas and work being done, and I am happy to share those with you. During this past quarter, the Technical Certification committee has been busy updating and revising. We have revised and added new material to the CCT manual and exam. The update of the manual is scheduled right after the August CCT exams. We will then be adding new exam questions to reflect the changes and new material the manual now covers. In October, the committee will begin our annual review and update of the CPAT/CCAT manual and exams. The manual will be updated in time for you to study for the February 2013 exams. The committee is very interested in receiving feedback if examinees have used study sessions, used the coaching kit, study
manual or whether assistance was provided in taking the exam. This will be a great help to us to see if chapters and/or facilities are providing training and assistance to help study and pass the exams. This feedback also helps us to determine the usefulness and popularity of our study tools. Therefore, the committee will be asking three yes or no questions during the sign in phase of the upcoming certification exams. They will be: 1. If your chapter held certification study sessions, did you attend? 2. Did your employer offer any certification study sessions to help you prepare for the exam? 3. Did you use the AAHAM CPAT/CCAT Exam Study Manual? In other news, I am an official blogger now. Yep, that’s right! I have never blogged before but thanks to the National AAHAM office, I have been brought into the current century. I update the blog every few weeks, so if you get an opportunity, go to the AAHAM website and click on the technical
Brenda Chambers, CPAM Technical Certification Chair certification blog link. For those of you on Facebook or LinkedIn, the blog should automatically be posted there too. Starting with this issue, be sure to read the new article series in the Journal on the importance of certification and why you and your colleagues should be encouraged to take the exams . During the month of September, the committee will be presenting a webinar on federal rules and regulations. Whether you are studying for the CCT exam or for the CPAT/CCAT exam, the material covered will assist you with those items covered in the exam. Don’t forget to look at the AAHAM website frequently for continuous updates on webinars, blogs and certification. The Technical Certification committee continues to strive to bring you the best in education and certification. Please continue to share your thoughts, ideas and suggestions on how we can better meet your certification needs. I can be reached at brenda. email@example.com. n
CPAM Certified Patient Account Manager CCAM Certified Clinic Account Manager Certificaiton opens the door to the possibility of career advancement. Earning an AAHAM certification demonstrates that you have mastered the common body of knowledge for your profession. Sitting for these exams requires commitment and dedication. The CPAM/CCAM Exam Study Manual will help assist you in preparing for the CPAM/CCAM Exams. Written by AAHAM, for AAHAM’s own certification programs ensures that this manual is the gateway to studying for and passing these professional exams. Included in the manual are chapter review questions and study tips. Log on to www.aaham.org for more information and to order your Exam Study Manual today!
from the desk of the membership director
Moayad Zahralddin AAHAM Membership Director
on’t forget! This year Patient Account Management Week (PAM Week) will be held October 15-20. This year’s theme is “Feel The Strength” which recognizes the exemplary work performed by healthcare administrative management teams in hospitals, physician practices and healthcare related industries. PAM Week is your opportunity to promote your field through your hospitals and offices to honor your colleagues and bring awareness to the profession. Products to promote and support PAM Day are available in our online store. Be sure to check the AAHAM website for more information. It’s never too early to start recognizing your patient account management staff! Networking with your peers and colleagues is one of the biggest benefits AAHAM membership offers you. This active and involved network of other professionals offers you a resource you can’t find any where else. AAHAM is the only national organization dedicated to the revenue cycle, both management and the front line staff. If you are looking for an edge in your career path, either in a job search or moving up the ladder in your current position, certification is the way to go. We offer two levels of certification; professional and technical, visit our website to learn more. Thank you for letting me serve all of you, and I hope to see you all in Bonita Springs for the ANI!
Welcome New Members Aksarben Chapter Velda Walker Greater Florida Buccaneer Chapter Cassandra Acoff Jill Ash Vincent Giusto Barbara Gleeson Linda Gusa,CPAT Sonda Hilgeman H. Wayne Isenhour Kelly Isidore Marianna Kaminski,CPAT Mark Kostreba Dolores O’Brien-Stanislaski,CPAT Mishell Penney Luisa Perez,CPAT David Rathel Michael Rogers Amy Schutte 36
Tammy Scott Kelly Tighe,CPAT W. Mikki Weston Denise Willner,CPAT Carolina Chapter Jumelle Brooks Michael Grover II Tracey Harmon,CPAT Joy Hong,CPAT Mark Kostreba Jimmy Tan,CPAT Benita Thompson,CPAT Evergreen Chapter Kelly Bruette Gopher Chapter Jennifer Farasyn Paul Martinson
Kristina Mulder Kimberly Wood Nancy Wrazidlo Hawkeye Chapter Liz Baker Jessica Campbell Mary Cowan,CPAT Wendy Edwards,CPAT Heather Ernst Joyce Schumacher Illinois Chapter Nicholas Barthel Benjamin Capp Coleen Cummings Ryan Duffy Jodi Glenn Greg Hannell
Continued on page 37
The Journal of Healthcare Administrative Management
from the desk of the membership director continued from page 36
Jessica Olson Jeff Porter Sidney Priebe Dorothy Richardson Dorothea White Michelle Whittaker-McCracken Inland Empire Chapter Victoria Antonucci Lee Ayers Lisa Higbee Corey Hoehne Anthony Nelson Denise Raymond Keystone Chapter Christine Nguyen-Le,CPAT Alisha Rohrer,CPAT Kimberly White Maryland Chapter Ilana Bar-Levav Deborah Bigsby,CPAT Jennifer Doherty Elaine Edwards Susan Hunter Devonn Litz Lisa Oliver,CPAT Tom Rawlings Danielle Reese Shahada Riley Jamie Roberts Alexis Skinner Mountain West Chapter Joshua Linegarger New Jersey Chapter Samuel Donio Jeanne Haas Cheryl Hayne Kelly Ann Hughes-Cascio Sara Polak Chris Scharle Western Reserve Chapter Mary Britton,CPAT Arley Cope Brenda Hubert Dorothea White Summer 2012
Northeast Pennsylvania Chapter Michelle Whittaker-McCracken Rocky Mountain Chapter Lee Ann Canterbury,CPAT Sharon Smith Phil Whartan Gretchen Wilson Pinetree Chapter Vincent DiPierro Deborah Dusablon Janet Hodgdon Barbie Mazurek Maria Peatfield South Florida Chapter Kim de la Garza Western Region Chapter Arley Cope John Feldman Jr. Nancy Hughes Michael Kennedy Michelle Moore Chris Oâ€™Dell T. Denise Ransdell Roni Teson Teresa Torkelson Ronald Walker Michelle Whittaker-McCracken Lisa Wong Virgina Chapter Jay Andrews Stacy Brooks,CPAT Pamela Cornell Donna Coughlin,CPAT V. Alice Fowler,CPAT Portia Jones,CPAT Nezenine Munoz Tammy Spring,CPAT Philadephia Chapter Mary DeSantis Marina Grace Roslyn Johnson Kathleen Knox,CPAT Kristina Reifsnyder Chris Scharle
Mid York Chapter Christina Borchert Christopher Cordero Catherine Dec Anna Forte-Cardinuto Vikki Smith Patricia Barcomb Georgia Chapter Elizabeth Janowiak Connecticut Chapter Angela Coppola,CPAT Ana Lima,CPAT Letizia Posta,CPAT Mark Rodrigues,CPAT Tara Sanford Kevin Wert Three Rivers Chapter Nadine Brletic Amanda Krezan Texas Bluebonnet Chapter L. Daniells Lois Karen Mitchell Mark Sena Terrence Simonds Elaine Stephenson Kayla White Indiana Chapter Victoria Hebert Michelle Whittaker-McCracken Wisconsin Chapter Amber Whitley Michelle Whittaker-McCracken Chennai Chapter Balakrushna Dash Music City Chapter Dianna Anders,BA States Without a Chapter Donald Borchert Patti Burchett Kimberly Lake Cheryl Marable
___________APPLICATION FOR NATIONAL MEMBERSHIP___________ NAME: ___________________________________ TITLE: ___________________________________ EMPLOYER/ORGANIZATION NAME: ___________________________________________________________________ PRIMARY ADDRESS: _________________________________________________________________________________ CITY: _________________________________________________ STATE: _________________ ZIP: _________________ PHONE: __________________________ FAX: __________________________ LOCAL CHAPTER: __________________ E-MAIL ADDRESS: _____________________________________ WEBSITE: ____________________________________ HOME ADDRESS: ____________________________________________________________________________________ CITY: ______________________________ STATE: ____________ ZIP: ____________ HOME PHONE: ______________
How did you hear about AAHAM?
If referred by AAHAM member, please give name: _________________________________________ _ Membership Type:
NATIONAL MEMBERSHIP - The fee to become a National member is $175. If you join anytime between July 1st and August 31st, the dues are $140 for the rest of the current year. If you join between September 1st and December 31st, the fee is $210 for the rest of the current year and all of the following year. STUDENT MEMBERSHIP - The student membership fee is $50. If you join between July 1st and August 31st, the pro-rated dues are $35, and if you join between September 1st and December 31st, dues are $65 (for 15 months of membership). To qualify for student membership you must currently be taking 6 credit hours per semester. Student members receive all the benefits of membership with the exception of voting, eligibility for professional certification, and cannot be a proxy for a chapter president at any national board meetings.
PAYMENT OPTIONS For Credit Card Payment:
Card Number: ________________________________ Exp: ____________ Name as it appears on card: ______________________________________ Signature: _____________________________________________________ Billing Address, if different from above: ____________________________ _____________________________________________________________ Please allow two weeks for processing after your application is received at the national office. Dues are not tax deductible as a charitable contribution, but may be as a business expense. Please note: Membership is on an individual, not institutional, basis and is non-transferable.
For Check Payment: Please make checks payable to AAHAM and send application with your payment to:
AAHAM Membership 11240 Waples Mill Road, #200 Fairfax, VA 22030 AAHAM Tax ID: 23-1899873 __YOUR PAYMENT TOTAL:__ NATIONAL DUES: ___________________ LOCAL DUES: _______________________ TOTAL ENCLOSED:
AAHAM Providing Excellence in the Business of Healthcare Certification, Compliance, Leadership Development, Networking, Advocacy
Local Chapters: AAHAM has 32 chapters throughout the US and India. Local chapters offer you more opportunities for education and networking. Please see the listing of local chapters below to help you decide which chapter you should belong to along with your National membership Name of Chapter
Please Check the Appropriate Codes in Each Category Below
Aksarben #01 Greater Florida Buccaneer #03 Carolina #04 Evergreen #05 Gopher #06 Hawkeye #07 Hawthorn #08 Illinois #09 Inland Empire #10 Keystone #11 Maryland #13 Mountain West #14 New Jersey #16 Western Reserve #18 Northeast PA #19 Rocky Mountain #21 Pine Tree #22 Rushmore #23 South Florida #25 Western Region #26 Virginia #27 Philadelphia #29 Mid-York #31 Tennessee #32 Georgia #33 Connecticut #34 Three Rivers #37 Texas Bluebonnet #40 Indiana #42 Wisconsin #44 Chennai #49 Music City #53
Nebraska Tampa/Orlando, Florida area North & South Carolina Washington State, West of the Mountains Minnesota Iowa Missouri Illinois Washington State, East of the Mountains Central Pennsylvania Maryland Utah New Jersey Ohio North East Pennsylvania Colorado Maine North & South Dakota Southern Florida California, Arizona, Nevada Virginia Philadelphia, Pennsylvania New York Tennessee Georgia Connecticut Pittsburgh, Pennsylvania Texas Indiana Wisconsin Chennai, India Tennessee
$0.00 $40.00 $30.00 $30.00 $40.00 $0.00 $35.00 $25.00 $25.00 $25.00 $20.00 $25.00 $35.00 $0.00 $30.00 $40.00 $25.00 $0.00 $20.00 $0.00 $25.00 $35.00 $40.00 $30.00 $30.00 $35.00 $30.00 $50.00 $25.00 $25.00 $0.00 $25.00
Years in Healthcare: ❏ 0-5 ❏ 6-10 ❏ 11-20 ❏ 21-25+ Certification: ❏ CHAM (NAHAM) ❏ CHFP (HFMA) ❏ FHFMA (HFMA) ❏ CHCS (ACA) ❏ Other (please list) Employer Type: ❏ Vendor/Corporate Partner ❏ Billing ❏ Collection Agency ❏ Consulting ❏ Outsourcing ❏ Software/IT ❏ Provider ❏ Law Firm ❏ Other (please list) Position: ❏ President, Administrator, Executive ❏ Director, CEO ❏ Partner, Principal, Owner ❏ CFO/Controller, COO, CIO ❏ Vice President ❏ Assistant VP/Assistant Administrator ❏ Director, Manager, Supervisor ❏ Technician ❏ Clinical ❏ Academic ❏ Other (please list) Responsibility: ❏ Accounting ❏ Administration/Operations ❏ Admitting/Access ❏ Audit ❏ Benefits ❏ Budget ❏ Compliance ❏ Business Development, Sales, Marketing ❏ Information Services/Technology ❏ Managed Care ❏ Medical Records ❏ Medicare/Medicaid ❏ PFS, Patient Billing & Collections ❏ Reimbursement ❏ Third Party Administration ❏ Other (please list)
AAHAM Providing Excellence in the Business of Healthcare Certification, Compliance, Leadership Development, Networking, Advocacy
national calendar October 17-19, 2012 ANI, Hyatt Regency Coconut Point, Bonita Springs, Florida
October 16-18, 2013 2013 ANI, Sheraton New Orleans New Orleans, Louisiana
October 15-17, 2014 2014 ANI, Manchester Grand Hyatt San Diego, California
the JHAM network Movers & Shakers
Don’t forget to give us your information for the Movers & Shakers section of The Journal. This section includes job announcements (changes or promotions), birth and death announcements, and wedding announcements. Send your “news” to Sharon Galler at Sharon@aaham.org
Please send us notices of your upcoming events/meetings, chapter news and photos. We would be happy to post them for you!
All address changes can be made via fax or mail to the National Office or you can update your information yourself on-line at www.aaham.org.
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did you know? By Moayad Zahralddin
September 13... Fortune Cookie Day
September 2012… Hispanic Heritage Month, International Square Dancing Month, National Blueberry Popsicle Month, National Courtesy Month, Chicken Month, Baby Safety Month, Little League Month, Self Improvement Month 2 ..........National Beheading Day 5 ..........Labor Day, Be Late for Something Day 6 ..........Fight Procrastination Day, Read a Book Day 7 ..........Grandparent’s Day 8 ..........International Literacy Day 9 ..........Teddy Bear Day 10 ........Swap Ideas Day 13 ........Fortune Cookie Day, National Peanut Day, Positive Thinking Day 14 ........National Pet Memorial Day -second Sunday in September 16 ........Mayflower Day, National Play Doh Day, Working Parents Day 18 ........National Cheeseburger Day 19 ........International Talk Like A Pirate Day 20 ........Oktoberfest begins 21 ........International Peace Day, Miniature Golf Day, National Women’s Friendship Day 22 ........Business Women’s Day, Elephant Appreciation Day 23 ........Dog in Politics Day 28 ........Ask a Stupid Question Day, National Good Neighbor Day
October... National pizza month
October 2012… Adopt a Shelter Dog Month. Breast Cancer Awareness Month, Domestic Violence Awareness Month, National Diabetes Month, National Pizza Month, National Vegetarian Month, Sarcastic Month; Weekly Celebrations… Oct 1-7 Customer Service Week, Oct 8-14 Fire Prevention Week 1 ..........World Vegetarian Day 5 ..........Do Something Nice Day, Oktoberfest in Germany ends, World Teacher’s Day 6 ..........Mad Hatter Day, Physician Assistant Day 7 ..........World Smile Day 8 ..........American Touch Tag Day 11 ........It’s My Party Day 13 ........Columbus Day 14 ........Be Bald and Free Day, National Dessert Day 16 ........Bosses Day 17 ........Wear Something Gaudy Day 19 ........Evaluate Your Life Day 21 ........Babbling Day 23 ........National Mole Day 25 ........Make a Difference Day 26 .......Mother-In-Law Day 30 ........Mischief Night 31 ........Halloween, Increase Your Psychic Powers Day
November 1... Book Lovers Day
November 2012… Child Safety Protection Month, National Adoption Awareness Month, National Epilepsy Month, Native American Heritage Month, Peanut Butter Lovers Month, Real Jewelry Month, National Sleep Comfort Month 1 ..........Book Lovers Day 2 ..........Look for Circles Day, Deviled Egg Day 3 ..........Housewife’s Day, Sandwich Day 6 ..........Marooned without a Compass Day 8 ..........Cook Something Bold Day, Dunce Day 11 ........Veteran’s Day 13 ........Sadie Hawkins Day, World Kindness Day 14 ........Operating Room Nurse Day 15 ........Clean Your Refrigerator Day, America Recycles Day 16 ........Have a Party With Your Bear Day 17 ........World Peace Day 20 ........Absurdity Day, Universal Children’s Day 22 ........National Adoption Day 26 ........Shopping Reminder Day 29 ........Square Dance Day 30 ........Stay At Home Because You Are Well Day
The Journal of Healthcare Administrative Management
Coaching Kits With the new AAHAM Coaching Kits, you are equipped to conduct interactive, thorough, and effective sessions to prepare participants for their CPAM/CCAM or CPAT/CCAT exam. Each kit, packaged in a convenient binder, includes: • Detailed preparation instructions, including a materials checklist • Overview of the adult learning principles built into the kit • Scheduling suggestions so you can customize your timetable • Tips and suggestions for facilitating each portion of the coaching session • CD with slides to guide participants through the session • Materials and instructions for activities including laminated cards for learning games, quizzes, a cross-word puzzle, and more • Participant guide originals, so you can make copies and include as many exam-takers as you would like • Extensive glossary of terms included in the exams Each coach will need one copy of the CPAM/CCAM or CPAT/ CCAM Exam Study Manual (sold separately); coaching session participants will not need a copy of the Exam Study Manual.
Log on to www.aaham.org for more information and to order your Exam Study Manual today!
S IN LA TI
E TAKING YOUR REVENUE CYCL
TO NEW ALTITUDES