Investor Presentation - Statesman Resources Ltd

HFMA Utah Chapter, Vital Signs, Winter 2014

HFMA Utah Chapter, Vital Signs, Winter 2014

Upcoming

Events

HFMA/AAHAM

Alliance Meeting

March 12-14

St. George

Meeting/Officer Installa-

tion/Golf Tournament

May 16

River Oak Golf Course

Inside this issue:

President’s Message

President’s Message 1-2

Save the Dates 3

Outpatient Medical Necessi-ty: Minimizing Exposure to Financial, Compliance and Audit Risks

4-5

HFMA/AAHAM Alliance

Meeting Advertisement

6

Website Update 7

Medical Necessity—Will

ICD-10 Specificity Result

in Increased Denials?

8-10

Member-Get-A-Member 11

New Members & New

Member Spotlights

12

Board Member Spotlight 13

Chapter Officers 14

Sponsors 15-16

State of the Chapter

I recently watched the State of the Union address by the President of the United States

and I thought it would be appropriate to discuss the State of the Chapter. In my first arti-

cle, I discussed my desire for the chapter to receive the HFMA Shelton award, which rec-

ognized the highest performing chapter, within the next five years. I also outlined things

our chapter needs to do to be considered for the award. Since I am half way through my

year as chapter president, I wanted to reflect on the work that has been done and what

still needs to be completed.

Member Satisfaction Survey

Late last year, HFMA sent out a survey asking members to rate their chapter perfor-

mance. The anonymous results indicate that 60% of our members are highly satisfied

with the chapter. While I am very pleased with the chapter satisfaction and survey partici-

pation rates, I know that we can continue to improve. The Chapter Board is reviewing the

results and will continue to do whatever it takes to meet your needs and improve the

chapter.

Chapter Vision

Improve chapter educational seminars

Since September 2013, the chapter has had three successful and well-attended educa-

tional seminars. One of the objectives of the chapter is to provide educational opportuni-

ties for its members so they can understand the challenges and changes going on in the

industry. Our chapter education goal was to provide 14.0 hours of education per mem-

ber. The chapter is currently on pace to hit this goal with the two remaining educational

seminars in March (St. George) and May (Salt Lake City). The Program committee is also

making sure that specific educational topics identified in the chapter satisfaction survey

are covered in future seminars. If there are any additional educational topics that you

would like to be addressed in the educational seminars, please contact Chris Coccimiglio,

the President-elect and Program Chair.

(Cont’d on next page)

Announcements:

If you have any contribu-

tions to the newsletter, please contact

McCall Rowley at [email protected].

HFMA Utah Chapter, Vital Signs, Winter 2014 Page 2

President’s Message cont’d

Increase sponsorship dollars

Sponsorship dollars allow the chapter to offer educational seminars at discounted rates, bring in higher quality speakers,

provide free certification trainings (i.e certification practicum), and to reimburse members for certification exam fees if

they pass the exam. For 2014, our Chapter Board is striving to attain $30,000 in sponsorships, which is significantly

higher than previous years. We are currently short of our goal, but we will continue to work hard so that we can hit our

goal. If you are aware of any organizations that would be interested in supporting our chapter, please contact Brian

Ebright, the Sponsorship Chair.

Increase certified members

The Utah chapter currently only has 8 certified members. To increase this number, the chapter partnered with the other

Region 10 chapters to offer a free certification practicum, which helps participants prepare to take the certification exam.

Our chapter had 7 members, including myself, commit to complete the practicum and take the certification exam by June

1. The commitment of these members will significantly help us increase the number of certified members.

Increase the number of members that volunteer

The chapter leadership team is constantly looking for members to help with the program, membership, sponsorship, certi-

fication, and newsletter committees. Earlier this year, I sent out an email asking for members to serve on these commit-

tees. A number of members stepped up to the plate and have sacrificed some of their time to serve. Even with the addi-

tional support, our chapter could still use additional help. If you are interested in helping out, please let me know.

Increase the number of chapter members

This year the Chapter Board wanted to increase chapter membership to

185. Since we have already reached this mark, I would like to add another

15 member by the end of May. If you know anyone who currently is a mem-

ber and should be, please contact Michele Ebright, the Membership Chair.

Develop chapter leadership succession plan

Successful organizations develop and implement leadership succession

plans. Even though the chapter has had great leaders throughout the years,

we need to continue to identify and develop the next generation of leaders.

The Chapter Board is currently developing a succession plan and identifying

potential leadership candidates from every healthcare system and vendor

organization in the state. If you are interested in becoming a chapter lead-

er, please let me know.

As you can see, the chapter is doing well, but we still need to do more. With

your help, we can continue to improve our chapter and receive the Shelton

award. Thank you for all of your help and support.

Thanks,

Chris Bruerton


Save the Dates for Upcoming Events!

Page 4 HFMA Utah Chapter, Vital Signs, Winter 2014

Outpatient Medical Necessity: Minimizing Exposure to Financial, Compliance and Audit Risks

By Mary Guarino, VP, Product Management, Craneware InSight

Medical necessity and prior authorization are two of the leading reasons payors deny claims, but these denials can often be prevented by im-proving training and communication between physicians and the revenue cycle team. Ensuring services are medically necessary is not simple. National coverage determinations (NCDs) and local coverage determinations (LCDs) change frequently, which makes matching related CPT/HCPCS codes and ICD-9 codes especially challenging. In fact, the overwhelming majority of medical necessity denials are caused by ICD-9 codes that don’t match procedural CPT codes. With CMS and payors converting to ICD-10, this process will become even more complicated. Healthcare organizations should be prepared to handle additional medi-cal necessity denials and address ICD-10 requirements to support both medical ne-cessity and prior authorization requirements. Validating medical necessity at the time services are ordered is the best defense for reducing medical necessity denials and ensuring compliance with Advance Benefi-ciary Notice (ABN) requirements for Medicare as well as requirements for commer-cial Notice of Non-Coverage. Medical necessity software allows healthcare organiza-tions to determine, in real time, whether diagnoses support the medical necessity of the procedures ordered, if the service requires prior authorization and evaluate any clinical criteria. Flagging services with medical necessity issues before the services

are rendered ensures accuracy of coding and compliance with ABN guidelines. Medical neces-sity software also helps structure communica-tion and supports the education of physicians, clinical staff and the revenue cycle team on cur-rent medical necessity rules and payor require-ments.


Outpatient Medical Necessity: Minimizing Exposure to Financial, Compliance and Audit Risks (cont’d)

By Mary Guarino, VP, Product Management, Craneware InSight

To evaluate the effectiveness of medical necessity software, consider the following: Are LCD/Medical Necessity requirements maintained for your Regional

Medicare Administrative Contractor (MAC) for both Part A and B, national coverage determinations (NCDs) and commercial payors?

Do the LCDs contain not only CPT to ICD-9 verification, but also check for frequency, gender and age criteria as well as primary and secondary di-agnosis coding?

Is coding available for LCDs that have a probability for future RAC medical necessity audits?

Are qualified individuals reading and interpreting difficult LCDs to ensure accurate results?

Are prior authorization warnings available for all payors?

Are Medicare Advantage plans being properly evaluated based on the payer’s requirements?

Are there tools to handle your state Medicaid rules and those of Medicaid managed care replacements?

Are CMS and payer websites monitored weekly to ensure the latest policy updates?

Is direct access provided to view current policies to validate services?

Are ABNs or notice of non-coverage issued before providing services that do not meet “medical necessity” guidelines?

Is there a review of payor medical necessity denials to create front-end warnings?

When will your solution be ICD-10 ready and is there an associated cost?

Also with the changing regulatory environment, these questions should not be overlooked: What impact does the Affordable Care Act have on your payer population and medical necessity/ prior

authorization requirements?

What is your payer population of uninsured that may be shifting to Medicaid or new commercial payers?

Does your facility have a well-defined ICD-10 implementation plan including training for physicians and the revenue cycle staff?

Up-front monitoring of all medical necessity and prior-authorization policies issued by CMS, Medicare contractors and commercial payors is fundamental to ensuring total earnings are not at risk and that healthcare organizations are not exposed to post-payment audits and po-tential compliance issues. The proper medical necessity tools and processes can assist healthcare organizations as they establish and sustain revenue integrity, including mitigating compliance risks, improving staff efficiency and ensuring reimbursement for services ren-dered. Mary Guarino, Vice President of Product Management at Craneware Insight, has more than

25 years of professional healthcare experience. Her expertise includes revenue cycle man-

agement, product development, medical necessity, managed care contracting, physician

practice management and an extensive knowledge of Medicare regulations. Mary is an active

member of HFMA and is a speaker at state and regional conferences on best practices for

reducing medical necessity denials.


Healthcare Alliance Seminar Details

Healthcare Alliance Seminar March 12th-14th, 2014

Best Western Plus Abbey Inn & Conference Center 1129 South Bluff Street, St. George, Utah 84770

Members: $169.00 until March 1, $199.00 after March 1

Non-members: $199.00 until March 1, $219.00 after March 1 Golf Tournament: $30.00/9 holes – Coral Canyon GC March 12th, 12PM

Lunch Included for Golf 10.8 CPE hours (HFMA)

Save the Date and Register Today on our website!!!! http://hfma-ut.org/?page_id=28

We have a great group of speakers coming from across the country including:

Lisa Goren, Legacy Health

Doug Barry, Vice Pres, Bon Secours Charity

National AAHAM Speaker, Legislative Update

Matt Graham, Leavitt Partners

And many more to come!!!

Including a Payor Panel to discuss Healthcare Reform and changes still coming

(Altius, Select Health, University of Utah, United, Cigna, BCBS)

HOTEL ACCOMODATIONS

Please make your hotel reservations by contacting the Best Western Plus Abbey Inn & Conference Center.

Best Western Plus Abbey Inn & Conference Center 1129 South Bluff Street St. George, Utah 84770 Toll Free 888-222-3946 Local 435-652-1234 https://reservations.bwabbeyinn.com/

There is a group rate of $93.00 per night*.

* Guests must identify themselves using Utah Healthcare Alliance group when making the reservation.

http://hfma-ut.org/?page_id=28

https://reservations.bwabbeyinn.com/

Announcements:

If you have any

contributions to

the newsletter,

please contact

McCall Rowley at [email protected].


Utah HFMA Chapter Website

Utah HFMA Chapter Website

We have listened to your comments and feedback!!!

Please check out the revised site at http://hfma-ut.org/.

A big THANK YOU

to Chris Coccimiglio

and Dave Coccimiglio

for spending time to

revise and update the

website!!

If you have comments or

feedback on the revised

website, please contact

Chris Coccimiglio at

[email protected].

The Utah HFMA chapter website has been updated to provide better information to you, our chapter members.

Medical Necessity—Will ICD-10 Specificity Result in Increased Denials? By Linda J. Corley, Vice President—Compliance, HIM Consulting and Coding Services Xtend Healthcare


Medical Necessity—Will ICD-10 Specificity Result in Increased Denials? (cont’d) By Linda J. Corley, Vice President—Compliance, HIM Consulting and Coding Services Xtend Healthcare

Page 9 HFMA Utah Chapter, Vital Signs, Fall 2013

Medical Necessity—Will ICD-10 Specificity Result in Increased Denials? (cont’d) By Linda J. Corley, Vice President—Compliance, HIM Consulting and Coding Services Xtend Healthcare

Page 10 HFMA Utah Chapter, Vital Signs, Fall 2013


Member-Get-A-Member Program

MEMBER-GET-A-MEMBER PROGRAM

HFMA members are leading the change in the healthcare finance industry. Help build the momentum. Invite your peers, your staff, and others in

your organization to join the nation's leading membership organization for healthcare financial management executives and leaders—HFMA.

Recruit new HFMA members and you could win:

HFMA apparel item, duffel bag, or smartphone accessory

$25, $100 or $150 Visa Prepaid Cards

Cash prizes of $1,000 or $2,500

Apple iPad Mini

Grand Prize of $5,000*


New Members and New Member

Spotlights

New Members James Croxford—Senior Staff Accountant, Air Medical Resource Group

Connie Privett—Staff Accountant/AP Supervisor, Air Medical Resource Group

Michael Bennett—Director Revenue Integrity, University of Utah Health Care and John Bainbridge

Sandy Drollinger—Associate Director of Accounting and Finance, University of Utah Health Care

Debra Clough—Regional CBO Director, Iasis Healthcare and Dave Coccimiglio—Operations Manager, Link Debt Recovery

Carrie Jacobs—Consultant, Prezio Health and Justin Demers—Revenue Cycle Director, Accretive Health

Christine Boren—Budget Supervisor, Intermountain Healthcare and Philip Magdziarz—Sales, Collection Center INC

Suzanne Shepherd, Revenue Cycle Executive at Cerner, transferred into our Chapter from the St. Louis Chapter.

New Member Spotlights Michael Bennett

Company I work for: University of Utah Healthcare Job Title: Director of Revenue Integrity Department I work in: Patient Financial Services

Educational background: MBA/MHA – University of Washington Bachelor of Science – Mathematics, University of Utah

My family includes: My wife, son – 4 , daughter – 2.5 The best part of my job is: The challenge of working with a lot of data.

If I'm not at work, you'll find me… playing/watching sports, reading a book Pets: 2 yr old Cockapoo

Hobbies: Woodworking, music (piano, guitar) My favorite food is: Rolls

My proudest moment was: The birth of my kids The best advice I ever received: Find a passion for what you do.

I joined HFMA because: Continued networking and additional learning A person may be surprised to know that: I love opera music.

Dave Coccimiglio Company I work for: Link Debt Recovery Job Title: Sales Mgr

Educational background: BS Economics from UofU

My family includes: 10 Daughter won the 4th grade spelling bee, 8 Son, master lego builder, 5 Daughter, who pretends to be asleep every time I

walk in the house (she thinks it’s the cleverest thing, it makes me laugh every time), 10 mo old Daughter, who has skipped crawling and is go-

ing straight to walking.

The best part of my job is: The challenge of improving on systems for better results.

If I'm not at work, you'll find me…Playing with my family. Hobbies: Raising a family My favorite food is: Sushi

My proudest moment was: Joining the HFMA, and to be fair experiencing successes my children have.

The best advice I ever received: Don’t sweat the small stuff, and it’s pretty much all small stuff.

I joined HFMA because: I want to learn about the industry and be more involved.

A person may be surprised to know that: I am older, BUT less bald than my brother Chris.

HFMA Utah Chapter, Vital Signs, Fall 2013 Page 13

Board Member Spotlight

Meet...

Chris Coccimgilio

President Elect/Program

Chair

Job/Department/Company I work for: Link Debt Recovery

Education: BAA in Business Management and Marketing, University of Utah

What I like most about my Job: I love the opportunity to meet a variety of clients with different needs and challenges.

What I like least about my Job: Managing Employees :)

How long I have been in Healthcare: 9 years

When I joined HFMA: January 2005

Other Chapters I have belonged to and/or Board positions filled in other Chap-

ters: None

My position on the Utah Chapter Board and Why I enjoy being on the Board:

President-Elect, I love working with the different people on the committees and boards to help make the Utah chapter better and

better each year

Personally about me – I have a twin brother

My family includes: My wife Breanne and two children Chloe and Charlie, with a new baby girl on the way :)

My Hobbies include: Tennis, Soccer, Softball, puzzles


President

Christopher S. Bruerton

[email protected] (801) 442-3315

President-Elect/Program Chair

Chris Coccimiglio


Secretary /Program Co-Chair

Shauna Wardrop


Treasurer

Jennifer Muhlestein [email protected]

801-587-2827

Past Chapter President

Jared J. Spackman

[email protected]

2013-14 Utah Chapter Officers

& Board of Directors

Director (Newsletter Chair) McCall Rowley

[email protected]

Director (Membership Chair)

Michele Ebright

[email protected]

Director (Founders Contact) Dan Orton

[email protected]

Director (Certification Contact)

Zandra Anderson [email protected]

Director (Sponsorships Chair) Brian Ebright

[email protected]

Link Chair

Douglas M. Smith

[email protected]


2014 Utah Chapter HFMA Sponsors

Platinum Level Sponsors - $3,000 Annually


2013 Utah Chapter HFMA Sponsors - Continued

Gold Level Sponsors - $2,000 Annually

Silver Level Sponsors - $1,000 Annually

Bronze Level Sponsors - $500 Annually

2014 Utah Chapter HFMA Sponsors cont’d

Documents

Investor Presentation - Statesman Resources Ltd