InsiviaInsivia

By NCDS

HBMA RCM Advisor Q3 2019 – President’s Message

Navigating the Evolving Topic of Business Intelligence

As I began in the medical billing field, some of the highest “business intelligence” needed was simply convincing healthcare providers they should change from their antiquated internal system of pegboard accounting and ledger cards to using a billing company that could computerize and organize all their accounts. A no-brainer!

Now, a Google search of “business intelligence for medical billing” brings up pages of listings of articles, information, and vendors. That is a bit of brain overload.

So, how do we as medical business professionals navigate such a hot, intense, evolving topic such as this? You look to your partners at HBMA for support. One of the greatest benefits of being a member of HBMA are the resources provided through our vendor community. Our association offers a central point for members to seek out established, qualified vendors to enhance our own service offerings, improve our operations, and even deliver education to help us gain better understanding of what we need to know to make sound business decision. The use of business intelligence (BI) in our industry was completely new just a few years ago, and now many companies have integrated BI into their daily operations to improve efficiencies, enhance reporting, and learn from real-time data analytics.

In this edition of RCM Advisor, you will find a host of articles contributed to help us better understand what business intelligence is and how we can use it in our businesses today. You will also find many of the authors of these articles will be presenting at our HBMA 2019: The Healthcare Revenue Cycle Conference, Sept. 12-14, 2019, in Las Vegas, Nevada. Please take time now to explore these articles and sign up for our fall conference to learn more about business intelligence, along with a host of other subjects of interest and impact in our industry.

The expert authors that contribute to these articles explain the growing need for information in our business, not just data, but information organized in a meaningful way for your company and your clients. That is BI, getting information and analysis that you can use to make critical decisions. You will find great details on what BI can do and how it does it in the articles “Creating Healthcare Innovation With Data” on page 19 and “Beating Competitors With Analytics” on page 24, along with a variety of other exciting topics in the rest of our quarterly publication.

– Mick Polo, CHBME, HBMA President
mickp@ncdsinc.com

By NCDS

HBMA RCM Advisor Q2 2019 – President’s Message


 Staying on Top of

Compliance

Our medical billing and revenue cycle management industry is evolving continually. Our companies must be adding expertise, implementing more technology, generating new ideas, and finding operational efficiencies to keep up with competition, pricing pressure, and ever growing client needs and demands. In such an intense environment, it is easy to lose track of the details. It is also often difficult to distinguish our services from those.

However, one significant factor that can set our companies apart and show we have moved beyond “billing” into our new world of RCM and more is the level of compliance and security that we have solidified in our daily processes, as well as our overall corporate philosophy and approach. Recognizing this, I engaged with our HMBA vendor partner, the Healthcare Compliance Pros, to embark on the journey to achieve the HBMA Compliance Accreditation. My initial evaluation showed the per FTE model to be a cost-effective way to move into full compliance while keeping my budget tight and internal team focused on daily billing responsibilities for our clients.

To this point, in my own company’s compliance efforts, we had developed and implemented a comprehensive compliance plan as well as maintained an active compliance committee for monitoring internal activities and keeping updated on official requirements. However, with the speed of business these days, my concern was not with the strength of our efforts but rather in the information overload that was occurring trying to stay abreast of current regulations or what exposure we may have to risks that we were not even aware existed. As a small- to mid-size RCM company, I was also concerned that regularly scheduled committee meetings, formal minutes, and follow-up tasks could get overlooked in light of prioritizing everyday revenue- generating work. Compliance is not a place where today’s RCM company can afford to relax their standards.

Working through the accreditation process has been simple and effective. It is a self-paced, staged, gradual, and customized process. I was relieved to learn that all our existing compliance information could be incorporated into the HCP platform, so all our efforts to this point were not in vain and all our prior records were retained. We have continued to progress through the list of requirements with the assistance of helpful HCP representatives for training, questions and answers, and periodic check-ins to keep us moving forward. Regular reminders are emailed as needed monthly and/or quarterly to keep compliance information up to date and recurring events on the schedule. As we progress with completing each accreditation standard, we receive additional reminders to keep them on track so the program builds on itself and you can continue to meet HIPAA and OIG essentials to maintain the proper level of compliance.

In a recent HBMA Snap Survey, we found that 64 percent of members who responded provide compliance training for clients. The HBMA Compliance Accreditation program is a great way to add credibility and validity to these services, as well as provide clients with more comprehensive assistance. Additionally, 71 percent of respondents provide coding compliance to clients. Included in the HCP package is the ability to ask questions and get advice and consulting to avoid other outside costs, legal fees, etc. while providing these expanded business services to clients.  And without surveying, it is fair to say that 100 percent of our companies cannot afford the risks associated with a compliance violation, both financially or to our corporate reputations. I encourage all of you to explore the HBMA Compliance Accreditation program, a great member value. Several members are already completing and being awarded the accreditation seal and certificate and, as a result, are achieving a higher level within the RCM community.

How well does your compliance program measure up? Begin the HBMA Compliance Accreditation process and find out. Already involved? What stories do you have to share about the accreditation process? HBMA wants your feedback.

– Mick Polo, CHBME, HBMA President
mickp@ncdsinc.com

HBMA RCM Advisor Q3 2019 – President’s Message
HBMA RCM Advisor Q2 2019 – President’s Message
HBMA RCM Advisor Q1 2019 – President’s Message