Winter Edition / February 2018

GopherTracks

CentraCare Plaza Building1900 Centracare Circle, St. Cloud, MN

2018 Payer Panel April 5th

Ed Norwood Boot Camp April 6th

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Fellow AAHAM Members,

It is truly remarkable how fast the months fly. As we gear up for the start of another calendar year we welcome our new 2018-2019 MN AAHAM Board Members, Chris Fisher and our new Chapter Secretary Jennifer Marty. A position on the Minnesota AAHAM Board of Directors is an important one. We strengthen partnerships with the Payer Community, empower members by offering opportunities to advance and maintain their certifications, and support the shared vision of being part of the largest revenue cycle organization in the Nation with quality education and relevant networking opportunities.

Minnesota AAHAM recently celebrated our 40th Anniversary, and our chapter received a milestone achievement of reaching 40 years of promoting AAHAM’s mission.

It was quite a humbling opportunity for me as your President to have had the honor of accepting this award on behalf of our Board and our members.

Giving back to the communities that serve our chapter has become an important part of our chapter. If any of our members have ideas for an organizations we can spotlight at any of our upcoming meetings, please share your ideas with one of our board members. I would also like to give a special thanks to our generous sponsors who continue to raise the bar each year in support of our mission. Please check out our incredible Corporate Partners listed in the newsletter.

These past two years have been full of milestones, successes and progress. Some changes were behind the scenes while others were public and noticeable improvements. As we start our new year, we will be continuing our mission and working to finishing 2018 stronger than our previous year. Please join us for the April 5-6 Payer Panel to receive your CEUs and network with other experts in the field.

This year our Legislative Day will be March 26 – 27 in Washington DC. Our topic we will be 340b. The 340B program enables covered entities to stretch scarce Federal resources in order to reach more eligible patients. Beginning January 1, 2018, cuts to the 340B program went into effect. H.R. 4392 was recently introduced to prevent implementation of Medicare payment changes for hospitals that purchase drugs under the 340B drug discount program.

If you have never been part of this event, this year is a great year to get involved. Please consider being a part of this event.

We will be back in St. Cloud for our spring payer panel, which will be hosted by our members at CentraCare. Also, we are excited to have Ed Norwood back for additional education during our spring meeting.

I look forward to seeing everyone back in St. Cloud in 2018.

Respectfully,

Marie Murphy

AAHAM Gopher Chapter President

MN Gopher Chapter AAHAM Members: Please Remember to Up Date Your Profile with National AAHAM

AAHAM finished 2017 with 3454 members- an all time record!

President's Message Marie Murphy

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2018 Spring Conference Schedule Pam Brindley

Wednesday April 4th

5:30 PM Board Meeting/ Holiday Inn

Thursday April 5thThe annual Payer Panel Meeting will be on Thursday April 5th at the CentraCare Health Plaza Building in St. Cloud, MN. We will have representatives from eight payers and possibly more. Representatives will provide updates with important changes and issues within their companies. Each representative will have a time to present and go over answers to questions previously submitted. Attendees will also have the opportunity to submit in writing any other “last minute” questions which reps will take back to their office to get answers.

9:00-9:30 AM Registration/ Welcome 9:30-10:15 AM Lisa Wichterman, Medical Policy Specialist, MN Department of Labor and Industry, Workers’ Compensation Division

10:15-11:00 AM Jean Roberts, Provider Outreach & Education, National Government Services

11:00-11:45 AM Kate Mikonowicz, Network Management Consultant, Blue Cross of Minnesota 11:45-12:30 PM Lunch with Payers

12:30-1:15 PM Pansi Millage and Linda Monchamp, Provider Training, Minnesota Department of Human Services

1:15-2:00 PM Cheryl Wilson, Manager, Provider Relations & Contract Manager, HealthPartners

2:00-2:45 PM Kevin Davis, Contract Manager, PreferredOne

2:45-3:15 PM Laura Gildemeister, Senior Provider Analyst, Medica

3:15-4:00 PM U Care

5:30-7:00 PM Social at Holiday Inn

Payer Panel Questions

Attendees will have the opportunity to submit in writing any other ‘last minute’ questions which reps will take back to their office to get answers. Submit questions to Jason Rhode at jrhode@hfmi.com or 952-232-6686by February 20th.

Friday April 6th8:00-8:30 AM Breakfast/ Registration and Charity Presentation

9:00 AM-Noon Ed Norwood Boot Camp When Payers Won't Listen/ Denials Management and Appeals Letter Writing Workshop

Workshop will include Minnesota laws and the components of writing a great letter. This will be a good follow-up to the Payer Panel session.

Noon-1:00 PM Lunch and Business Meeting

1:00-4:00 PM Ed Norwood Boot Camp (Continued)

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To learn more about CEU's and to access the Online CEU Reporting Form, click on the link below:

http://www.aaham.org/Certification/RecertForm.aspx

Online CEU Reporting Form National AAHAM Resources

Convention Lodging Information Holiday Inn 75 37th Ave S St. Cloud, MN 56301 Toll Free 1-877-424-2449/ Hotel Direct Number (320) 253-9000 Holiday Inn Website:

Attendees can call the hotel directly and request a room under the AAHAM Group Block Reservations must be made by March 5, 2018. The Hotel will continue to accept reservations after the cut-off date on a space and rate available basis only. Convention Room Rates: Weekday Friday One Queen Bed $89.95 + tax $94.95 + tax Two Double Beds $89.95 + tax $94.95 + tax

https://www.ihg.com/holidayinn/hotels/us/en/st-cloud/stcmn/hoteldetail?cm_mmc=GoogleMaps-_-HI-_-US-_-STCMN

Conference Registration Link

Click on the link below for Conference Registration

http://events.constantcontact.com/register/event?llr=j5nsxufab&oeidk=a07ef1etp8vc5e75576

Why earn an AAHAM certification?AAHAM certification is an investment in your personal growth and your professional future. For over forty years, AAHAM’s elite certification program has set the standard of excellence in patient financial services and the revenue cycle.

It doesn’t matter whether you are new to the healthcare revenue cycle or are a seasoned veteran, our family of AAHAM certification examinations offer a complete career ladder beginning with the Certified Revenue Cycle Specialist and culminating with the Certified Revenue Cycle Executive.

We have a certification that will help advance your career. Plus the learning doesn’t stop once you have obtained certification. Our certifications are maintained through a continuous education process. This assures you stay abreast of the important changes and updates that continually occur in our rapidly changing healthcare environment.

AAHAM certification options include:

• The AAHAM Certified Revenue Cycle Executive • The AAHAM Certified Revenue Cycle Professional • The AAHAM Certified Revenue Integrity

Professional • The AAHAM Certified Revenue Cycle Specialist • The AAHAM Certified Compliance Technician

AAHAM offers the certification exams three times a year in March, July and November.

Certification News National AAHAM

2018 Certification Calendar

December 15, 2017Registration deadline for March 2018 Exam Period

March 12-23, 2018March 2018 Exam Period

April 18, 2018Registration deadline for July 2018 Exam Period

July 9-20, 2018July 2018 Exam Period

August 15, 2018Registration deadline for November 2018 Exam Period

November 5-16, 2018November 2017 Exam Period

December 19, 2018Registration deadline for March 2019 Exam Period

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2017 Fall Conference40th Chapter AnniversaryThis year's conference sessions proved to be educational, informative and even fun. Throughout the two days, the ever popular Heads and Tails game was played between programs. Participants won prizes while also raising money for a homeless charity in St. Cloud. During the evening social, the chapter's 40th anniversary was recognized with a cake. An open bar was generously hosted by IC System and maxRTE.

Jason Rhode, CRCP-I

maxRTE Account Executive

In last month’s analysis of 850 client hospitals’ payment transactions, accounting and consulting firm Crowe Horwath’s Crowe Report found “an alarming disparity of performance across five major national commercial managed care payers in key performance indicators (KPIs) for the revenue cycle such as accounts receivable (AR) and denials.” This article concludes with some solid suggestions to mitigate the effects of an increasingly challenging operating environment.

Findings confirm that hospital financial executives are facing increasingly challenging revenue cycle management and worsening payment:

• Some health insurers are making it more difficult for hospitals and health systems to collect reve-nue—52.2 days for the lowest AR and 67.7 days for the highest.

• Initial denial rates among those five national pay-ers varied from 7.5 percent to 11.1 percent of net patient service revenue (NPSR); one of every 10 dollars of revenue is at risk for nonpayment.

• Uncollectible claims ranged from 0.8 percent to 2.4 percent of NPSR.

• The payer with the highest denial rate used the request for additional medical information descrip-tion more than three times as often as the payer with the lowest rate.

The disparity in denial activity – with similar claims denied dissimilarly – puts hospitals at a disadvantage. A disconnect between hospital managed care contracting and revenue and billing cycle departments over what is actually collectible exacerbates the problem.

Darker Days Ahead

In a 2018 “Healthcare Outlook,” Navigant predicted an uptick in uncompensated care after years of decline as a result of potential cuts to the Affordable Care Act (ACA), growing reliance on high deductible insurance plans, and a rise in uninsured populations. A November Moody’s Investors Service report found that bad debt increased in 2017 after a decline from 2014-16 and predicted that bad debt will grow 6-7 percent in 2018, partly attributable to rising copayments and increased patient reliance on high deductible health plans.

It’s no wonder that a Navigant/HFMA survey of 125 hospital and health system CFOs found that 90 percent are concerned about consumer self-pay and less than half have established revenue integrity programs. Navigant Managing Director Jake Morris’ advice to hospitals:

• Tighten revenue cycle functions.

• Implement strategies for rating credit quality to target collection efforts where they’re likely to yield results.

• Develop manageable payment plans for house-holds with less income.

Clear Clouds of Uncertainty

Here are some suggestions for hospitals plagued by denials, especially in areas of eligibility, medical necessity (particularly for outpatients), level of care assignment, and notifications.

• Use software that reveals eligibility and co-pay-ments to help staff educate patients about charges for services and what they will be billed.

• Establish policies and procedures around Emergen-cy Department leveling.

• Focus on point-of-service collections and clearly communicating out-of-pocket costs to combat health insurance illiteracy.

• Work closely with payers to reduce denial rates to avoid:

- Unhappy patients getting caught in the middle, receiving unexpected bills

- Dissatisfied health plan members

• Combine business office and medical records de-partment to create an RCM team.

• Incentivize staff for each upfront payment collect-ed.

There will always be challenges associated with revenue cycle management. However, finding solutions that will help your team work quickly and efficiently is the key to weathering the storm.

Hospitals Mired in Increasing Payer Denials, Uninsured Challenges

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Brad Skelton, maxRTE Regional ManagerHospitals and medical practices are facing what I’d call an economic pandemic, spawned by high-deductible health insurance plans (HDHPs) gaining traction as insurance costs continue to rise. In the last 10 years, HDHP enrollment has increased from 4 percent to nearly 25 percent, and deductible amounts for employer offered plans have increased 67 percent in the last five years (Henry J. Kaiser Family Foundation).

As a result, healthcare collections have reached a critical level, with many patients simply unable to afford deductible amounts that can quickly rise into the thousands of dollars. While some have access to credit, many do not. According to a study by Availity, physicians reported that only 56 percent of patients were able to pay the full amount requested during point of service collection efforts, with more consumers maxed out on their credit limits. A SuccessEHS study found that a staggering 79 percent of patient balances that aren’t collected at the point of service will never be paid.

Tools, training, and the following best practices will enable your staff to communicate with patients about financial issues, heading off future collection issues. Patients need to understand that your first priority is providing their continued care, and without payment, your organization’s ability to do so may be compromised.

Before the Patient Visit

*Determine Insurance Eligibility & Estimate Financial Responsibility

Before the patient arrives for their scheduled visit, your front office should determine the patient’s active health insurance coverage, terms and conditions, deductibles and copayment options. You will know what will be covered by insurance, how much the insurer will pay, and what your patient is responsible to pay, so you can provide your patient with a clear understanding of their requirements and out-of-pocket expenses.

Another opportunity for front office staff is to contact the patient prior to the scheduled visit to review the estimated patient responsibility. During these conversations, front office staff should attempt to collect the amount due from the patient, or set up a repayment plan.

News FeedStopping the Collection Pandemic Facing Hospitals and Medical Practices

These approaches not only supports a successful patient collection plan, but also facilitates a timelier, more complete claims handling process.

During & After the Visit

*Counsel Patients about Self-Pay Options

The rising cost of health insurance has motivated a high number of people to opt for no insurance, but many younger, healthier people prefer to pay for healthcare as needed. In either case, when patients with an outstanding balance call for an appointment, your staff should ask for a payment of their outstanding balance and let them know they’ll be expected to make an additional payment at their appointment. Having patients sign an agreement to take future funds from their credit card on file is yet another fiscal safeguard.

Consider your overall patient checkout process. A critical part of the process is to have your office staff review any previous payment arrangements that have been made. This will help limit post-visit collection activities.

*Handle Collections Internally—for as Long as Possible

While the use of collection agencies for past due amounts may sound like a reasonable course, a recent report by the ACA International stated that medical practices recover less than $14 for every $100 owed once they turn bad debt over to third-party collection agencies. An earnest internal collection effort starts with training your staff to make reminder calls to patients who have outstanding balances and providing a script for them to follow. If a patient has not made progress in trimming their outstanding balance within a predetermined time frame, then need to consider outsourcing its collection.

Summary

These practices should improve your cash flow while maintaining good patient relationships and delivering a better experience. The benefits of improvement in upfront payments, increased patient satisfaction, and a reduction of accounts receivable will foster a healthy bottom line so you can continue to keep your patients healthy.

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Click on link below for Legislative Day Information and Registration Brochure

http://www.aaham.org/Events/LegislativeDay.aspx

News Feed

Revenue Cycle Improvement Begins on the Front End

Marcy Marquis, CRCP-P

Client Services Manager – maxRTEThe Healthcare Financial Management Association (HFMA) defines the healthcare revenue cycle as “all administrative and clinical functions that contribute to the capture, management, and collection of patient service revenue.” The front-end part of the cycle manages patient-facing aspects, and the back-end handles claims management and reimbursement—each with its own departments, staff, and policies to drive revenue through the cycle.

However, the front-end (scheduling, patient registration, eligibility and authorization, and upfront patient collections) has a huge impact on the back-end’s success, so here are some front-end strategies that will improve the flow of the healthcare revenue cycle.

Patient registration and eligibility checks

After the patient is scheduled to minimize wait times and to ensure that patients have the appropriate time to meet their needs, the revenue cycle moves to registration and eligibility verifications. Staff uses the electronic health record or practice management system to record patient data, including demographics and insurance information.

Most important, staff should gather accurate information before a patient walks through the doors to lay the groundwork for billing and collecting claims in the most efficient and effective manner possible. They can prevent claim denials on the back-end by performing eligibility and authorization verifications.

Eligibility issues top the list of common reasons for claim denials, according to Medical Group Management Association (MGMA). Verifying information and completing prior authorization requirements is critical to avoiding claim denial. While providers should contact payers prior to a patient visit to ensure that services are reimbursable, staff does not always have time to wait on hold for customer service.

The quickest, easiest, and most accurate way to validate plan-specific benefits is with a cloud-based electronic eligibility verification system that integrates with the providers EHR system. Finding out real-time patient coverage effective dates, co-pays, and deductible information interactively with all payers in a single click saves an enormous amount of time:

• Eliminates visits to each payer’s website

• Eliminates having to mine pertinent information from lengthy payer responses

• Provides patient payment history

• Verifies billing address

• Improves efficiency and productivity of staff, leading to increased revenues

Upfront patient collections

With high-deductible health plans becoming more popular, patients are responsible for a significant portion of healthcare costs. Enabling front-end staff to collect copayments and deductibles helps reduce back-end collection efforts. One of the most successful ways to increase upfront collections is to offer an incentive for payment in full. A discount offered to the patient, if paid in full will limit back-end collections.

In Summary

The front-end can help the back-end staff navigate the complex web of different payer requirements and mitigate claim submission and reimbursement challenges.

maxRTE has been helping healthcare providers shorten the revenue cycle for more than 20 years. With maxRTE, just one click validates plan-specific benefit data such as patient coverage effective dates, co-pays and deductible information. Visit maxrte.com for your free web demo.

there (The first word in the subject of all our blasts is AAHAM), and add moayad@aaham.org to your safe list along with MN Gopher Chapter AAHAM.

2. If the e-mails are not in your junk mail, you’ll need to contact your company’s IT Dept. Tell them that you’re a member of the organization and specify that e-mails come from Constant Contact and to add moayad@aaham.org and MN Gopher Chapter AAHAM to the safe or white list. They’ll know what that means.

National AAHAM and the MN AAHAM Gopher Chapter send out messages via a mass e-mail system called Constant Contact. Some hospital systems are blocking those e-mails- it has to do with the mass mail program. Hopefully, with your help, we can get past the hospitals’ e-security.

If you are not receiving e-mails from National AAHAM and MN Gopher Chapter AAHAM, please take the following steps:

1. First, check your junk mail, especially if you have a non-work e-mail (Gmail, yahoo, Hotmail, Verizon, Comcast, etc). If you see any e-mails

Getting E-Mail from National AAHAM and MN Gopher Chapter AAHAM

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MN AAHAM Officers/ Board of Directors and Committee Chairs

Board Chair: Richard Rogers, CRCE-I/ 2017

ARS / Magnet Solutions1822 North 60th StreetMilwaukee, WI 53208 Phone: 414-690-6099888-302-8444 (O)Email: richard.rogers@ar-solutions.biz

Secretary: Jennifer Marty/ 2018-2019

Rycan/TruBridge Technologies3725 Airport Blvd.Suite 208AMobile, AL 36608Phone: 507-337-6365 Email: Jennifer.marty@trubridge.com

1st Vice President: Pam Brindley, CHFP/ CRCS-I/ CRCS-P/ CCAE/ 2017Avadyne Health85250 Apple Hill RoadBayfield, WI 54814 Phone: 866-812-2149Email: pbrindley@avadynehealth.com

2nd Vice President: Rhonda Helgeson/ 2017

Tri-State Adjustments3439 East Ave SLa Crosse, WI 54601 Phone: 800-562-3906Email: rhonda@wecollectmore.com

Treasurer: Dawn Buck/ 2017-2018

Mille Lacs Health System200 North Elm StreetOnamia, MN 56359-0800Phone: 320-532-2641Email: dbuck@mlhealth.org

Ruth Fladmark/ 2017

CentraCare Health1406 Sixth Avenue NorthSt. Cloud, MN 56303Phone: 320-251-2700Email: FladmarkR@centracare.com

Kelly Swearingen/ 2017-2018

North Shore Health515 5th Avenue WestGrand Marais, MN 55604Phone: 218-387-3277Email: kelly.swearingen@northshorehealth.com

Greg Young/ 2017

I.C. System, Inc.12527 Central Ave.Suite 220Blaine, MN 55434 Phone: 612-275-0351 Email: gyoung@icsystem.com

Christopher Fisher/ 2018-2019

MaxRTE1555 Southcross Drive WestBurnsville, MN 55306Phone: 952-373-0665Email: christopher@hfmi.com

By-laws Richard Rogers, CRCE-I

Certification Tamora Ellis, CRCE-I

Chapter Excellence

Corporate Sponsors Richard Rogers and Greg Young

Education Pam Brindley and Rhonda Helgeson

Legislative Janet Curtis, CRCE-I,C

Membership Tom Osberg

Publications Pam and John Brindley

Scholarship Janet Curtis (ANI), Janet Curtis (LEG)

Website Richard Rogers

Welcoming John Brindley

President: Marie Murphy, CHFP/ 2017

Eide Bailly LLP4310 17th Ave SFargo, ND 58108 Phone: 701-476-8321Email: MCMurphy@eidebailly.com

Jason Rhode/ 2017-2018

HFMI/maxRTE4350 Metcalf DriveEagan, MN 55122 612-396-6610Email: jrhode@hfmi.com

Committee Chairs

Membership/ Mailing List

Tom Osberg

Colltech, Inc.15600 35TH Ave N, #201Plymouth, MN 55447 Phone: (800)487-3888F: (763)553-1655Email: tosberg@colltechinc.com

Board of Directors

Officers

Other Contacts

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Gold Sponsors

Avadyne Health Pamela Brindley 866.812.2149maxRTE Christopher

Fisher239.989.5060

IC System Greg Young 612.275.0351Tri-State Adjustment Rhonda Helgeson 800.562.3906

Silver Sponsors

Collection Resources Mary Donnay 320.260.8204

Bronze Sponsors

Colltech, Inc. Tom Osberg 800.487.3888

MN AAHAMCorporate Sponsors

Platinum Sponsors

Accelerated Recievables Solutions/ Magnet Solutions

E: Richard.Rogers@AR-Solutions.biz

Richard Rogers 888.302.8444

Advertising Rates Business Card size $25.00 1/4 page ad $50.00 1/2 page ad $70.00 Full page ad $100.00

Advertisers will receive 25% discount with 1 year commitment when paid inadvance. All ads must be camera ready.In addition, members can advertise positions for free in the Gopher Tracks.

Non-members will pay a $25.00 fee to advertise in the Gopher Tracks.There is also advertising available on our website for a fee.

Contact jbrindley54@gmail.com for more information if needed.

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The Officers and Board of Directors would like to express out gratitude to our Corporate Sponsors for their continued support of our mission. It is through your support that we are able to deliver on our mission of providing top quality educational resources to our members. In addition, your sponsorship helps our chapter engage lawmakers in the important work of legislation which impacts our industry on the state as well as national level.

To our Provider Members, when looking for partners to provide services and products to your institutions, please include our sponsors in your consideration. They have made a commitment to our chapter to support both the chapter and you, the members.

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3 Minutes15 Questions

Profound Insight

+

What’s your

Score?(Get it here: www.avadynehealth.com/pfx)

Pamela A. Brindley CHFP, CRCS – I,P, CCAE (515) 669-9396 PBrindley@avadynehealth.com

TSA is a leading provider of collection services for the medical industry.

FAST FORWARDYOUR MEDICAL COLLECTIONS.

We of fer: customized collection programs advanced collection technologies exceptional professionalism & customer service

That’s why we collect more. Contact us to learn how.

Tri-State Adjustments, Inc.wecollectmore.com p: 800.562.3906e:rhonda@wecollectmore.com

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Reimbursement Doesn’t Have to Be an Obstacle CourseWhen you have maxRTE on your team, capturing accurate bene�ts data at the front end of the revenue cycle avoids costly back-end collection. It’s the quickest, easiest

way to validate plan-speci�c bene�ts.

claim denied due to processing errors

deciphering lengthy payer reports

expensive transaction- based services

Helping health care shorten the revenue cycle

No more logging into individual payer websites to request benefit coverageNo more mining pertinent info from lengthy payer responses

Integrates with any EHR system Easy-to-use, intuitive design Web-based SaaS for set-up in minutes Easy to budget for a flat monthly fee

One-click obstacle elimination:

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Click for additionalGopher Chapter Information:

www.mnaaham.com

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LINKS:Leg Day Scholarship Application Form

http://www.mnaaham.com/download/1803/

AAHAM ANI Scholarship Information

http://www.mnaaham.com/download/1801/

AAHAM ANI Scholarship Points and Submission Form

http://www.mnaaham.com/download/1798/

Corportate Sponsorship Information and Form

http://www.mnaaham.com/download/1061/

MN AAHAM Membership Form

http://www.mnaaham.com/download/1058/

National AAHAM Membership Application Form

http://www.aaham.org/Portals/5/Files/2017MemBrochure.pdf

By Laws

http://www.mnaaham.com/resources/bylaws-constitution/bylaws/

Constitution

http://www.mnaaham.com/resources/bylaws-constitution/constitution/

Constitution and By Laws PDF

http://www.mnaaham.com/wp-content/uploads/2017/01/MN-AAHAM-BandC Approved-100715.pdf

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