underway for additional ses-sions—watch for more info to come. The Carolina Chapter will also be conducting nominations and elections this fall for its 2008-2009 Officers. Our Chapter has many good opportunities for members to participate on the Board by running for an office or participating on a committee. Please consider being a larger part of Carolina AAHAM. I would like to thank our Cor-porate Partners for their contin-ual support of the Carolina AAHAM Chapter. We are truly grateful for the support and dedication that our Partners provide. Without them, many things would not be possible. Best regards, Lori Sickelbaugh Carolina AAHAM President

Greetings everyone! I hope that you enjoy this issue of “The Carolina Communica-tor”. Providing this publication has been a group effort, and I’m so pleased to be able to send you this outstanding prod-uct. A BIG “Thank you” to those that assisted in getting this newsletter off the ground, especially Bree Stokes and Amy Anderson!! So many things are taking place in our Carolina AAHAM Chap-ter. We had a great meeting this past May in Asheville and are busy with planning for fu-ture events. In this edition, you will find details of a one-day meeting that will be held No-vember 8th in High Point, NC. The agenda is very strong and timely. The dates and location have been set for the 2008 An-nual Meeting. The Education Committee is actively working on speakers and planning for this event that will be held at the Koury Convention Center

in Greensboro, NC, from April 30-May 2, 2008. I hope that you will join us at these worth-while events. Continue to check our Chapter website at

www.aaham.org for “Event” updates and registration details. The Certification Committee has also been busy with orga-nizing and conducting study sessions for both the Technical and Professional Certification exams. It is wonderful to see a strong interest again in AA-HAM certification. This was a well received session at our May meeting and plans are

President

Lori Sickelbaugh

First Vice President

Steve Duncan

Second Vice President

Becky Grover

Secretary

Treasurer

Geoff Miller

Presidents Message

I N S I D E T H I S I S S U E :

Corporate Sponsors

2

Upcoming Events 3

Certification 6-7

Lessons from Two Sides of the Fence

8-9

Hiring Collections Services

10-11

Charity Care Issue

14-15

Annual Fall Seminar Agenda

19

Board Members

B E C O M E A M E M B E R

T O D A Y !

CAROLINA COMMUNICATOR

F A L L 2 0 0 7

P A G E 2

Thanks to all of

our 2007

Corporate

Sponsors for their

continued support

of AAHAM.

Corporate Sponsors 2007

Contact Becky Grover for more

information of how to become a

Corporate Sponsor

(704) 943-3393

C A R O L I N A C O M M U N I C A T O R

Company Name Website Address Contact Person AHC Healthcare Receivables Management

www.ahcinc.com Barry Bierman bbierman@ahcinc.com 561-289-7573

AllianceOne www.AllianceOneInc.com Tim Oconnor Tim.Oconnor@AllianceOneInc.com 336-712-9770

AMCOL Systems, Inc

www.amcolsystems.com

Jay Rickman, Jr. Jay.Rickman@amcolsystems.com 803-217-3831

CBCS, Inc www.cbcsnational.com Elizabeth Price eprice@cbcsnational.com 614-223-0613

Mosaic Revenue Solutions

www.mosaicrevenue.com

Steve Ford sford@mosaicrevenue.com 800-563-4807 x354

FirstPoint Collec-tion Resources

www.firstpointresources.com

Steve Duncan sduncan@firstpointresources.com 800-678-4580 x3350

HRA/AccessOne www.hrainc.com Bill Peters bpeters@hrainc.com 704-941-6101

Jon Barry& Asso-ciates, Inc

www.jbarry.com

Brylan Gann bgann@jbarry.com 800-264-0384

ONLINE Collections

www.ONLINECollections.com Bree Stokes Bree@ONLINECollections.com 252-757-2113

PMAB,LLC www.pmab2.com Ruthie Waters rwaters@pmab.com 704-779-0827

Professional Recovery Consultants

www.prorecovery.com Geoff Miller gmiller@prorecoveryinc.com 919-489-7791

Redsolve, Inc www.redsolve.com Dr. Charlie Annunziata drcharlie@redsolve.com 888-387-1161 x707

SCA Collections, Inc

www.scacollections.com Dan Nichols dnichols@scacollections.com 800-334-7713x201

TPL Company LLC

No website Beth Graves beth.graves@tplcompany.com 888-875-1346x201 615-473-1378 cell

Upcoming Events P A G E 3

November 8, 2007—Election Re-sults to be announced.

November 8, 2007—Revenue Cycle Excellence Location: Millis Regional Health Education Center High Point, North Carolina Topic: Patient Access and Denials Management April 30, 2008—2008 Annual Meeting Dates: April 30—May 2, 2008 Location: Koury Convention Center Greensboro, North Carolina Topic: More details to follow

New Members

NC AAHAM Welcomes our Newest Supporters

______________________________________________ Anita Bennett, Maria Parham Medical Center Cathy Boyette, Johnston Memorial Hospital Patricia Foster, Maria Parham Medical Center Angela Gardner, Access One Med Card Eric Green, Duke University Health System Terry Hancock, Northern Hospital of Surry County Susan Hollifield, Spruce Pine Community Hospital Angie Hutchins, Interstate Credit Collections Consandra Price, Medical University of SC Tammy Prince, Duke University Health System Graham Self , Systemware, Inc. Kathleen Sigler, Spruce Pine Community Hospital Coletta Small, Maria Parham Medical Center Elizabeth Staas, Advanced Patient Advocacy, LLC Bree Stokes, ONLINE Collections Kim Walsh, Duke University Health System

Join the Carolina Chapter of AAHAM today!

Don’t forget to VOTE and support those that lead our

Chapter towards excellence!

Don’t miss out on this wonderful opportunity!

P A G E 4

G E T I N V O L V E D

I N T H E C A R O L I N A

C H A P T E R O F A A H A M T O D A Y !

AAHAM needs support and involvement from

members.

Annual Spring Conference 2007

The Annual Spring Conference was an exquisite celebration of the many years of hard work and dedication to ever-improving the educational level of our North Carolina Chapter members. The “Taking your Revenue Cycle to New Heights” approach for the 2007 Annual Spring Conference was truly successful. On behalf of the North Carolina Chapter members we would like to extend our appreciation to those that shared in the education of the attendees. Special Appreciation goes to Amelia Bryant, Neal Smith, Denise Fetters, and Day Egusquiza. The CCAM and CPAM certification study sessions were also a success, thanks to all those who helped in making the sessions a hit!

C O N T A C T T H E

S U P E R V I S I N G

O F F I C E R O R

C O M M I T T E E

C H A I R P E R S O N T O

B E C O M E

I N V O L V E D .

C A R O L I N A C O M M U N I C A T O R

P A G E 5

“Understanding your needs, surpassing your expectations.” The AllianceOne Healthcare Services Division is a leading provider of quality financial services to healthcare providers and institutions nation-wide. We offer comprehensive revenue cycle management and support services, including: ▪ Eligibility ▪ Interim Staffing ▪ Project Staffing ▪ Medical Record Coding ▪ HIM Support ▪ EBO Services ▪ Early Out to Bad Debt Collections ▪ Revenue Cycle Assessments & Audits Our people understand the challenges faced by the ever-changing healthcare industry. We focus on supporting our clients with both personnel and systems solutions that deliver positive results and value enhanced services. Tim O’Connor V.P. Sales. Healthcare Services Division (336) 712-9770 Tim.Oconnor@allianceoneinc.com

Certification Update Congratulations to those individuals who have recently passed the Technical Certifica-tion exam! For more than 25 years, AAHAM certifications have defined new levels of professionalism in the health-care administrative field. AAHAM’s certification pro-grams are widely recognized in the industry and not only help keep you in pace with the in-dustry but also help you gain recognition from employers and others in the industry. Certification promotes personal challenge and satisfaction, and in many instances can get you the job or promotion you really want.

Educating Staff and Management In our industry, educating staff and management teams is im-perative to our success. But how do we continue to provide quality education and learning opportunities with limited monetary resources available to us? And equally important is how do we document the edu-cation, and knowledge levels of our staff? AAHAM’s certifica-tion programs can be the solu-tion to these concerns and can be tailored to fit any PFS of-fice. In North Carolina, several PFS offices have made certifi-cation a requirement for career advancement and/or as a part of their compensation package or bonus structure.

Technical Certification There are three different op-tions available for Technical Certification. Certified Clinic Account Technician (CCAT), Certified Patient Account Technician (CPAT) and Certi-fied Compliance Technician (CCT). In addition, AAHAM offers a Dual CPAT/CCAT Certification. Each exam is designed to indicate a compre-hensive body of technical knowledge in those respective areas. Listed below is the subject matter covered on each exam:

CCAT CPAT CCT

Acronyms Advance directives Annual Medicare deducti-bles Bad debt Bankruptcy Chapters CMS 1500 (a.k.a. HCFA 1500) claim form and fields usage Coding formats (HCPCS, CPT, ICD-9-CM) Collections Coordination of Benefits Credit reporting E/M coding basics ESRD RBRVS basics Registration functions Timely filing requirements Treatment consents UPIN Utilization Review

Acronyms Admission functions Advance directives Annual Medicare de-ductibles Bad debt Bankruptcy Chapters CMS 1450 (a.k.a. HCFA 1450 or UB-92) claim form and form locator usage Coding formats (HCPCS, CPT, ICD-9-CM) Collections Coordination of Bene-fits Credit reporting DRG basics (IPPS) DRG window EMTALA Payment methodolo-

Acronyms Anti-kickback legislation Civil Monetary Penalties Civil Rights Act Compliance plan compo-nents Corporate Integrity Agree-ment Federal Regulatory Agen-cies Investigations Non-compliance fines Reporting Safe harbors Self-disclosure protocols

P A G E 6

“AAHAM’s

certification

programs are

widely recognized

in the industry…”

Get the job promotion

that you really want.

C A R O L I N A C O M M U N I C A T O R

P A G E 7

“Our special thanks to

Linda McLaughlin

of the VA Chapter who

conducted the interactive

study session which was a

big success.”

Ask about being certified today!

C A R O L I N A C O M M U N I C A T O R

Did you know... Technical Certification …you do not have to be a member of AAHAM to sit for the technical exam. …the technical exam can be taken at your own location at a time conven-ient to you. All you need is PC with internet connec-tivity and a proctor! …technical exams are of-fered 4 times a year - in February, May, August and November

…the exam fee ($75) INCLUDES a comprehen-sive study guide available for printing online – a great PFS resource! …technical certification must be renewed every 3 years by retaking and passing the exam OR be-coming an AAHAM mem-ber and earning CEU’s. …exams are graded online and results are known IMMEDIATELY upon

completion.

Did you know... Professional Certification Professional Certification demonstrates a proven in-depth knowledge of all ar-eas of Patient Financial Services, specific areas in-clude patient access (admissions), billing, col-lections and accounts re-ceivable management. The exam is scheduled for 8 hours, and includes multiple choice, short answer, and essay questions. Did you know… …the professional exam is

offered twice a year, on the last Saturday of April and September. …requires National Mem-bership and continuing education requirements must be met. …requires at least four years experience or two years experience plus a two-year degree from a college or university. If you are considering sit-ting for the Professional exam I would encourage you to check out the certifi-

cation page at www.aaham.org. Start talk-ing to other certified mem-bers about the benefits of becoming certified, how to plan for success and obsta-cles and study tips. Talk to your superiors to gain their support guidance. Think about partnering with a friend or colleague to form a “buddy system” for study-ing. There are endless re-sources in our industry that can be used to help you succeed. The learning op-portunity is great and the rewards are many.

The Carolinas Chapter of AAHAM, along with the Virginia Chapter, recently held an or-ganized Professional Certification Study Session in conjunction with our Annual Spring Meeting at the Grove Park Inn on May 2, 2007. Our special thanks to Linda McLaughlin of the VA Chapter who conducted the interactive session which was a big success. We hope to offer more similar sessions in the future. If you are interested in taking the exam or attending a study session or would just like more information, please contact Kevin Young at (336) 277-1208 or ksyoung@novanthealth.org.

Lessons from Two Sides of the Fence P A G E 8

A longtime Director of Nurses for the hospital I spent many years of my career once told me that after she retired she was admitted to the hospital with pneumonia. Her com-ment to me was not until being hos-pitalized with pneumonia that she realized how sick the pneumonia patients she had cared for so many years were. The lesson I have learned from moving to the other side of the fence (the vendor side) is that Patient Financial Service Direc-tors are BUSY PEOPLE!! I truly believe the demands are greater today than they were a few years ago when I made my change. Here are some of the issues that I believe are critical and some practical ad-vice from what worked for me, what still works for Patient Financial Directors, and what I think is critical in the industry today. Customer Service Customer Service should always be at the top of the list. I learned from my father’s experience as a patient at North Carolina Baptist Hospital that exceptional customer service made the difference for my family. It was the little things that made the difference from the admission to paying the cashier in the parking deck. The exceptional customer service made a critical situation much easier. Discussing the ac-count with a knowledgeable team member who made me feel they were my personal Patient Account Representative made the process not only understandable, but expedited the process. Here are my thoughts on Customer Service: ▪ Many of our PFS personnel are

creating the first impression for your institution. Admis-sion Representatives, Preadmission Repre-sentatives, and Schedulers are most always the first con-tact made. If that

initial contact is negative, then the rest of that visit could be negative. The patient most likely will remem-ber that first impression. It is our responsibility to create positive and lasting impressions. Again, it is the little things that you that will make the difference. Compassion and understanding are critical. Many of these people are facing potentially difficult or life altering situations. ▪ Provide continual customer service training and educational opportunities for staff to sharpen their customer service skills. Awards and incentives can also help. I found that staff retreats were one of the best things I could give a staff member. Customer Service Representatives and Patient Account Representatives must be knowledgeable regarding every aspect of the patient account. An understanding of charges and payments is critical. These repre-sentatives must continually be aware of their patient’s needs and rights. Representatives, too, must provide exceptional customer ser-vice. Personally, I believe this is a function that should not be out-sourced. A patient is smart enough to know when they are talking with someone not on site at the hospital. That personal touch is taken away. It is similar to calling for a hotel reservation and talking with some-one in a foreign country. Registration Registration, simply stated, insures the success of the Patient Financial Services Department. These are the folks that make the first impression and gather the information. Poor demographic or insurance informa-tion results in slow or no payments.

It all starts here. Hiring and retain-ing capable Registration Represen-tatives is a challenge for Directors. They are normally the lowest paid in the PFS Department; however, we are asking them to do the most. We expect them to gather good information, work with patients who could be in a very stressful situation involving them or a family member, collect cash up-front, perform the role of a Financial Counselor, be the medical personnel’s personal assis-tant, and provide exceptional cus-tomer service. High turnover is typical in the Registration area. What can we do to make this situa-tion better? Here are some of my thoughts: ▪ Be sensitive in the interview process. Hire people you truly be-lieve can work under stressful situa-tions. Look at the person’s ability to communicate. This is crucial. ▪ Push for higher wages for Reg-istration personnel. At the same time, push for adequate staffing levels. Representatives become overwhelmed and unproductive when too much is placed on them and the results are poor information. We all know what that means. ▪ Provide incentives for staff members in this area. ▪ Research and implement soft-ware that will make the registration process more efficient. (i.e. insur-ance eligibility software) Make sure your Registration area is user friendly and comfortable for the patients.

PFS Directors are busy people.

“Customer

Service should

always be at

the top of the

list.”

Advice from a Former Patient Financial Services Manager Written by: John Cook

Lessons from Two Sides of the Fence cont. P A G E 9

Upfront Collections In order to keep A/R days at a minimum, many hospital and insti-tutions are implementing Upfront Collection initiatives. This is one area in-house that can make a huge impact. It will also educate your community. I highly encourage Directors to make this a priority. A good program involves some steps to insure it will provide the desired results. This is what worked for me: ▪ Develop a policy and proce-dure that you will adhere to. This will also provide a guide for staff members. ▪ It is crucial to have the policy and procedure approved by Admin-istrative personnel and even Board members. Their total support is needed. In many instances, this is a new program and may generate complaints to Administration or Board members. ▪ Train your staff to ask for the right information and how to ask for money. I have found an outside trainer works well in this situation and that it can actually be fun. Make it enjoyable for your staff. ▪ Involve everyone who is af-fected by this in the implementation process. For example, you need the support of clinical staff. The last thing you want is an ER nurse ad-vising the patient not to worry about the hospital bill. ▪ It is how you ask for the money that produces results. If you ask a patient if they are going to pay today there answer most likely will be no. Never give the patient and opportunity to say no. If you ask the patient if they would like to pay today, again their answer will most likely be no. Instead, ask the patient how they will be paying today? ▪ Financial Counselors should be available to Registration Repre-sentatives if needed. Always keep a copy of your policy for quick access.

Increasing Cash and Lowering A/R Days This is the BIG ONE!!! In my role on the other side of the fence I will occasionally ask a Patient Financial Services Director what keeps them awake at night. Sure I hear NPI numbers, UB04, new regulations on Medicare bad debts, and some other things; however, the universal re-sponse is the need to bring in more cash. Do I have an answer for that? Of course I do. I am in Sales. In all seriousness, I will say I have learned much from working both the provider and vendor side. The biggest issue facing our Directors today is time and the increasing burnout in the field. If I could say anything worthwhile it would be to work smarter. ▪ Take a serious look at what your department doing. Are you getting the results that you expect? Are you doing things to just make your bottom line look better, but not getting good results? ▪ Take a look at yourself and your time? Are you making the most effective use of your time? ▪ Develop new strategies as needed? ▪ Provide the patient with excep-tional customer service. A part of that exceptional service is helping them understand their accounts. We are beginning to learn more about consumer driven healthcare. The company I represent is in the Patient Friendly and revenue cycle communication business. Commu-nication that is understandable will provide the best results. These results will reduce call volume and bring cash in much faster. ▪ Hire the right people. Promote teamwork. Work for the common goal. Talk with others in the field. Find out what their best practices are. And what about you?? My final thoughts are a little more on the personal side. Keep them in

mind. ▪ Stick to your personal stan-dards and maintain personal consis-tency. ▪ Develop new habits as needed. ▪ Ask yourself, “what do I need to give up?” ▪ Be an agenda driven person. Stick to your priorities. Plan with what you have and bring something great out of it. John Cook is Director of Market-ing and Sales for Data Image in Mooresville, NC. He served for twenty two years as Director of Patient Financial Services at Wa-tauga Medical Center in Boone. He has spoken for many organizations including HFMA and AAHAM.

“Promote teamwork. Work for the common goal.”

“Develop a

policy and

procedure that

you will

adhere to.”

P A G E 1 0

C A R O L I N A C O M M U N I C A T O R

Hiring Collection Services: Raising the Bar For every creditor or Patient Accounts Manager, engaging any new collection agency is a leap of faith. The creditor is never certain what he or she will actually get; whether the agency will deliver on its promises; whether the process will work well with their culture or for their accounts. Creditors consider all of these ques-tions before they buy. The Trouble with Selling Collection Services Collection services are intangible by nature. You can't see, touch, smell, or taste them before you buy them. This

intangibility often makes services diffi-cult to depict in clear and meaningful ways. References are almost meaning-less. After all, what an agency does for its largest client it doesn’t do for its smallest, right? And every agency that has ever been fired had good references or they would never have gotten hired in the first place. While important in the overall scheme of things, references are usually not a good indicator of the future success of a relationship. Many collection agencies' inability to depict their services tangibly leads to the fol-lowing conditions:

Condition Description Difficult to conceptualize

Credit grantors and patient account managers have diffi-culty picturing, in their mind's eye, the full gamut of services process and outcomes.

Difficult to evaluate The difficulty in conceptualizing leads to difficulty in evaluating the service. Creditors don't know what level of service they'll get, what the level of performance will be, or when it will be achieved.

Uncertainty and perceived risk Without a clear evaluation framework, the level of un-

certainty and perceived risk rises. Added uncertainty and risk is anathema to selling services, especially in a sales environment where you have to establish trust.

Difficult to promote the offering Difficulty conceptualizing also leads to difficulty in creating focused marketing communications (from the agency's perspective) and difficulty selling the services from the prospective client's perspective.

P A G E 1 1

With a clearer sense of tangibility, agen-cies can promote their services more clearly and minimize the clients' risk (both perceived and actual) of engaging their services. Clear depictions of the benefits of specific service tangibles will help clients and prospects to conceptual-ize, evaluate, and promote the offerings internally. Buying collection services is a leap of faith. Agencies can shorten that leap of faith with a higher level of sales profes-sionalism. Canned sales pitches, empty sales claims, poorly trained salespeople, and self-involved sales presentations do nothing more than build barriers between the agency and the potential buyer. On the other side of the coin, when a collection agency takes a more profes-sional approach and shows real interest in building their services around your needs and requirements, Patient Account Managers need to be more forthcoming with information regarding their goals and objectives, collection history, posi-tive and negative agency experiences, and specific needs and preferences. When an agency approaches you with a higher level of sales professionalism, you have an opportunity to build a long-lasting quality partnership. Too many times, Patient Account Managers are unwilling to discuss historical agency performance and other expectations (such as approach to patients). This makes it virtually impossible for a col-lection agency to build a service package around your needs and requirements; no matter how committed they are to that process. This requires open, two-way communications. The other common mistake made by creditors and patient account mangers alike, is hiring agencies based on the lowest possible fee. There is a point

Written by:

Marc Trezza, President

www.searchnetcorp.com

snctrezza@mindspring.com

“The other common mistake made

by creditors and patient account

managers alike, is hiring agencies

based on the lowest possible fee.”

where fees are too low, and the hospi-tal is the first one to suffer as a result. If an agency cannot make a profit at the fee required, they will have to cut costs. This means any number of things, such as: Larger queues (more accounts per col-lector file) Using more trainees Reducing work standards (no skip tracing under a certain dollar balance, for instance) Sending fewer letters or making fewer phone calls on each account These are just a few examples, all of which hurt performance. The attrac-tion of a lower fee is spoiled by a lower return. To use an extreme ex-ample; If you were to place $1,000,000 with each of two agencies (agency A at a 10% fee and agency B at a 50% fee) – and agency A collects only $10,000, your return on $1,000,000 is $9,000. If agency B collects $100,000 your return is $50,000. In this case, the lower fee cost you $41,000. Building open communications with the right agency at the right fee is the key to a long term, mutually profitable relationship with fewer headaches and increased revenues for all concerned.

Hiring Collection Services: Raising the Bar cont.

P A G E 1 2

C A R O L I N A C O M M U N I C A T O R

Dawn Baddeley Cooper—August 6, 2006 Barbara Barnas—August 6, 2006 Chris Bigness—August 6, 2006 Marcia Curry—August 6, 2006 Reid Davis—August 6, 2006 Nadezhda Duncan—August 6, 2006 Allyson English—August 6, 2006 Jo Ann Fields—August 6, 2006 Malissa Henderson—August 6, 2006 Rhonda Coolidge—November 6, 2006 Fay Mooney—November 6, 2006 Tami Morgan—November 6, 2006

Alan Murphy—November 6, 2006 Angela Murphy—November 6, 2006 Mary Heath—November 6, 2006 Janene Birdsong—February 7, 2007 Sonya Boulware—February 7, 2007 Janice Briggs—February 7, 2007 James Robinson—February 7, 2007 Katrina Minix—May 7, 2007 Crystal Pender—May 7, 2007 Janet Soles—May 7, 2007

Congratulations Recent CPAT Certifications!

Carolina AAHAM

Needs Volunteers

AAHAM needs support and involvement from it’s members.

No matter how much or how little time you can contrib-ute, your colleagues will appreciate your efforts. If you are not involved, there is no time like NOW to get involved. It is often said, the more time you contribute to an organiza-tion, the more you gain from your membership.

Getting involved in the Carolina Chapter of AA-HAM is as simple as con-tacting the Supervising Officer or the Committee Chairperson responsible for the area you’d like to become in-volved in.

P A G E 1 3

P A G E 1 4

Marty Callahan is a vice president and oversees TransUnion’s Healthcare Information Services. Headquartered in Chicago, TransUnion is a leading g l o b a l i n f o r m a t i o n solutions company that offers a broad range of financial services that enable customers to manage risk and capitalize on market opportunities. The company uses advanced technology coupled with extensive analytical capabilities to combat fraud and facilitate credit transactions between businesses and consumers across multiple markets. Marty Callahan can be r e a c h e d a t mcallah@transunion.com.

Healthcare Providers Can Proactively

Address Charity Care Issue

By Marty Callahan, Vice

President, TransUnion

Healthcare Information

Services

Several state lawmakers have recently proposed legislation that would establish stricter stan-dards for charity-based healthcare organizations to maintain tax-exemption eligibility. Currently, the guidelines vary from state to state, requirements are unclear and hospitals often end up having to interpret vague state and local guidelines to establish their own charity care criteria. Without uniform standards, it is complex and challenging for hos-pitals to determine the appropriate level of char-ity care. While hospitals are at-tempting to clarify their charity care policies, some consumer advocacy groups claim public hos-pitals are not providing enough charity care to deserving individuals and are using overly aggres-

sive tactics when collect-ing a patient’s payment for services. Unfortu-nately, many hospitals have antiquated revenue cycle processes that might misclassify a pa-tient’s account as possi-ble collection, rather than as a true charity case, and the patient account be-comes part of the $46M in bad debt across the U.S. In either scenario, the medical services were ultimately provided to the patient at no charge. Only the accounting process was incorrect. In November 2006, the HFMA’s Principles & Practices Board updated Statement 15 to improve clarity and address con-gressional and legal questions regarding the charity care reporting practices of tax-exempt hospitals. As part of its recommendations, the board suggested provid-ers determine charity care eligibility and bad debt before or at the time of service. To better ful-fill its charity-based mis-sion, some hospitals are following Statement 15’s

recommendations and em-ploying new strategies with automated technologies that objectively and logically predict a patient’s eligibility for charity or other assis-tance. For example, after certifying permissible pur-pose under the Federal Fair Credit Reporting Act, those hospitals can check a pa-tient’s credit profile to pro-ject their financial resources. They can then better assist those patients who are un-aware that they may be eligi-ble for available Medicaid, State Children’s Health In-surance Program (SCHIP) and other public financial assistance, and also evaluate them for possible hospital discounts and charity . If a patient qualifies for a pro-gram, some technology sys-tems can generate the neces-sary paperwork, populate it with patient information and submit the appropriate Medi-caid, discount request and charity applications. In turn, registrars can spend more time counseling pa-tients and addressing their financial needs. With proper, evidence-based de-termination of a patient’s eligibility for financial assis-

C A R O L I N A C O M M U N I C A T O R

CONT. Charity Care Issue P A G E 1 5

tance, hospitals can help the truly needy as well as prove its decisions on a case-by-case basis and thereby meet exemption guidelines. Automated technologies can offer other benefits as well, including: • Identity Management – reduce fraud and better pre-dict financial performance by verifying Social Security Numbers, addresses, phone and other contact numbers from the beginning (i.e. at the point of registration). This not only helps in reduc-ing fraud losses, but also pro-tects patients from the many headaches that result from becoming a victim of the crime. • Determine Appropriate Payment Options – develop an automated process and leverage new technologies to

assess a patient’s financial situation and determine the best payment options. • Ensure Objective Char-ity Program – maintain a healthy revenue cycle and ensure objective, consistent and current results by con-ducting an ongoing assess-ment of the hospital’s charity program. • Collection Prioritiza-tion – prioritize collections efforts by incorporating data, evaluation models, decision systems, advanced analytics and expert consultation into an objective decision-making process. System Automation – auto-mate key steps in the hospi-tal’s revenue cycle to make informed decisions more quickly. For many health care provid-ers, it’s not as much a matter of wanting to give discounts

and charity care as it is hav-ing policies and processes in place to accurately assess a patient’s financial resources and determine who may be eligible for assistance – char-ity, public aid, discounts or payment plans. By address-ing this issue at the begin-ning of the registration proc-ess, the likelihood of a pa-tient going into collections is greatly reduced, resulting in fewer surprises for the pa-tient and a healthier revenue cycle for the healthcare or-ganization.

“In turn,

registrars can

spend more

time

counseling

patients and

addressing

their financial

needs. “

P A G E 1 6

Unlike other agencies, CBCS will segment the accounts by the highest

probability of payment and constantly update the data so that we can

identify and return lost revenue as patients’ circumstances change.

Did you know that 20% of the population moves every year? CBCS is dedicated to serving your business needs and turning aged re-

ceivables into new revenue, while you retain patients.

Let us help you recapture receivables previously thought uncollectible.

CBCS TURNS OLD ACCOUNTS INTO NEW ONGOING REVENUE. Only CBCS has the proprietary tech-

nology to recover money from your

aged accounts. After you have

exhausted all efforts, including those

of collection agencies, our sophisti-

cated and automated

system will identify accounts that still

have value.

For more information about

your debt resolution provider, Call Elizabeth Price at (614)223-0613 or visit www.cbcsnational.com.

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The Power of Education

Complimentary Insurance Reimbursement Law Work-shop This seminar is designed to educate your business office staff on the issues and strategies surrounding healthcare reimbursement by covering the commons challenges that hospitals face today with delayed and denied claims. Federal and state regulations governing healthcare collections will also be a focus of the workshop. You Will Learn: • Parental & Spousal Liability - Who is accountable for the

bill? • Refund Demands - Am I required to refund when re-

quested? • Slow Payment - How can I enforce existing prompt payment

rules? • Pre-existing Condition Investigations - How can I identify

those done in bad faith?

AHC Healthcare Receivables Manage-ment specializes in accounts receivable manage-ment solutions and complimentary educa-tion offerings for the healthcare industry. Employing over 500 healthcare reimburse-ment professionals, approximately 100 of which are attorneys, AHC utilizes federal and state regulations, established case law, and client specific protocols to provide guaranteed results to our 750 clients na-tionwide. AHC operates out of six loca-tions, with headquarters located in Manas-sas, Virginia.

Barry Bierman 561.289.7573

bbierman@ahcinc.com

Enroll Today: For information on our services or to coordinate a complimentary on-site reimbursement workshop for your business office, contact:

F A L L 2 0 0 7

We Recover More Dollars Faster Than Any-one Else. Guaranteed. (888) 511-7901 ▪ www.ahcinc.com

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C A R O L I N A C O M M U N I C A T O R

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Revenue Cycle Excellence November 8, 2007 Millis Regional Health Education Center High Point, North Carolina CONFERENCE AGENDA 8:00-9:00 Continental Breakfast 9:00-9:15 Welcome, Announcements and Introduction of Corporate Partners Lori Sickelbaugh, President Carolina AAHAM Becky Grover, 2nd Vice President, Corporate Partner Chair Carolina AAHAM 9:15-10:15 “Transforming Patient Access: A Case Study”

Susan Phelps, MBA, MHA, CPAM Director Revenue Cycle Management High Point Regional Health System

& Mark Cameron, FHFMA, MBA, MS Senior Manager, Healthcare Consulting, Pershing Yoakley Associates 10:15-10:30 Break 10:30-12:00 “Transforming Patient Access: A Case Study” continued 12:00-1:00 Lunch 1:00-3:00 “Denials Management: Nurses In The New Frontier” Shiryl Foster, RN, MSN,MBA, Manager Clinical Denial Management, High Point Regional Health System

& Susan Phelps, MBA, MHA, CPAM Director Revenue Cycle Management High Point Regional Health System

Call Steve Duncan at 800-678-4580 or Susie McCulloch 800-868-5699 email sduncan@firstpointresources.com or ircsolutionssmcculloch@.net to find out more about registration!

Certification Kevin Young CPAM Corporate Partners Becky Grover

Education Steve Duncan Historian Qwanda Fisher– Jones

Legislative Laurie Shoaf, CPAM Publications Bree Stokes Amy Anderson Membership John Cook

NC AAHAM Chairs

Today we challenge you to begin your journey , as so many of your neighboring hospitalsand medical offices have, to eliminate bad debt for the healthcare industry! Join us inour effort to extinguish write-offs and turn all your patients into good payers. ContactONLINE Collections today. Together we can eliminate bad debt.

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EXPERIENCE THE RESULTS THAT NO OTHER AGENCY CAN OFFER .

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The ONLINE Medical Credit FIle is used at the point of payment determination toassess the risk associated indoing business with a patient, allowing you to substantially decrease your bad debt before treatment begins.

ONLINE Collections

What this means for you: Better RESULTS with ONLINE.

The ONLINE Collections advanced technological approach has taken us far past the historical ways of collectingbad debt for our clients. Through the Exchange Advantage ONLINE proactively obtains new address andtelephone information from the members of our national Utility and Rental Exchan ges. Having this informationin real time allows ONLINE to locate your debtors and contact them more ef ficiently than any other agency.

ONLINE Collections ensures prompt recovery for all past due accounts receivable.ONLINE Collections offers you:> The Exchange Advantage.> The most advanced collections technology.> HIPAA Compliance.> Professional healthcare collections staff.> Live customer service.> New and improved automated dialers (allowing over 40,000 calls per day).

The ONLINE Medical Credit File allows you to:> Verify Identity to prevent the misuse of Social Security Numbers.> Assess the credit risk and likelihood that a patient will pay their bill, prior to treatment.> Make informed payment arrangements.