administrative boot camp: a roadmap to resources
TRANSCRIPT
Administrative Boot Camp: A Roadmap to Resources
Co-Presented by: SROA Membership and
Reimbursement and Economics Committees
Successful navigation of radiation oncology administration is a challenge faced by all new Radiation Oncology administrators. Whether you are new to management or a seasoned manager just stepping into the RadOnc specialty; finding the resources you need to successfully navigate your path can be a daunting task. This presentation will address the basics of the revenue circle management, where to find available resources, IGRT coding questions, reaching out for payer resolution, and networking with your peers.
Plus, we will take a look at how the mentorship program can benefit new members from an inside perspective.
The administrative boot camp will provide you with a roadmap to resources and focus on:
Revenue Cycle Basic Resources and how to locate them
IGRT Coding Networking with your peers
The Mentorship Program Committee Participation
Today’s presentation is a combined effort with SROA
Membership and Reimbursement and Economics
Committees
SROA Annual Meeting 2015 Disclosure: Gary S. Webster, MPH
With respect to the following presentation, there has been no relevant (direct or indirect) financial relationship between the party listed above (and/or spouse/partner) and any for-profit company in the past 24 months which could be considered a
conflict of interest.
Intake, Referrals, Registration, Scheduling, Insurance
Verification Cash Collections
Medical Policy/Benefit Verification,
Prior Authorization/Medical Necessity, ABN/NNC
Financial Counseling: Patient Estimates
Financial Needs Assessment Payment arrangements
Treatment Delivery: Supporting Documentation,
& Charge Capture
Medical Records: Documentation, Compliance,
ongoing education
Diagnosis & Procedure Coding & Billing: Documentation Review, Charge Analysis,
Concurrent Audits, Claims
Submission
Account Receivables Management
Lag days, Days in A/R, Revenue Adjustments and
write offs
Appeals
Follow up, peer-to-peer review, post review audit
appeals
Post Charge Audit Analysis Reports
Revenue Circle Continuum
Be Proactive
Hot Topics
Medical Record Documentation
Provider Signatures
Physician Supervision
OIG Work Plan
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Also Include
If you do have an outside review, consider formulating a “response document” to include with
your report to show your review of information and your corrective actions. 7
Point of Service Charge Capture
Charge Review: Diagnosis, Procedure,
Documentation Compliance
Clinic: Evaluation &
Management, Nursing, Rx, Status Checks &
Procedures
Simulation: CT, Immobilization,
Contrast, Physician Tx Plan, Special Tx
Procedure
Dosimetry Planning :
2D, 3D, & IMRT & Image fusion, Medical Necessity forms
Physics: Consults, Image fusion, Diode Measurements,
Continuing Medical Physics
Treatment Machines:
Treatment Delivery, Image guidance, Ports,
Verification
Auto Charge Capture:
Weekly Management & Physics QA
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Types of Chart Audits
Concurrent
Quality
Post
https://www.sroa.org/pub/5d807390-2354-d714-5199-27f47f97bc70
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Essential Denial and Appeal Reports
Know the reasons for Denials – Break it down
A strong revenue cycle process is key to the companies bottom line.
A/R Management Statistics
If we don’t manage our A/R:
Accounts Receivable Management: What are the Benefits
Accounts Receivable Management: What is the Risk?
Revenue Circle Intelligence
Revenue Circle Management – A/R
Managing your A/R is a valuable metric:
With effective management of denials and underpayments:
Essential Report Analytics
What reports should you have access to Monthly ?
Revenue Circle Management – A/R
Managing your A/R is a valuable metric:
With effective management of denials and underpayments:
Skills needed for A/R Management
Useful tools and websites
Places to go to for information and to keep you up to date on changes
Where to find…..
cms.gov/apps/physician-fee-schedule/overview.aspx
cms.gov/Medicare/Coding/NationalCorrectCodInitEd/index.html
ASTRO.org
ACR.org
Resources and Administrative links on SROA website / Member Network Tab
sroa.org
Staying up to date on Radiation Oncology Information and Changes
SROA Annual Meeting 2015 Disclosure: Joy Godby, BA, ROCC
With respect to the following presentation, there has been no relevant (direct or indirect) financial relationship between the party listed above (and/or spouse/partner) and any for-profit company in the past 24 months which could be considered a
conflict of interest.
Image Guidance Codes for 2015
2015 ACR ASTRO Users Guide
How do we bill for IGRT in 2015 –Nutshell Version Answer: All IGRT, MV, KV, CBCT, surface tracking, gating, interfraction, intra-fraction, transponders now use code 77387 for OPPS. Any type of Guidance 77387 can only be billed professionally with the two new IMRT(hospital 77385 and 77386, freestanding G6015 and G6016 codes and for Medicare G codes – G6001, G6002, G6017 and 77014. 77387 can be billed both professionally and technically with 3-D using treatment code 77412. Physicians and freestanding centers need to charge Medicare G6001, G6002, G6017 and 77014 (unless third party wants you to charge old deleted codes or hospital code). All other rules still apply for IGRT, no billing with SRS, SBRT and 2-D. If you perform with CT and KV based IGRT fraction/tx pick one can’t bill both. No charge the other for staff models.
New Image Guidance Codes Freestanding Facilities
ACR/ASTRO Freestanding and Hospital Based
ACR/Astro-Criteria for CPT Code 77387 When can you Submit a Charge /Documentation Needed
Freestanding HCPCS/Guidelines
Authoritative guidance for IGRT
Supervision Requirements for IGRT 1
2
3
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IGRT Codes with Current Supervision Requirements
1 9
9
? 9
2 9
SROA Annual Meeting 2015 Disclosure: Sansannah Johnson CPC, ROCC
With respect to the following presentation, there has been no relevant (direct or indirect) financial relationship between the party listed above (and/or spouse/partner) and any for-profit company in the past 24 months which could be considered a
conflict of interest.
Where it all began…Industrialization
Mentorship played important role in apprenticeships during the pre-industrial era in crafts and trades
Apprentices entered contract at early age and remained with one employer for several years to acquire skills, knowledge, and understand the cultural norms of the workplace
Subsequently adopted in mainstream business
A mentor is someone who sees more talent and ability within you, than you see in yourself, and helps to bring it out of you. With mutual respect, demonstrated through action as well as
attitude, your mentoring relationship can be mutually rewarding.
Definition of Mentorship & Mentors
“Mentoring may be defined as a relationship, formal and/or informal, between a novice and one of the more senior persons in the field for the purpose of career and personal development and preparation for leadership.”
Mentoring is an intense long-term relationship between a senior, more experienced individual (the mentor) and a more junior, less experienced individual (the protégé).
Mentor is someone who “brings to the table the experience of an examined life. They must be creative listeners who encourage and enable mentees to find their own path, using understanding and empathy more than direction.”
Mentor is someone of advanced rank or experience who guides, teaches, and develops a novice.
Stages of Mentoring
Initiation Getting to know each other (motivations, goals, work habits), identifying
knowledge and skill gaps
Cultivation Personal/professional goals, development of trust, scheduling future meetings and
frequency, mutual expectations and goals, measures of progress and success Giving and receiving (effective) feedback
Conclusion / Separation Formal transition by means of survey to informal mentoring or more of a peer
relationship Opportunity for mentee to demonstrate skills and operate independently and for
mentor to demonstrate that one has been successful in developing new talent
Types of Mentoring
Formal: Structured program that is often based on Myers-Briggs outcome
Natural/informal: Initiated by mentor or mentee reaching out to one another, Usually people with common goals/beliefs that stems into mentoring relationship
Team mentoring: Network of mentors with multiple perspectives, Reach more people in a time-efficient manner, Spreads the responsibilities of mentoring to multiple mentors, avoiding potential “mentor fatigue”, Draw upon knowledge of several mentors with different mentors providing expertise in different areas
Peer and near-peer: Individuals at same level providing skill training and sharing their experiences. Linked to improvements in listening and organization skills (mentors) and better work-life balance, time management, and increased scholarly activity (mentees)
Virtual: as follows…
Virtual Mentorship
“E-mentoring” Long-distance (email, phone calls, social media) or via national mentorship
databases (SROA) Pros
Bridging the mentoring gap Accessibility
Limitations No direct observation or accountability Misunderstandings can happen Should be seen as a complement to traditional mentoring, rather than a replacement. Access improvement: E-mentoring allows for mentors who have a disability, mobility issue, home obligation or work schedule to participate in a program. Tele mentoring has the potential to equalize access to mentors for the rural and marginalized participant.
Things to consider when making the commitment of Mentorship
Mentoring is a two way street, you get out of it what you put into it. -
A collaborative partnership between a mentor who possess greater skills and experience and a protégé to increase skillset.
A mentor will become not only your advisor, but your friend and confidante.
That doesn't happen instantly—building trust and personal interest takes time.
You set the tone at the outset of the relationship by demonstrating your commitment to the process.
Each agree to a one year time commitment. Preschedule meetings at a regular time and day of the week, which make it easier to honor.
Frequency of contact is important in the relationship to keep the learning process moving forward.
Your First Meeting
Establish the parameters for the necessary framework to optimize the relationship. Negotiate your mentoring arrangement, including goals, expectations, confidentiality, feedback processes, and meeting logistics.
Become acquainted with each other. Spend some time getting to know one other, building a rapport, sharing career histories and exploring what you may have in common.
Verbalize your vision and purpose of the partnership. It is important to establish a partnership where each individuals expectations form a good match. Talk about your mutual motivations such as why you wanted to participate in the mentoring process and what you hope to get out of the relationship.
Talk about confidentiality, including what is and isn’t acceptable to share with others.
Establishing the nuts and bolts of the partnership.
Establish if it is appropriate to contact each other outside of the scheduled meetings.
Benefits of Being a Mentor
Satisfaction of knowing that you are helping someone achieve their professional goals
Opportunity to build your leadership and management skills.
Opportunity to give back to your industry
Opportunity to build an enduring career network within our society
Gain insights and different perspectives
Sharpens your skills
Brings new ideas to the table
Rejuvenates you with renewed enthusiasm
Provides personal satisfaction that comes with helping someone else succeed.
Offers a new way of seeing things
Gives the opportunity to pay it forward
Expands your network
"We make a living by what we get, but we make a life by what we give." Winston Churchill
Responsibilities of Being a Mentor
Provide critical honest feedback
Offer Friendship
Inspire Encourage
Helps mentee set a clear agenda
Have dialogue prompts and be prepared for what is to be discussed on the agenda
Set realistic expectations
Be present and available, keep time commitments that work for real life.
Listen Ask questions Are role models Keep promises and hold mentee
accountable Are humble Give feedback Respect and honor confidentiality Set boundaries Demonstrate patience Value diversity Probes mentee with questions to solve
problems and challenges
Benefits of Being a Mentee
Having an insider’s perspective to help navigate your career
Someone to bounce ideas off
A cheerleader
Accountability
Critical Feedback
Help navigate decisions
Resources
Exposure to diverse perspectives and experiences
Provides impartial advice
Boost your career prospects and growth
Hones in on a sharper focus of skills needed to grow professionally.
Gain access to mentors network of contacts
Learn from real-world experiences
Allow for increased self-awareness and self-discipline
Responsibilities of Being a Mentee
Takes responsibility for being on time and managing the meetings with an open mind.
State career goals, strengths and talents, and identify ways the mentor can provide support.
Each new discussion with the mentor should include updates from previous talk.
Bring to the table a prepared list of topics to discuss
Provide experience what worked and what didn’t
Brainstorm new ideas and bounce them off of mentor so they
too can include their experience.
Every Great Achievement
was once considered
impossible….
Conclusion
Mentorship is a highly coveted experience with multitude of benefits for both
the mentor and mentee
Wide variety of mentorship styles and types…find which one(s) work for you.
Mentorship is dynamic and continuously evolving
Never too early to start mentor relationship
The administration in our field of medicine can be
further strengthened by mentorship and
paying it forward
SROA Annual Meeting 2015 Disclosure: Steve Meisner, MBA RT (R,T)
With respect to the following presentation, there has been no relevant (direct or indirect) financial relationship between the party listed above (and/or spouse/partner) and any for-profit company in the past 24 months which could be considered a
conflict of interest.
Chair, SROA Membership Committee
SROA Mentor Program
What We Learned
Why Become a Mentee?
Why Become a Mentor?
1st Year Program Results
Project Sub Committee Members