It's 11:00 AM - Do You Know How Many Agency Staff Are In Your Facility

The

Georgia Scroll

Volume 34 - Number 1 Winter 2001

2000

Rural Hospital of the Year

This Issue …

· Dixie Institute

· Trends in Hospital Accounts Receivable

· HIPAA on the Job

PRESIDENT'S MESSAGE

Halfway Through and Looking Good

Well, it’s Friday, December 15th and I am writing my third presidential message. Before I get too far into the message, even though you will not read this article until January, I would like to wish everyone a Merry Christmas and a Happy New Year.

Our next Institute meeting in Atlanta will be my last meeting as President and at the Spring Institute president-elect Eddie Phillips will be the new President. That is unless we have to recount the votes due to hanging or pregnant Chad's. I feel pretty sure that Eddie will be Georgia HFMA's new President since this is not the Florida Chapter. (Ha, Ha)

I can't begin to tell you how much Georgia HFMA has meant to me over the past years. I’ve had a lot of fun with the members and take pride in our accomplishments for the last six months. We are definitely meeting our goals as a chapter and I hope that the chapter is meeting your educational needs. Always remember that you can call or e-mail me with any concerns.

When I began the year as President, I took my position a little too seriously and tried to make sure all the I's were dotted and all the T's were crossed. As I arrived at the Savannah Institute meeting, I decided it was time for me to enjoy the year and not take the position so seriously.

Sometimes as a chapter leader you can get caught up with wanting to win all the awards, meet all the goals, and make sure all business concerns are met. I know in January and February I will be pushing people to meet the Chapter goals. At the same time, President-Elect Eddie Phillips will be trying to prepare for the next year and setting new goals. I do remember and I hope all future leaders remember that this chapter is for you. We need your help to ensure your networking and educational needs are in focus.

Healthcare continues to be a tough industry to make a living. The Balanced Budget Act and managed care contracts continue to reduce reimbursement. We struggle with cost containment due to the high rate of technology change and the labor shortage in our industry. We have also just ended a very tough presidential election and that will probably lead to changes in the healthcare environment. We can only guess what new legislative agendas will be heading our way in the next four years. We have lots of challenges in the future.

On a positive note, the Georgia Chapter continues to grow. Our membership has dropped from previous levels but is stable. We have a lot of new members that are full of enthusiasm and ready to be active in the chapter. Our older (mature) members are willing to help our new members become active in the chapter.

We have some great projects occurring the second half of the HFMA year. We have a rural healthcare initiative in partnership with GHA that will bring more financial education to some of the rural hospitals in Georgia. Our web page is expanding to become a valuable tool for the membership. We are in the process of installing a credit card feature for institute and forum registration. We are now able to e-mail brochures for your convenience for institutes and upcoming forums. I eventually envision the day when we will utilize e-mail and the web site for almost all of our communications including weekly updates for the membership.

We are planning Medicare and Medicaid training for business office associates in the winter, partnering with the appropriate agency. We also have a very strong Accounts Receivable committee in partnership with GHA to work with payers and providers to produce a better cash flow process. Also, we will have a project this year to build a home with Habitat for Humanity. This will be in honor of Dwight Sims.

All in all, it looks like a great year. I appreciate your confidence in the leadership and I certainly appreciate the honor of serving you.

Tim Beatty, FHFMA

President

In This Issue...

President’s Message ................................................. 2

Coffee Regional Medical Center .............................. 3

It’s 11:00 a.m. - Do You Know How Many

Agency Staff Are In Your Facility ......................... 5

New Service Change ................................................ 7

Dixie Institute 2001 ................................................. 8

Member Spotlight ..................................................... 12

13Fall Institute Highlights ....................................... 13

Trends in Hospital Accounts Receivable ................. 17

HIPAA on the Job ...................................................... 19

Blessing in Disguise for HC Providers ..................... 23

Coffee Regional Medical Center

2000 Rural Hospital of the Year

Cover Story:

Coffee Regional Medical Center was honored by the Georgia Rural Health Association as the 2000 winner of the Rural Hospital of the Year Award. This annual award is given to the rural hospital in Georgia that has demonstrated excellence in service and organization and can be viewed as a model institution for others to emulate. Efficiency, quality of care, range of support services offered, community support, volunteer programs, access to indigent care and especially relevance to the rural community are some of the attributes considered in choosing the winning recipient.

At the awards ceremony held at Lake Lanier, Georgia, George Heck, President/CEO accompanied by Rep. Chuck Sims accepted the award for Coffee Regional Medical Center. The paper submitted for the nomination follows:

Coffee Regional Medical Center in Douglas, GA is serving our community by promoting health and delivering health related services. Moving into the new replacement facility in 1998, we are providing Coffee County and our immediate region an expanding medical staff, new services, specialties and technology. The efficiencies of this new facility allow the Medical Center to reduce FTEs and operating expenses and increase the profitability. As we attempt to convert our customers from the sickness model, this financial strength allows for investment in health and wellness programs.

The new 45 million-dollar facility represents the largest building project in the history of our county. The planning, financing, ground breaking and construction phases provided a time for our community to come together for a project that would ensure excellent health services for many generations. The new facility is a source of pride that has enabled us to attract many new physicians in both primary and specialty care. Since the inception of the building project in 1994 we have added 23 new physicians to our active staff that include specialists in ENT, gastroenterology, orthopedics, ophthalmology, emergency, urology, obstetrics/gynecology, pediatrics, internal medicine, anesthesia, family practice, podiatry and pathology. Additionally the facility accommodates many super specialties that consult from tertiary centers giving our community a more comprehensive medical service. It has been our Field of Dreams.

Our JCAHO review in 1999 gave an unprecedented accreditation score of 97. The Laboratory/pathology department is fully accredited by JCAHO, American Association of Blood Banks and CAP to ensure a well-trained staff and availability of advanced pathology studies. Imaging Services/radiology has comprehensive diagnostic services including mammography, stereotactic breast biopsy, CAT scan, MRI, nuclear medicine, echocardiograms, and ultrasound technology.

The Emergency room, staffed 24/7 with five board certified trauma care physicians, gives our community the confidence that emergency care is minutes away. The First Care (urgent) clinic offers a service to families with illness and minor injuries after doctor’s office hours. CRMC provides emergency medical/ambulance service to Coffee County, covering 618 square miles. crews. To reduce response times to outlying communities, CRMC has established two additional satellite EMS stations. In the recent Bike Ride Across Georgia (BRAG) they provided respite and first aid to the 2500 bike riders that pedaled through South Georgia.

The OB service delivered more than 850 babies in the past 12 months and offers many educational services to families including childbirth classes and breast-feeding instruction by a certified lactation instructor.

CRMC provides two Certified Athletic Trainers on-site to the school systems in our county. Besides evaluating and rehabilitating sports injuries, they provide sports physicals, rehab services and information to help avoid injuries.

Hospice of CRMC, a new service begun on February 16, 1999, completed their first year serving more than 50 patients and their families. The program is expanding the volunteer component with great results and has been chosen to receive United Way funding.

Recognizing the advantages in having a stable, well-trained staff, CRMC offers career employment for 500+ staff that includes a comprehensive benefit package that includes a 401K plan, health and life insurance, annual physicals, vacation/sick leave, education opportunities, recognition programs and health and wellness programs. In our recent fitness Walk Across America 65 employees pooled their miles to travel 2364 miles, equivalent to the distance from Douglas to Los Angeles.

Some of the many community health services and screens provided at no charge to our area include: colon cancer, prostate health, school sports physicals and the Community Health, Safety and Wellness Festival. CRMC served as one sponsor for the American Cancer Society Relay for Life that raised more than $60,000 and the March of Dimes Walkathon. 1999 was the First Annual CRMC Fall Fitness 5K Run/Fun Walk. The 165 participants from the staff and community celebrated health, wellness, fun and fitness.

CRMC contracts with Correction Corporation of American to provide emergency and inpatient health care to state prisoners. The hospital also serves a large indigent population by guaranteeing care without regard to ability to pay. In 1999, $2,395,511 was written off as free care to 4,542 indigent patients. Additionally, we have increased our efforts to secure funding sources for those that are eligible by adding bilingual financial counselors. The indigent care funding (ICF) that flows through CRMC to the Southeast Health district provides programs to the indigent population in our region. CRMC contributed $708,000 that includes: perinatal care, Lab/Pharmacy/X-ray, Hispanic outreach, Nicholls Satellite Clinic, PeachCare, Vision clinic, breast-feeding instruction, HIV/TB, School Nursing and cervical cancer screening.

Planning for the future, CRMC provides 12 nursing scholarships to South Georgia College to ensure well-trained aspiring nursing and health care professionals. We welcome many other mentor/student programs through the high school, and local voc/tech schools.

This year we are embarking on a new, but necessary challenge to create a CRMC Foundation to secure the long-term availability of healthcare in our community. Recognizing the value of high-quality local healthcare, the community has responded with financial support and volunteers.

CRMC served as one of the sites for Leadership Georgia 2000 where we had an opportunity to showcase our community and discuss the plight of rural health care with many of the future state leaders. It was an opportunity to dispel many myths about the quality of health care provided outside a metro area and reinforce the critical need to maintain access to healthcare in all communities. Additionally, George Heck, CEO, has taken a lead role in developing the Rural Health Cooperative. Including rural health providers with areas of common interest in southeast Georgia, the RHC is studying creative ways to keep rural healthcare accessible and make it more cost effective by searching for potential areas of collaboration.

Submitted by Annie Lott,

Coffee Regional Medical Center

It's 11:00 AM - Do You Know How Many Agency Staff Are In Your Facility?

By Patt Peterson, Kronos Healthcare, Visionware

In today’s dynamic healthcare environment, the question isn’t will you use agency staff, but rather, how frequently and is the use appropriate. Is there room for improvement at your facility? If you rely mostly on tally sheets and end of month totaling, then my guess is you can make a huge improvement on a costly component of your labor budget. The key is to automate data collection allowing agency use information to pass through the facility as part of a normal workday process. Eliminating unnecessary or inaccurate agency hours can contribute directly to improving the bottom line.

From Oops to Accuracy

A hospital in Hennepin, Minnesota noticed their agency charges increasing, but didn’t believe they had increased agency staff usage. Under the old process, the hospital would receive a monthly bundled bill from each agency. The Finance department would make an attempt to match up the hours relying on tally sheets, which were frequently missing. After realizing that the agency charges were remaining high, they implemented a review process of agency hours by cost center. What they discovered was a fraudulent case of triple billing - here is how it worked:

A radiology tech registered with a local agency but felt he wasn’t getting enough hours. So, he also registered with the two other agencies in town. The hospital would call him in for a shift. He’d work the shift and receive a signed form from his supervisor for hours worked. He’d then take the work form to each of the three agencies saying he’d worked the shift. Because the agencies were competitors, they obviously weren’t sharing usage information with each other so they didn’t catch on to the fraudulent practice. The hospital wasn’t able to keep accurate statistics and relied on the agencies to submit correct bills. At the time of the discovery, the radiology tech had cleared more than $100,000 a year for part-time employment.

Here are quick tips you can use to organize your agency-monitoring program:

* Automate time collection. Each unit that calls on agency help should have a stack of reusable generic badges (3 for Agency ABC, 3 for Agency XYZ, etc) so as the worker shows up at the start of the shift he clocks in and the information is sent to your database.

* Create a Productivity database. Select a vendor who offers daily productivity tracking, or create an in-house excel spreadsheet. This step is important because the hours from the time collection system normally go to Payroll. With this process, the Agency hours are diverted to the Productivity database so you have a daily feedback loop.

* Set expectations about Agency use. It is helpful to see if your actual volume warrants the use of Agency staff (see example). The more timely the feedback loop - the greater the opportunity the cost center manager has to effect change.

* Create an official launch date for the program. Without a deadline, you’ll waste valuable time waiting for fires to die down. Face it, there will always be urgent matters to attend to - meanwhile, you miss an opportunity to improve expenses now.

* This same process can be used to track Staff Pool use and Volunteer use.

Adventist Florida Hospital of Orlando utilizes a daily reporting tool. Director of Financial Planning, Richard Brannon, states they do not use the report to hold managers accountable but rather to improve the decision making in a day-to-day environment. This approach works best when it is set in a collaborative environment. We just want to give our managers the best information possible.

Get comfortable with change. Abraham Lincoln wrote: “The best thing about the future is that it happens one day at a time.” To have your finger on the pulse of labor activity, you need a good reporting tool. Try to set up your reporting with a goal of distributing reports daily. This gives your management staff reaction time within a pay period to decide if premium rates of pay like Agency and overtime make sense.

As you can see in the example, this cost center is experiencing fluctuations in workload from one day to the next. For the most part they have more work than they have staff to cover. However, that isn’t true for every day. For September 19th, 21st, and 22nd the hospital was able to cover the workload by offering their regular staff overtime, and the agency use wasn’t necessary. Over time, this type of feedback improves a manager’s ability to manage volume.

Building on your success.

With a detailed reporting tool in place, you build an incredibly rich database of agency usage. This information can improve your bargaining position. You can negotiate for a better rate based on trends of previous year use. Even if you choose not to negotiate rates, having this level of detail makes auditing the monthly billing statements from your agency providers much easier and more accurate.

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CPAR Celebration!

By Mary Kay Tam

The exams have been taken and the results are in! All CPAR candidates have received their grades. If you haven’t, please call the CPAR Hotline.

The awards banquet will be held February 8, 2001 at the Gwinnett Marriot. All 2000/2001 CPAR graduates, along with a representative from their organization, have been invited to attend. There will be the annual awards presentation, dinner and dancing.

In addition, there will be a speaker that afternoon at 2:30 that has yet to be announced.

HFMA congratulates this years CPAR graduates and thanks all those employers who help support this worthwhile educational program.

J a n u a r y 2 0 0 1 f a s t f a c t s o n c e r t i f i c a t i on

To allow members who purchased the 1999-2000 self-study courses for HFMA certification every opportunity to test using these materials, testing on the 1999-2000 materials is being extended through March 31, 2001. The additional time is intended to allow people who did not realize the testing procedure has changed to make use of their study materials before they become obsolete. Testing now is done through the HFMA chapters. Candidates need to arrange the administration of examinations through their chapters. Anyone who wants to be examined using the 1999-2000 tests should inform HFMAs career development staff upon registration so that the correct test will be available when the candidate and proctor sign in.

The new 2001-02 exams will be available on January 1, 2001. The self-study courses for these exams were released in June 2000. HFMA members who want to take the new exam should begin preparing now if they have not yet started.

For more information about HFMAs certification program, contact your chapter certification chair or HFMAs director of career development, Pepper Zenger, at (800) 252-HFMA (4362), ext. 308 or pzenger@hfma.org.

New Service Change

to Assist Hiring Organizations

HFMA's Exec-u-Trak Career Network is offering a new alternative to hiring organizations!!!

Currently hospitals can utilize the HFMA Exec-u-Trak database for individual position openings. Cost for this service is $2200, which is substantially less than other options, such as national classified advertising, recruitment firms and most large employment web sites.

We will begin offering clients an option to pay a 12-month charge to gain unlimited access to the service. This will be an advantageous alternative to organizations that plan to hire two or more financial management professionals over a twelve-month period. The cost for this service is $2900, which is below other alternatives like Monster ($4,000), Headhunter ($3,600) or CareerBuilder ($9,000). The twelve-month period begins when an organization signs up for the service (i.e., February, 2001 thru January, 2002).

More important, HFMA's Exec-u-Trak service targets only health care finance professionals. In addition, the program continues to provide more than just web site listing to assist with recruitment. Companies will continue to benefit from our data base search and National Opportunities Bulletin. Our program and experience are explained in greater detail at our web site http://www.ndi-services.com/hfma.htm.

Because many organizations are finalizing budgets and hiring plans for the coming year, we thought it was important to get this information to you to share with your Human Resource Department and with other members in the Chapter. As an added incentive to kick off this new program, organizations that sign up for the service before March 31, 2001 will receive a 10% discount and will only pay $2600 for the first twelve-month period.

As you are aware, HFMA's Exec-u-Trak is not supported through any member dues and only generates revenue on a fee for service basis. We are pleased to continue to offer programs and services that benefit both members and organizations.

Please contact me if you have any questions about Exec-u-Trak at info@ndi-services.com or (810) 225-6239.

Dave Kosteva

HFMA Exec-u-Trak Administrator

limb Every Mountain has been selected as the theme for this years Region V Dixie Institute, tying in with our Smoky Mountain meeting location. The theme signifies the obstacles that we must surmount, our struggles to reach their pinnacles, and the discovery of an even higher mountain of difficulties to address and overcome. As the pioneers of our great country crossed the Cumberland Gap of the Appalachians to travel to their planned destinations of success on the frontier, there is no easy path for our traverse. We must climb a treacherous trail to address the issues of health care financial activity. HFMA has been our guide to maintain our passage across these mountainous ranges by offering educational and networking events. The Region V Dixie Institute is one of the several prominent opportunities to acquire the necessary tools of instruction to Climb Every Mountain.

Don't miss the exciting programs offered at the Dixie Institute! The keynote speaker will be Scott O'Grady, USAF pilot, whose plane was lost in the hostile territory of war-torn Bosnia. Captain O'Grady was helping enforce the NATO no-fly policy over Bosnia when a Soviet-made anti aircraft missile slammed into his F-16. In July 1998, Captain O'Grady began his current assignment as an instructor at Fairchild Air Force Base, Spokane, Washington with the Joint Survival Agency. His book Return with Honor remained on the best seller list for six weeks. A movie version of Captain O'Grady's experience will be available in the near future. Captain O'Grady will tell us of the incredible story of his six-day ordeal in adverse territory and his struggle to survive in the barren landscape before his valiant rescue by the U.S. Marines.

Dr. William Cleverley will provide two sessions - Dashboard Assessment of Your Financial Profitability and Improving Your APC Profitability. Dr. Cleverley is the President of Cleverley & Associates; a firm specialized in providing benchmarking services for hospitals in the financial, operating, and clinical areas. The firm emphasizes data interpretation and business solution identification that will enable hospital clients to improve their financial performance. Dr. Cleverly is a part-time faculty member at The Ohio State University where he has taught courses in healthcare finance since 1973. He is the author of forty-three books dealing with application and use of financial management principles and data in healthcare organizations.

Judy Horowitz will present Millennium Trends: What Can We Expect, How Can We Prepare? Judy is a Vice President in the Atlanta office of Jennings Ryan & Kolb. She has over 18 years experience in health care management consulting and is a frequent speaker on topics such as strategic and financial planning, managed care contracting, and medical staff development.

A General Sessions Panel will address Future Financing of Health Care Delivery. The National office of the Healthcare Financial Management Association - HFMA - will be well represented for this presentation. Ron Long, HFMA Chairman-Elect will moderate the discussion. Panelists include Connie Cape, HFMA Chairman; Richard Clarke, National HFMA President; our own Mary Beth Briscoe, National Board Member from Alabama; and Joyce Zimowski, National Board Member from New York.

Ron Long is Vice President of Finance and Health Plans at Saint Mary’s Health Network, Reno, Nevada. Rono's designation as Chairman of the Board of HFMA will begin June 1, 2001. He earned his B.Sc. in Accounting from the University of Portland. Ron has been a member of HFMA since 1982. He served the Nevada Chapter as Vice President, President-Elect, and President. Connie Cape's current involvement in HFMA is voluntary elected Chairman of the Board of Directors of HFMA during the 2000-01 year beginning June 1, 2000. She is currently serving the healthcare industry as a consultant for management and finance issues in Barleton, Michigan. She is a graduate of the University of Missouri in Columbia, Missouri. Connie has been a member of HFMA since 1973 and served the Eastern Michigan Chapter as Treasurer, Secretary, Vice President, President-Elect, and President. Richard Clarke is President and Chief Executive Officer of HFMA, Westchester, Illinois. He has held this position since June 1986. He attained Fellowship in HFMA in 1983. He was president of the Colorado Chapter of HFMA, served on the HFMA National Matrix, and was member of HFMAs Principles and Practices Board. Mary Beth Briscoe is Senior Vice President and CFO of Eastern Health System, Inc., in Birmingham, Alabama. She received her B.Sc. in Accounting and her MBA from the University of Alabama. Mary Beth has been a member of HFMA since 1984. She has served the Alabama chapter as Vice President, Treasurer, Secretary, President Elect, and President. She is currently a voluntary elected Director of HFMA for the period 2000-03 beginning June 1, 2000. Joyce Zimowski is Vice President for Finance, ViaHealth in Rochester, New York. She has been a member of HFMA since 1982. Joyce has served the Rochester Regional Chapter as Treasurer, Secretary, President-Elect, and President. She received her BBA degree from St. Bonaventure University, Olean, New York. Her involvement with National includes serving as Chapter Liaison Representative (1992-93), as a CAT (Chapter Advancement Team) Consultant (1994-99), and on the Executive Committee (1999-01). She is currently serving a voluntary elected Director of HFMA during the 1998-01 term, beginning June 1, 1998.

Breaks out sessions include three of Region V's outstanding leaders who have voluntarily served in their state affiliated HFMA chapter and in HFMA National positions. John McGuire FHFMA, CPA of the South Carolina chapter will address his audience on March 12. John is the Senior Administrator of Greenville Memorial Hospital, the flagship institution of the Greenville Hospital System (GHA) in Greenville, South Carolina. His involvement with National includes serving on the Matrix, Chapter Liaison Representative, the Board of Directors, the Executive Committee, Chairman-Elect of the Board of Directors and voluntary elected past Chairman of the Board of the HFMA.

It has been stated that implementation of HIPAA regulations will cost more than Y2K. This recently passed legislation is the latest mountain of challenge that we must ascend. Lawrence Laddaga, member of the South Carolina chapter and founder of Laddaga, Drachman & Garrett, PA-Attorneys at Law in South Carolina will address the issue. The title of his presentation Are you HIPAA to the Groove? Yeah Baby will summarize HIPAA legal aspects of electronic data submission, patient privacy, and medical necessity. A member of the South Carolina Bar, Lawrence currently represents Region V as Chapter Liaison Representative-elect. He served the South Carolina chapter as Vice President, Secretary, Treasurer, President-elect and as President of the 1997-98 term.

Have we really reached the crest of understanding and implementation of OP PPS? I think not. There is still so much information that we need to survive the Medicare payment reductions for hospital outpatient care. Pam Townsend, past president of the Alabama chapter and Vice President of Finance at Baptist Health Systems in Birmingham, Alabama served as Region V Chapter Liaison Representative in 1999-2000. Her CLR peers selected her to serve on the 2000-2001 HFMA National Nominating Committee. Pam will provide expert advice regarding reimbursement for healthcare delivery in the hospital outpatient area. She has the credentials to be recognized as an expert in this field; Pam's responsibilities at Baptist Health Systems include reimbursement, budgeting, cost accounting, strategic planning and managed care. Pam previously spent nine years as Director of Healthcare Consulting services at Coopers & Lybrand and eight years in Provider Audit and Reimbursement at BlueCross and BlueShield of Alabama.

Steve Simms, President of Attitude-Lifter Enterprises, will present Don't Lose Your Marbles, a very probable opportunity for those of us who must make stressful financial decisions regarding the delivery of healthcare in today’s environment. As a motivational speaker, he will provide encouragement to us in our difficult positions as members of the financial management team of health care providers.

The Schedule of Events also includes speakers of expertise to address Compliance, E-Commerce, Data Warehousing, Managed Care, Silent PPO's, Hospital Consolidations, Internet Strategy, and Investment Portfolios. The PRO's from each state of Region V will provide a forum to address the Payment Error Prevention Program.

Dixie Institute participants will have many opportunities to visit with the more than sixty exhibitors and event sponsors. Institute sponsors provide the necessary financial assistance to facilitate programs to improve our technical skills. Their attendance and product demonstrations answers the questions of how we implement the newly acquired technical knowledge that enhance the daily operations of the finance division of your facility.

Many networking occasions are planned for you to visit with old friends and make new acquaintances in Region V. Many think that the strength of the region is supported by the friendships and sharing of successful activities. A Casino Night will be held on March 12 with many prizes available for auction using your winnings.

We encourage you to plan your calendar to make time available to attend this event. Registration to fund the fees and expenses of these outstanding speakers is $375. The Tennessee chapter has negotiated an affordable off-season room rate of $82 per night in one of the best hotels in Gatlinburg.

Call early for your hotel reservation. The telephone number is 1-800-421-7275. Mention the HFMA Dixie Institute when you call. A block of rooms is available for HFMA registrants until February 10, 2001. A roll over hotel contract is available with another facility when all rooms at the Park Vista are reserved. For additional information, please contact Cindy Sharp at (901) 644-8588 or me at (901) 448-1672.

Carolyn Moffitt, FHFMA,

Dixie Institute Co-chair

Cindy Sharp, FHFMA,

Dixie Institute Co-chair

HFMA DIXIE INSTITUTE 2001 REGISTRATION

Name	Title
Facility
Street Address
City	State	Zip
HFMA Membership #		Phone

Check All that Apply:

HFMA Member Non-Member FHFMA CHFP Officer

CPA Past President Board Speaker Sponsor

Special Meal Request (please be specific):

__________________________________________________________________

Golf Information:

Golfing, weather permitted, call Mike Weeks at (423) 744-3326 after March 5, 2001.

Institute Fees:

Full Registration (includes all breaks, social events, lunch and educational materials during the Institute)

HFMA Members Full Registration $375.00 _____________

Non-Member Full Registration $425.00 _____________

(Additional full registrations from the same institution are eligible for a $25.00 discount.

Multiple discounted registrations must be submitted together prior to institute.)

One-Day Registration $200.00 _____________

Guest Tickets, Each Reception $ 10.00 _____________

TOTAL FEE _____________

NASBA CREDITS = 19 CPE’S

Make Check Payable to: Tennessee Chapter HFMA and send Payment and Registration to:

Cynthia Maruart, FHFMA, CPA

University Health Systems

HFMA HOTLINE 9000 Executive Park Dr.

Bldg. D, Suite 150

Knoxville, TN 37923

(865) 251-4534

or fax to: Carolyn Moffitt, FHFMA

(901) 448-8065

Chapter Chatter...

Congratulations to Larry Bradley on his new position as Operations Director at NCO.

“Get Well Soon” Cheers to Shirley Carmichael of Emory University Hospital and

Jim Phillips, District Sales Manager, NDC Health Information Services.

Congratulations to John Frank from Crisp, Hughes, Evans, LLP and his wife,

Julie on the third addition to their family. Mary Alexandra was born on October 19.

Member Spotlight

LIZ WILkEY

______________________________________________________________________________________________

IT’S THAT TIME OF YEAR AGAIN!

The Awards Committee is seeking nominations for the Ann P. Longshore Distinguished Service Award and the Oliver J. Booker Scholarship Award.

The Ann P. Longshore Distinguished Service Award recognizes an outstanding Chapter member for his/her efforts. Nominations for candidates are based upon the member's service to the Chapter and are submitted to the Awards Committee with the recipient approved by the Board. The Recipient must be a member of the Georgia Chapter (with current officers and board members excluded) and can only receive the award once every five years.

The O.J. Booker Scholarship Award was established as a continuing memorial to Mr. Booker, who passed away in 1987. Colleagues remember him as a highly effective manager who always encouraged employees to further their education and enrich themselves. Nominees for the scholarship are selected from among students of the highest academic standing in the financial fields who expect to enter the healthcare financial management industry. The $1,500 award is designed to help a member of HFMA in their educational endeavors. Nominations can be made by any member of the chapter. Nominations should include name, address, and phone number, place of employment, HFMA member or relationship, degree/program pursuing, college/school, and reason for nomination.

The Ann P. Longshore Distinguished Service Award and the O.J. Booker Scholarship Award will be presented to the 2001 recipients during the Spring meeting at Callaway. Please submit your nomination by March 30, 2001 in order to be considered. For your convenience, a nomination form is on the this page.

SEND NOMINATIONS TO:

Judy King Williams, FHFMA

McKessonHBOC

5995 Windward Parkway

Alpharetta, GA 30005

FAX: 404-338-6101

Registration Form

GA HFMA Advanced CPAR Program

At the GA HFMA Fall Institute in November 1998, the new Advanced CPAR Program was introduced. To achieve Advanced CPAR status, you must fulfill the curriculum requirements by receiving ten (10) credit hours obtained from attendance at qualifying sessions. As indicated, the various sessions required to earn Advanced CPAR status will be offered periodically throughout the year and in different areas of the state, as well as at each Institute.

Sessions for March 20, 2001

Main Auditorium at Children’s Healthcare of Atlanta at Scottish Rite

Session One- 8:00 a.m.-10:00 a.m.

Medicare/ Medicaid (2 credit hours)

Linda Corley, Senior Consultant, Advanced Receivables Strategy (Medicaid)

Robert Bolden, Dir. Fiscal Services, GHA (Medicare)

This session will include information on SSI applications and retroactive Medicaid.

Session Two- 10:00 a.m.-12:00 p.m.

Managed Care (2 credit hours)

Talmadge D. Reece, Director, Healthcare, Nationwide Credit

Topics will include managed care contracts, identification of Silent PPOs; tracking payment discrepancies; terms often used, but not understood; and understanding basic contract interpretation.

Session Three- 1:00 p.m.-3:00 p.m.

Legal Issues (2 credit hours)

Jan McCurdy, Attorney, Harkins & Henry Attorney at Law

This session will include information on COBRA, Medicare fraud & abuse, hospital liens, bankruptcies, and garnishments.

Session Four- 3:00 p.m.-5:00 p.m.

Reimbursement (2 credit hours)

Linda Corley, Senior Consultant, Advanced Receivables Strategy

This session will cover the Charge Master and its affect on reimbursement.

Directions:

Going 285 East: Get off at Glenridge (which is right after Roswell Road). Turn right at bottom of ramp. Get in the left lane and make a left at Johnson Ferry Road. Across from Northside Hospital at Meridian Mark, turn right. Scottish Rite on left. Turn left where indicated

Going 285 West: Get off at Peachtree Dunwoody Road (which is right after Ashford Dunwoody Road). Turn left at bottom of ramp. Make right at Johnson Ferry Road. Make left at next light (Meridian Mark) Scottish Rite on left. Turn left where indicated.

Coming from Downtown Atlanta: Take I-85N to I-285 West to Peachtree Dunwoody Rd. (after Ashford Dunwoody Rd). Turn left at bottom of ramp. Make right on Johnson Ferry Rd. Make left at next light (Meridian Mark) Scottish Rite is on left. Turn left where indicated.

Registration Form

GA HFMA Advanced CPAR Program

Main Auditorium @ Children's Healthcare of Atlanta at Scottish Rite

1001 Johnson Ferry Road

At the GA HFMA Fall Institute in November 1998, the new Advanced CPAR Program was introduced. To achieve Advanced CPAR status, you must fulfill the curriculum requirements by receiving ten (10) credit hours obtained from attendance at qualifying sessions. As indicated, the various sessions required to achieve Advanced CPAR status will be offered periodically throughout the year and in different areas of the state, as well as at each Institute.

Please forward registration information to your employees who are CPAR Graduates.

The registration fee is $25.00 per session

Name _________________________________Badge Name_____________________________

Organization____________________________________________________________________

Street_______________________________________ Phone ____________________________

City/State/Zip ___________________________________________________________________

March 20, 2001 Registration

Session 1 $_______

Session 2 $_______

Session 3 $_______

Session 4 $_______

Total $_______

Make checks payable to: HFMA Georgia

Mail Registration Form and Payment To:

Lil Kloock

Advanced CPAR Chairperson

C/O Meridian Healthcare Staffing

24 Perimeter Center East #2414

Atlanta, GA 30346

For additional information - call

Sakina Brown at 770-351-0500 ext. 248

Fax 770-351-0400

trends

in Hospital

Accounts Receivable

By Lee Evins, FHFMA

DO NOT READ THIS if you are expecting a highly scientific, research intensive, in-depth, hypothesized view of trends in accounts receivable (A/R). What you will read, should you be so brave, are one person’s observations after 21 years in A/R management (and occasional mismanagement). The reading of this article is intended to be light and yet interesting, and yes, maybe even informative.

The author has learned through years of experience operating healthcare business offices that there are some trends in this business which are guaranteed, sure as the world, no doubt about it, as certain as death and taxes. It is also true that other trends exist but which are not quite as predictable. Still other circumstances seem to be or are assumed (there’s that word) to be trendable BUT. This article is the author’s experiences encapsulated, bottled as it were, and given free to new comers to the business, to old timers who may or may not agree, and to any other interested party trying to find some rhyme or reason to the ebb and flow of cash and the subsequent mood of the CEO and CFO.

I. Trends in the industry you can count on: You Can Bet Your Bottom Dollar - It's Gonna Happen:

Observation Number 1: CFOs are never happy more than ten minutes regarding cash flow

Observation Number 2:

If cash is exceptional one month, CFO’s expect that same level of collections each month from then on

Observation Number 3: CEOs and the Board almost always believe anything CFO’s tell them so Patient Financial Services (PFS) Directors are seriously on the hook for, at least, better than average cash flow if not miraculous cash flow

Observation Number 4:

It does not matter what area of the hospital or organization is creating backlogs, which are not under the authority and responsibility of the PFS Director; if cash is bad, PFS is usually called upon to explain. Cash may be negatively affected by Medical Records transcription - coding - chart copying backlogs, late charges from big departments may be holding up billing, and a myriad of other cash busting problems may hound PFS, but no matter. You better watch out, you better not cry, you better not pout, I’m telling you why. You better go fix it.

II. Trends in the industry you can probably count on: P.U.N.G. (Probably, Usually, Normally, Generally it’s gonna happen):

Observation Number 1:

PFS Directors usually have a litany of reasons (with an occasional veiled or outright excuse) why cash wasn’t at the level expected by the CFO

Observation Number 2: Frequently the PFS Director is right

Observation Number 3: CFO’s and CEOs should therefore pay more attention to PFS Directors

Observation Number 4: Regarding Number 3; Dream on. (with the exception being my boss who completely understands I (#4) & II (#2 & 3) and who is supportive in every way. No - Really!

III. Trends in the industry - I think (observed assumptions):

Following are ideas I have Elected to believe but the decision on the validity is TOO CLOSE TO CALL. After reflection I may need a ReCount!

Assumption # 1: Market Trends Equal Healthcare Cash Trends:

For several years now I have been under the impression that cash flow in the healthcare arena was inextricably tied to the ebb and flow of the stock market. I speculated that the ups and downs of the NASDAQ, Dow and particularly the S&P 500, investment heavy catchment areas for the insurance and healthcare industry, controlled the overall cash health of the organization I worked for. I occasionally used the argument The market is down on my boss when cash flow was off. My theory is even shared by at least one other great mind in the business. I recently attended an HFMA session where Deborah Kolb, Ph.D., Executive Vice President of Jennings Ryan & Kolb was discussing Profits and Revenue Returns. Debbie was discussing why denials are increasing and among her conclusions there was one comment which lends credence to my theory that if the market is down, so is healthcare cash. In her words, Payer’s are playing games with provider’s money to generate cash flow and compensate for the dismal financial performance of most payers So, is it true? Do market trends hold hospitals and other healthcare organizations hostage when it comes to cash flow? Is there a correlation between the investment misfortunes of payers and payments to providers?

Following are the year 2000 to date NASDAQ, Dow and S&P 500 trends, reporting monthly average indexes, showing the percent of change from the average of the previous month. The red CASH column shows the percent of change of the per/day average for the month from the per/day average for the year which WellStar experienced in cash related to combined Blue Cross, Commercial, HMO, and PPO collections 30 days after market fluctuations (chart one) and 60 days later (chart two). My assumption has been that there should be a correlation between a downturn in the markets and an ultimate down turn in Commercial and Managed Care cash.

Just a footnote for the purists in the audience: I do not propose to be completely versed in the idiosyncrasies of the markets or other diversities in ones investment portfolio, such as futures trading, or derivatives, etc. This article is a simple approach to a simple question. Do changes in the primary investment avenues affect cash in healthcare organizations?

Compare your organizations cash trends to the trends noted here and draw your own conclusions.

Market % of Change From

Prior Month

Assumption # 2:

School's out/Schools in:

Another of the I think this is true but I’m not positive trends is the effect of the beginning and ending of the summer vacation period which naturally corresponds with the ending of one school year and the beginning of the next. Note the downturn in WellStar's Commercial and Managed Care cash in June and July. But January to July was nothing to write home about. Certainly the beginning of the school year had no ill effect on cash. The fact is that the early part of the year WellStar PFS was just getting reborn after the separation from Promina. PFS was planning and executing the moving of the entire PFS function to the WellStar Administration Building, which took place in early July. It is clear that extenuating circumstances can skew the numbers. If you have the prior year data for your organization, review this the data and see if your organization experiences this assumed phenomenon year after year. I could not show a correlation at WellStar.

Assumption Number 3:

Cash is Always Bad Between Thanksgiving and the End of January.

Though the charts in this article do not include December cash, because I am writing this in mid-December, I can unequivocally state that this assumption is always anticipated by PFS Directors, rarely accepted by Administration as a legitimate excuse for poor cash flow, is sometimes true, but not always. What I believe can be repeatedly demonstrated is that November is usually a weak cash month and January is usually among the poorest cash months of the year. December, well, that's about a 40% ok for the month to 60% marginal to poor performance for the month in my experience.

Conclusion:

Charts are only paper and trends are only history. Today and tomorrow and the opportunities they present are what are real and important. That is why they call today the PRESENT.

After reviewing the charts I am convinced that there are other factors more likely to negatively or positively affect cash than the markets, school schedules or holidays. The primary factors for success in PFS are:

· ATTITUDE

· Developing a Team

· Hard work

· Organization

· Motivation and developing a sense of urgency

· Employee satisfaction and retention

· GETTING OUTSIDE THE BOX (be creative), address issues previously thought out of your area of responsibility. Anything affecting A/R is your responsibility

· Making vendors Partners in improvement and holding them accountable

· Focus - Identify backlogs and delays - eliminate them one at a time - even if they are not in PFS

I believe healthcare organizations can maintain reasonable cash flow regardless of swings in the markets, anomalies created by holidays, and summer vacation. Administration should be told, and shown in historical perspective through graphs, what seasonal fluctuations and market gyrations can do to cash flow. But my conclusion is that the negative effects of these events can be minimized with a strong PFS Team, with focus and determination, and with creativity (a prayer now and then won’t hurt either).

I would like to express appreciation to Greg Fortgang, Systems Analyst for WellStar Patient Financial Services, for his research and technical assistance in the preparation of this article.

HIPAA on the Job:

Understanding Chain of Trust and Business Partner Agreements

Confused about the differences between privacy and security? You’re not alone. Combine these with the jargon-laden chain of trust and business partner agreement issues, and a whole new set of questions about HIPAA implementation emerges.

Privacy, pursuant to HIPAA, addresses the rights of an individual regarding his or her individually identifiable health information; how to exercise those rights; the responsibilities of organizations to support an individuals rights; and the use and disclosure of that information.

Security is the means by which the confidentiality of information and rules for use and disclosure are implemented. Security also extends to the integrity and availability of health information and includes health information that is not individually identifiable.

The HIPAA regulation on privacy, when it is finalized will have important implications for an organizations HIPAA security effort. As your organization considers the implications of the privacy and security rules, anticipate key provisions such as:

* policies, processes, and safeguards to ensure the use of the minimum necessary individually identifiable health information for a given use or disclosure. This should define certain requirements for security, including access controls and increased creation and use of deidentified data

* audit trails of disclosures pursuant to required authorizations. For example, prior authorization is required for use or disclosure of all identifiable health information for marketing. This requirement should be built into security decisions on audit trails

* processes for making addenda and corrections and notifying other information users. If the process for modification and notification is going to be automated, it should be anticipated with other HIPAA requirements

* processes and controls for enabling additional restrictions on access to identifiable health information, which could define additional access controls and authorization processes

* business partner requirements, which should be considered at the same time as chain of trust partner agreements

* training requirements for privacy, which should be coordinated with security training1. Chain of trust agreements (CTAs) are required under the proposed security standard, but nothing in those regulations describes what provisions the CTA must include. CTAs are required between entities that share health information electronically. Currently, if a provider wants to submit claims electronically to a payer, the provider and payer enter into a contract that defines how the communications will be done, when and if remittance advices will be provided electronically, how often the transmission will occur, in what format the transactions should be submitted, and so on. That contract is not currently referred to as a CTA, but it could be considered one.

Business partner agreements (BPAs) are a requirement under the privacy regulations. A covered entity must include three basic overriding principles in its contract with a business partner, and the proposed privacy regulations would include nine specific provisions as well. BPAs are required between entities that share protected health information-regardless of whether the sharing is done by talking, writing, copying, faxing, electronically, or some other way.

Currently, no state or federal laws require BPAs. As an example, when a consulting firm conducts an audit of a covered entitys revenue cycle, the covered entity will most likely provide the firm access to protected health information. In addition, the firm may require the covered entity to sign an engagement letter that describes the scope, approach, timing, and fees for the project/engagement. That engagement letter (also referred to as a letter of understanding or arrangement letter), however, does not include most, if any, of the provisions that are mandated under the privacy regulations. As such, an engagement letter without modifications cannot be considered a BPA.

What Is a Chain of Trust?

The chain of trust concept of the security regulations extends protection to external trading partners with whom we exchange patient information electronically. An example of a trading partner would be a clearinghouse or payer. A physician is not typically a trading partner and would not fall under the chain of trust requirements. However, physicians are still required to comply with an organizations internal confidentiality agreements and security awareness training-as are all employees, internal staff, and external vendors.

The proposed privacy rule (164.518 [b][2][iii]) states: The covered entity must require members of its workforce trained as required by this section to sign, at least once every three years, a statement certifying that the person will honor all of the entitys policies and procedures required by this subpart.

What Is a BPA?

A BPA, according to the privacy regulations, extends a long list of terms to both trading partners and other vendors with whom we may not exchange information electronically, but who may have access to the information during the normal course of business or providing services. This may include software vendors, consultants, and maintenance firms. Business partner agreements are not required for the purpose of treatment, payment, and healthcare operations. Physicians, for example, would not need a business partner agreement with the hospital.

How Do the Security and Privacy Proposed Rules Differ Regarding CTAs?

There seems to be considerable overlap and some conflict between the proposed security and privacy rules regarding chain of trust and business partner agreements. The two overlap in their basic intent to protect the confidentiality of individually identifiable health information, but they also differ.

The security rule calls for security measures to be maintained at a minimal and acceptable level throughout the trading partner chain when exchanging protected health information. This means that the same level of protection measures established by the host partner shall be maintained by the receiving trading partner(s).

The proposed privacy rule addresses the specific accountabilities to which business partners must adhere. These accountabilities are required to mirror the host partners responsibilities as defined under the proposed rule. For example, this includes rules for disclosure and use of protected information. Also, such BPAs shall contain remedies, penalties, and termination provisions, as appropriate.

The proposed rules defined under security and privacy regarding business/trading partners are important and should be assessed and implemented under the guidance of your organizations legal counsel.

How Can I Tell the Difference Between CTAs and BPAs?

BPAs are very different from CTAs. BPAs must include specific provisions that are spelled out in the privacy regulations. What probably currently exists between covered entities and their business partners (this, too, is a new term; no state or federal law currently defines business partner) is a contract that defines how the two will communicate information electronically.

As such, the only thing that agreement can be called is a CTA. This may be confusing to most people as the industry has recently adopted the term business partner and everyone assumes that a contract with a business partner is, therefore, a BPA. The contract may actually have nothing to do with sharing protected health information.

What If I Work for a Clearinghouse?

If you work for a clearinghouse, it is obligated to meet the HIPAA security regulations. Your business partners, therefore, would also be obligated to your level/standard of data security. This should be addressed in your contract. Because this data sharing is critical to operations, the notification of disclosure to the patient would occur only upon his or her demand via the security officer or designee.

Can An Individuals Health Information Ever Be Disclosed Without Authorization?

As a general rule, covered entities would be able to use or disclose an individuals protected health information without authorization for the purposes of treatment, payment, and healthcare operations. Further, the clearinghouses contractual relationship with its subcontractor should spell out the expectation that a certain standard of data security is required. The covered entity would not be required to provide an accounting of disclosures for treatment, payment, and healthcare operations.

Can a Patient Get an Accounting of Disclosures?

Under the proposed regulations, the patient would not be entitle to an accounting of disclosures made by a covered entity for treatment, payment, or healthcare operations (164.515[a][1]), even if he or she demanded it. This would cover most disclosures by a clearinghouse to its business partners.

How Should We Treat Affiliates?

It is advisable for any entity sharing protected health information with another entity to address that arrangement in an agreement, either a CTA (under the proposed security rule) or BPA (under the proposed privacy rule). An example would be those affiliates to whom hospitals have voluntarily released patient information (physician practices or groups like radiologists or pathologists that are either given direct access to the database or have the information transmitted to them in some fashion). Make sure the affiliates understand the limitations on the use of that information as well as the requirement that the information be kept secure.

The exact terms of that agreement will vary depending on the nature of the relationship, whether it is a provider and a business partner, a provider-to-provider transfer, where both gain access to information for treatment purposes, or provider to payer. The proposed regulations do have specific terms that should be included in provider-to-business-partner or provider-to-chain-of-trust-partner agreements.

Depending on the situation, you could take the position that pathologists and radiologists are acting as providers in the patient care continuum and would be considered providers, which for disclosures for the purposes of treatment would not require a BPA. Neither would a patient authorization for release of information or disclosure of release of information to the patient be required.

Remember to review these types of scenarios with your legal experts to be sure that you and your organization are protected and HIPAA compliant.

Final Transactions, Code Sets Rule Published

In August, the Department of Health and Human Services (HHS) published the final regulations concerning HIPAA transactions and code sets. The new standards establish standard data content and formats for submitting electronic claims and other administrative health transactions. By promoting the greater use of electronic transactions and the elimination of inefficient paper forms, the administrative simplification regulations are expected to provide a net savings to the healthcare industry of $29.9 billion over 10 years, according to an HHS press release.

Health plans, clearinghouses, and providers that transmit transactions electronically will be expected to comply with the rules within 26 months of publication of the final rule-October 2002.

HHS Secretary Donna Shalala stressed that the rule assumes that privacy protections will be in place by the time the rule takes effect. If such protections were not in place the press release states, Ò HHS will seriously consider suspending or withdrawing the transaction regulation

The text of the final rule is available online at http://aspe.os.dhhs.gov/admnsimp/index.htm and in the August 17, 2000, Federal Register.

Notes

1. Koss, Shannah. Getting Ready for HIPAA Security Requirements. Paper presented at HIMSS 2000 National Convention, Dallas, Texas, April 2000.

2. Freuently Asked uestions Available at the HIPAAcomply Web site, www.HIPAAcomply.com.

3. Interview with Lisa Dahm, JD, Deloitte & Touche LLP; Houston, TX, August 1, 2000.

Bonnie Cassidy, MPA, FHIMSS, RHIA, is a principal with the North Highland Company, Atlanta, GA.

Blessing In Disguise for HC Providers

HIPAA Offers $62 Billion in Savings

Through Elimination of Paper Record

For those healthcare providers who are courageous in the brave new world of the Health Information Portability and Accountability Act (HIPAA) there is a huge - and overlooked - economic windfall. While the hype has been centered around the electronic data interchange (EDI), the real money comes from taking advantage of electronic medical records technologies - estimated at over $62 billion.

Conversion from paper to electronic medical records will save over twice as much as the final and complete conversion of all paper transactions to EDI - $62 billion versus $28 billion. Electronic storage of records emancipates providers from the tyranny of being legally forced to maintain an ever expanding and expensive historical archive of paper records.

U.S. hospitals and doctors maintain paper medical records, which spreads out and rises - Mt. Everest like - into a 36 cubic mile mass. Viewed another way, paper medical records stored by providers could cover all of the State of Delaware and 58% of the State of Rhode Island. In a little noticed provision Effect on State Law (Title II, Subtitle F, Part C, Sec. 1178 (a) General Effect, Subsection (1) General Rule, Subsection (2) Exceptions) HIPAA frees providers from the shackles imposed by archiving seven years of hardcopy historical medical records. The effect on state law mandates electronic records have equals standing with paper records and supercedes existing state law. The import of this regulation is that all paper medical records can - and should be - immediately converted into electronic records.

The costs (and trials and tribulations) of converting paper to electronic image is no longer a reason for providers not to take action. Conversion is no longer the arduous undertaking requiring the Heads down data entry of huge quantities of paper records.

Conversion today is easy, fast and inexpensive. It involves the electronic scanning of documents into a database and costs between 1.5 and 3 cents per page. The result is electronically stored, indexed, retrievable and can be remotely printed. The paper document management nightmare will disappear as it enables the integration of physician and hospital records, reduces record loss, improves record retrieval, and provides a unified audit trail.

Reduces Exposure to HCFA Compliance Penalties

Through the HIPAA legislation, HCFA has at its disposal $1 billion a year to spend on its fraud and abuse control program. The power of this funding initiative will put healthcare providers even more at risk for sloppy documentation and document management controls and processes. The economic carrot and this risk management stick provides an urgency for adopting imaging technologies generally acknowledged to also improve patient care. Seldom have economics, sound clinical documentation, and ethics been so well aligned in healthcare.

The MIP (Medicare Integrity Program) is the core of the HIPAA fraud and abuse program (covered in Title II; Subtitle A; Sections 201 and 202) using between 58-64% of all funds allocated. Adoption of EMR technology will not only significantly lower the risk and hassle of Medicare audit but will contribute to the management of an IRS audit and control malpractice risk.

HCFA’s emphasis on automated fraud control will not uickly go away or easily be forgotten. It is being driven by a claims review rate that has fallen steadily since 1989 as total Medicare claims have climbed to the current annual volume of over 800 million.

As It That Weren't Enough -

Eligibility and Lost Co-Pays - $5.4 Billion In Savings HIPAA also holds out the offer of $5.4 billion in savings through reduced eligibility error and lost co-pays. Hospitals suffer an average bad debt loss averaging 5.3%. Most of this stems from eligibility error. Automation of eligibility verification offers lower operating costs and reduction of bad debt dollars. With full implementation of HIPAA and integration of real-time credit card Point-Of-Service (POS) terminals into patient registration lost co-pays will be a problem of the past.

HIPAA IN PERSPECTIVE

HIPAA is real. HIPAA is not a rerun of the great Y2K hype and fizzle. It's as real as Erisa and the Federal Reserve Act and may be every bit as important in both the short and long term. HIPAA is the second of two pieces of legislation designed to preserve Medicare. The first was TEFRA which introduced the concept of value based reimbursement. HIPAA is directed toward simplifying healthcare administration, rooting out all Medicare fraud, and most importantly establishes the Federal bureaucracy (e.g., DHHS/HCFA) as the regulators of electronic commerce in healthcare. By the end of 2003 the federal bureaucracy will be annually administering 10.5 billion electronic healthcare transactions.

EDI has gotten the most publicity and still offers significant opportunities for those providers who have been slow to take advantage. Implementation will be mandated throughout healthcare by October 16, 2003 according to the compliance schedule announced in DHHS's (Department of Health and Human Services) final rule on Standard Electronic Transactions.

Small healthplans, those with 50 or less members were granted a one-year extension. Providers are facing a more rapid compliance schedule with full compliance due by October 16, 2002. With so short a fuse, its important they understand their compliance date is only two and 1/6 years away.

HIPAA is full of risks and opportunities. It is the first giant step of healthcare down the same road that led to nationwide chains of networked ATMs and Internet banking. By 2020 providers and payers will be unable to imagine a world where seamless electronic healthcare wasn’t the norm and where a patient record was not available anywhere in an emergency.

By Richard Kadas - Accelerated Receivables Management

PUBLIC RELATIONS TEAM REPORT

By Audrey Brooks, Meridian Healthcare Staffing

The Public Relations committee has been busy coordinating activities for our chapter. We encourage members to participate!

? CALLING ALL CFOs ... Last quarter letters were mailed to all Georgia Hospital CFO's asking for their input and comments about participation in HFMA. So far the response has not been too good. So, if you are one of those who received the letter and have not responded, we need and value your input!!!

? SPECIAL OLYMPICS ... Georgia HFMA members are being sought to volunteer at the Special Olympics. So look for more information in future publications.

? GHA CONVENTION ... HFMA was represented by several Public Relations Team members at the GHA convention on January 8-10.

? MEDICARE EDUCATION ... HFMA and BCBS are working together to present an update for seniors around the state to bring them up to date on changes in their coverage. This was a huge success last year.

? HABITAT FOR HUMANITY: It was proposed at Savannah that HFMA become involved in Habitat for Humanity as a memorial to Dwight Sims. Unfortunately, at press time confirmed dates and exact locations were not available. However, here is the current plan. There will be two sites: North Fulton County and Coweta County (where friends, family and co-workers of Dwight can participate). EVERYONE is encouraged to participate, either by donating their time to build a house or money for the supplies. Several Saturday dates in February and March have been reuested. A vendor is willing to donate T-shirts for all members who participate. Look for more information and sign up sheets at the Winter Institute, on the web site and the hot line. This is a wonderful opportunity for everyone to participate in Dwight's memory and help our communities. So get ready!!!