Well another Super Bowl has come and gone. Another party and a few more pounds. This weekend was an extremely exciting one for our family as my daughter won the Tennessee Indoor Rowing Championship for her age group. If you don't know that is it is a sport were you get on a machine and row and row and row until you are exhausted. It is sort of like healthcare these days. We row and row and row and wonder if we are ever going to reach the finish line.
We are working on the cost report notebooks and got a little delay with the conversion from IACS to EIDM. We want to get some information on EIDM before we release the notebooks sometime in mid-February. By now you should have your cost report checklist and your cost report agreement. If you do not, let me know and I will get you one right away. Please let us know, if you want us to do your cost report if you have not done so already. We have limited spots and they are filling up fast. Last year we did 120 cost reports and we are going to try to limit this years number to 100.
We are moving the webinars back until March, 2015 as well. With all the cost reports and other projects on my desk I just needed to have some time to get them done before I got the webinars finished. Remember, if you are a client of ours (paid us money in either 2014 or 2015) there is no charge for any of the webinars and a webinar pass for 2015 is $75.00. That will get you in all of the webinars in 2015. We will repeat the Billing Webinars several times and the New to RHC several times as we have many new clinics just getting on board with RHCs and that is how we train them on some of the basics of RHCs. We will be adding a new webinar, Preparing for your RHC Inspection very soon as well.
I apologize for the way these week's newsletter looks. We are in the process of completely redoing it along with website and it is about half way finished. I needed to get the information out about the delay in the webinars before I got on the plane to New York tomorrow, so this is what you get. At least it is free.
Well, I have got to cut it short for this week, I am headed out to New York working on starting up some new RHCs. Have a warm and safe week.
Weekly Article Roundup:
"The Decline of the Rural American Hospital and How to Reverse It" via Harvard Business Review
"Three Factors Affecting the Kentucky Mid-Level Practitioner Workforce" via The National Law Review
BILLING WEBINAR RESCHEDULED
Part 3 of 3 of our Rural Health Clinic Beginning Billing has been rescheduled to March 11 at 2:00PM to 3:00PM EDT.
You should have received an email alerting of you of the reschedule and directing you to a link to join on the day of the webinar.
If you are signed up, look for an email today or in the morning with the password for entry into the webinar. To make registration easier for everyone that is not a client of HBS, we are offering a $75 pass that will get you in all the webinars. That way you have access to all the information, without having to sign up to each one and pay each time. If you have already paid the $75, please sign up for the webinars and we will provide you with the access code.
Click here to register for the RHC Beginning Billing Webinar Session 3 of 3 on March 11 at 2:00PM EDT.
Rural Health Clinic Beginning Billing Session 3 of 3
In this third webinar on Billing, we will discuss commingling, preventive services, global billing for surgeries, specialists, non-rhc time, transitional care management, chronic care management, hospice, and a number of more complex billing issues.
The session will be conducted by Mark R. Lynn who is Certified Public Accountant (inactive) and has over 30 years of experience with cost reporting and has prepared over a 1,000 RHC cost reports personally.
If you have questions before the webinar, email them to firstname.lastname@example.org and we will include them in the content of the Webinar if appropriate.
There is no cost for this webinar if you are a client of Healthcare Business Specialists, LLC. If you are not a cost report, start up, Live Seminar attendee or annual evaluation client within the last 12 months) there is a $75.00 charge for the webinar and handout that will be emailed to you. These sessions will be recorded are are available after the webinar with the same pricing format. The webinar is password protected and only HBS Clients and those who have paid will be provided the password. If you register do not complete the payment process within 14 days your registration information will be deleted so a spot can open up for others. The seating for this webinar is very limited, so sign up early.
After registering, you will receive a confirmation email containing information about joining the webinar.
On March 4th, 2015 I will be speaking for the Alabama Office of Primary Care and Rural Health in Clanton, Alabama on March 4, 2015. The seminar will have speakers from Cahaba GBA and Alabama Medicaid and from AMS Software as well. If you would like more information contact, Robert (Rob) Boyles with the Alabama Department of Public Health, Office of Primary Care and Rural Health, 201 Monroe Street, Suite 1040, Montgomery, Alabama 36104. Telephone number is 334-206-5425. Email email@example.com.
Click here to Save the Date for the seminar.
Influenza and Pneumo Billing
Someone asked this question on the NARHC listserve and since I did not have anything else to do, I answered it. It will help you as you get your cost report information ready.
Would anyone be willing to share how they bill Flu and Pneumonia Clinics in the Critical Access Hospital setting? Do you bill UB/1500 or Roster Bill Medicare?
Here is my answer:
"None of the above.
All RHCs include influenza and pnuemo shots on the Medicare cost report. Prepare a log with Patient name, HIC number (Medicare), and date of injection and submit that with the cost report workpapers and compete worksheet B-1 if independent and one of the M series if provider-based.
You will need to provide the total number of influenza and pnuemo shots provided to all patients regardless of payer as well. (and possibly break out Medicaid depending on your state)
Additionally you should have copies of the invoices to support the cost of the vaccines purchased as those direct costs are reimbursable as well.
While not always required, a time study to determine the amount of time it takes to provide a flu or pnumo shot is desirable. In the absence of a time study, most MACs use 10 minutes per shot.
You will also have to provide "total nursing time" - that computation includes the total hours worked by physicians, NPs, PAs, and nurses. (lines 1, 2, 3, and 5 of the independent RHC cost report). At least that is they way I compute it.
The cost report preparer will develop a ratio of time providing shots (10 minutes (typically) multiplied by the total number of shots provided) divided by "total nursing hours and that ratio will be used to allocate staffing costs.
Everything we are hearing looks like the Prevnar 13 and 23 for pnuemo are allowable on the cost report and even if the 2nd shot is required because it is a CDC recommendation it will be allowed as well. Of course, the proof is in the pudding - when we go through a few desk reviews - we will know for sure.
There you go. More than you ever wanted to know about influenza and pnuemo shots. Hope this helps."