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Updated: 2/6/2012
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by Healthcare Business Specialists Mark R. Lynn RHC Consultant Email: la_vita_nouva@hotmail.com Suite 214, 502 Shadow Parkway Chattanooga, TN 37421 Tele: (423) 899-0945 Fax: (800) 268-5055 Specializing in Rural Health Clinic Reimbursement RHC Cost Reports - Annual Evaluations - RHC Startups - RHC Seminars Welcome to the Healthcare Business Specialists home page dedicated to Rural Health Clinics (RHCs). We have designed this site to provide the latest information on rural health clinics and information on Rural Health Clinic Update and RHC Boot Camp seminars. The seminars cover Medicare cost reporting, billing, annual evaluations, certification, and the operation of RHCs as certified by Medicare under Public Law 95-210. We hope that you find the website helpful to you and please let us know if there is something we can do to make the website more useful. Healthcare Business Specialists is a Chattanooga, Tennessee-based consulting firm which specializes in rural health clinic reimbursement and prepares rural health clinic cost reports, annual evaluations, provider enrollment, and RHC startups. Mark R. Lynn, CPA (inactive) is trained as a certified public accountant and has over 30 years experience in the healthcare field with almost 25 years of experience devoted almost exclusively to rural health clinics. We have been conducting rural health clinic seminars for over 20 years. Annual Evaluations Cost Reports Contengency Reviews RHC Startups
CMS announces corrected RHC rate for 2012 February 6, 2012: I am completely revising the 2012 Medicare Workpaper Notebook with updated forms and content. I should be finished in the morning and will Fed Ex (2-day) to our clients by mid-week. Here is some of the information from the book that you can use to help get your information ready for cost reporting. 2012 Medicare Cost Report Checklist for Rural Health Clinics 2012 Medicare Cost Report Model Workpapers for Rural Health Clinics (12 Tabs) CMS announces revised rate for RHCs for 2012. The new maximum cost per visit is $78.54. CMS Corrected RHC Reimbursement Rate for 2012 - January 30, 2012
HBS Update for February 3, 2012 Our latest newsletter dated February 3, 2012 includes information on a change to the maximum RHC reimbursement rate for 2012, a new study on rural health clinics and high tech, something on negative reimbursement from Trailblazer, an update on the 3-day rule and Trailblazer losing the MAC contract for their region. HBS Update February 3, 2012 (17 Page PDF) To Register for our seminars, email, fax, or mail this form to us or register online 2012 RHC Billing and Cost Report Registration Form (7 pages).pdf Look for this Postcard in the mail: 2012 RHC Update Seminars PostCard 4 by 6.pdf Look for this brochure in the mail as well: 2012 RHC Seminars Brochure (2 page mailer).pdf Here is a cheat sheet from for 5010 Claims Processing based upon the February 2nd, 2012 HRSA Technical Assistance phone call. If you would like the slides from that phone call, here is the link: Slides (PDF - 1 MB) This is the cheatsheat that includes all 81 Form Locators from the UB-04 and instructions on how each form Locator should be completed. Plus, at the end it has a reference guide with several great links that will help you with RHC billing. 2012 5010 Transition UB-04 Claims Requirement Cheatsheet.pdf
Its time for RHCs to start trying figure out how to get the P S and R report from Medicare. Here is a good two document to help you get started. We will have full instructions when our Cost Report Notebook is finished next week. This should get you started. If you want to start accumulating information, you can use the 2011 checklist for now. I provided a link to it as well: https://www.cms.gov/psrr/downloads/Registration_Tips_FI_MAC.pdf 2011 RHC Cost Report Checklist.pdf
Pinnacle Business Solutions has a good Excel Spreadsheet for the accumulation of Bad Debts. Here is a Link to the spreadsheet. http://www.pinnaclemedicare.com/provider/parta/ar/EXHIBIT5BADDEBTS.xls
RHC Seminar Registration is live for 2012 February 1, 2012: After a bit of a delay, the registration for the RHC Seminars is now open and live. We are doing the seminars a little differently this year to give you more options. With more options, there is more confusion, so if you have any questions just email them to Mark Lynn at la_vita_nouva@hotmail.com or call me at (423) 243-6185 (my cell phone) and I will try to answer any questions you have. Here is the RHC registration form that you can fax to me at (800) 268-5055 or scan and email to me. Here is the link: 2012 RHC Billing and Cost Report Registration Form (7 pages).pdf
Online Registration is live and you can register by clicking on the following hyperlinks. There is an online registration form for each of eight seminar locations. If you have questions, or get confused when registering multiple people from the same clinic for different seminars, you may want to use the Registration form above and only use one per person. You can always, just email me if you have any questions.
HBS Update January 31, 2012 Here are some of the items that were sent out in our newsletter yesterday. To get on the email listing send me an email to la_vita_nouva@hotmail.com and I will add you to the database. Just type in "subscribe".
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5010 Transition RHC Tele-conference on February 2, 2012
The next Rural Health Clinics Technical Assistance call has been scheduled for Thursday, February 2nd at 2:00pm (EASTERN). Our speaker, Janet Lytton, will be talking about RHC billing and will specifically address some of the challenges folks have been encountering since the transition from 4010 to 5010 officially began on January 1, 2012.
Here is the call-in information: Time: 2:00pm EASTERN Toll Free Number: 866-564-7431 Pass Code: 168265
The call is scheduled to last for one hour. Please feel free to share this information with colleagues who might benefit from hearing this presentation. If you have questions you would like to submit ahead of time, please send them to: info@narhc.org and put RHC TA question in the subject line. Slides that will be used during the presentation will be distributed via this listserve and posted on the Federal Office of Rural Health Policy website when they are available.
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CMS implements new 3-day rule related to hospital-owned clinics
I am trying to figure out how the 3-day rule affects rural health clinics that are hospital owned. Anyone have any ideas on how this will change the way provider-based and clinics that are owned by hospitals bill. I keep reading the information and it is just not sinking in. My thinking is that if a procedure is done in your hospital-owned clinic and it is either billed globally or procedure only, you are required to roll this procedure in the hospital inpatient bill if the hospitalization occurs within 3 days of the surgery. In addition the ruling greatly expands the interpretation of the services included in the 3-day window and now basically all diagnostic and non-diagnostic services that occur within 3-days of a hospital admission, must be bundled into the hospital admission. Does this sound right so far? Here are a number of links on the subject. Again, any help with this subject will be greatly appreciated:
http://www.wachlerblog.com/2012/01/cms-clarification-of-3-day- payment-window-when-inpatient-admission-is-denied.shtml
https://www.cms.gov/MLNMattersArticles/downloads/MM7672.pdf
https://www.cms.gov/manuals/downloads/clm104c04.pdf
(Note: Pay attention to Section 10.12 of the Medicare Claims Processing Manual Chapter 4 - Part B Hospital as it relates to this matter.) Something that is related to this issue is Cahaba announced at the Fall Meeting of the NARHC that they had changed their policy on office visits and hospital admissions on the same day. Previously, Riverbend's interpretation was that you could have both on the same day; however, Cahaba indicated that their interpretation is the same as most other MACs. Which is you have have only one per day, either an office visit or a hospital admission, but not both. I will post the question and answer section to our website this week at www.ruralhealthclinic.com.
______________________________________________________________________________________________________________________________________ Trailblazer Health Enterprises Updated Reference Materials
I have heard from a good source that Trailblazer has lost the MAC contract for their region; which if it is true would be very sad. Just in case it is true, I have been reviewing their website and saving everything I can to PDFs. If you were around when Riverbend lost the contract it was disturbing to go to that site and see a wealth of RHC information disappear overnight. Here are a couple of links that I have converted to PDF files and included on my DVD that I provide to seminar attendees:
http://www.trailblazerhealth.com/Publications/Job%20Aid/TheFiveStepProcessforBillingMedicare.pdf
http://www.trailblazerhealth.com/Publications/Job%20Aid/RHCUB04BillingExamples.pdf
http://www.trailblazerhealth.com/Publications/Job%20Aid/RHCReimbursementCalcs.pdf
http://www.trailblazerhealth.com/Tools/Fee%20Schedule/MedicareFeeSchedule.aspx?
http://www.trailblazerhealth.com/Publications/Training%20Manual/rhcmanual.pdf
http://www.trailblazerhealth.com/Publications/Training%20Manual/MSPQ.pdf
2009 Riverbend presentation on RHCs LCD in November 2008
LMRP Document from Riverbend as revised by HBS
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HPSA Listings updated as of September 1, 2011 HPSA Listings were updated as of September 1, 2011 and caused a problem for several RHCs that were in the process of becoming a rural health clinic. If you are planning or in the process of becoming a rural health clinic, you are encouraged to review these listings. The Am I Rural on the Rural Assistance Center website that many of us use to determine if an area is eligible for RHC status is no longer current and yield inaccurate information. Here is some of the information from the HRSA website regarding this publication:
A Federal Register Notice updating the list of designated Health Professional Shortage Areas (HPSAs) was published on November 3. This listing reflects all HPSAs that were designated as of September 1, 2011; all HPSAs that are NOT included on this publication are officially withdrawn as of the publication of the lists:
It is important to note that the HPSA data available through on-line searches, such as Find a HPSA and the Data Warehouse are updated daily and will not exactly match the Federal Register listings. New HPSAs may have been designated since September 1, 2011, and other HPSAs may have been proposed for withdrawal or had no new data supplied to support their continued designation. These changes will be reflected in the on-line searches but will not match the information in the Federal Register, due to the time required to prepare the official notice. If you have questions about the information on HPSAs, please contact your State Primary Care Office.
http://bhpr.hrsa.gov/shortage/
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RHC Billing and Cost Reporting Seminars
January 31, 2012
Well, it has been two weeks since I announced the seminars and I have not completed the registration forms or updated the website yet. We had a little emergency trip to Arizona, California, and Kentucky to clinics that received State inspections and were not up to date on their annual evaluations, so remember that is a condition level deficiency. The annual evaluation must be completed annually in order for the clinic to stay in compliance with RHC regulations.
We did get a couple things done in regards to the seminars. Carolyn Duncan will be back in St. Louis (April 27th, 2012) for a special session on CPT coding for rural health clinics from 1:00 PM to 3:00 PM and the cost will be $100.00 for this session. You can go to this, if you do not want to attend the cost reporting session. More on this session as I prepare the materials for it.
We did get a confirmation that the State Comptroller's Office in Tennessee will be attending the Nashville meeting. They can explain any questions you have regarding the quarterly Tenncare Report. Julie Rogers and Greg Hawkins are conformed for this meeting.
We have also confirmed that Adele Allison from SuccessEHS (http://www.successehs.com/) will be presenting on "Rural Health Clinics and Patient Centered Medical Home Status" at several of the locations. So far we have Birmingham, Savannah, and Columbia, SC as locations for Adele to present from 1:00 to 3:00 PM on patient centered medical homes. The cost for this session is $125.00 and can be attended instead of our cost reporting session. More on this as we firm up the details.
By the end of the week registration will be live on our website at www.ruralhealthclinic.com and we will be sending out another email with information on how to register.
HBS Update January 16, 2012 January 16, 2012: Several people have been asking about our RHC seminars for 2012. I am working on the materials and how to sign up at this time; however, if you want to save the date. Here are the locations and the dates. This year we will be doing something different. We will be doing a morning seminar on Billing from 9:00 to 12:00 and and an afternoon seminar on cost reporting and annual evaluations from 1:00 to 4:00. We wanted to spend more time in these basics as some people have been having problems in these areas and we wanted to go back through the basics to ensure everyone understood the basics. The Seminar schedules will be as follows: Billing: The cost of this session is $200.00 and includes the booklet/handouts and DVD. 9:00 to 9:55 The Building Blocks - What to do once you have become a rural health clinic - How to get Started. 10:00 to 10:55 How rural health clinic billing differs from RBRVS billing and some basic concepts/ 11:00 to 12:00 The Ten Most difficult Questions to answer regarding RHC billing and how to increase the revenues of your RHC. Lunch is on your own. Cost Report: The cost of this session is $200.00 and includes the booklet/handouts and DVD 1:00 to 1:55 What is the cost report, why it is important, what can go wrong, base year strategies, MACs, what is needed to complete a cost report. 2:00 to 2:55 Preparation of the cost report. Counting Visits. Physician compensation issues, Working with the MACs, Appeals, Preparing Workpapers, and a sample cost report. 3:00 to 3:55 Annual Evaluations. Why they are important? How to conduct one? When are they due? Files to assist you in preparing them. If you go to both sessions, the cost will be $300.00. Here are the locations, dates, and hotels. May 1, 2011. The latest newsletter on Rural Health clinics is attached below: 2011 HBS Update May 1 2011.pdf
This is the form that RHCs can use to settle with Cahaba during the start up process. This presentation on CPT Coding will be conducted on May 6, 2011 in St. Louis. 2011 CPT Coding Presentation by Carolyn Duncan in St Louis MO on May 6 2011.ppt
HBS Update Newsletter Dated April 5, 2011 We just completed the April 5, 2011 HBS Update Newsletter. There is a lot of interesting reading information in this newsletter regarding rural health clinics. As a reminder the RHC Update seminars start on Thursday in Nashville and Friday in Knoxville. It is not too late to register. Here is the table of contents to the April 5th newsletter. HBS Update Newsletter Dated April 5, 2011 Please check out our sponsors for the RHC Update Seminars Indianapolis, IN http://www.medmate.com/ Columbia, SC http://www.mdeverywhere.com/
HBS Update Newsletter Dated March 31, 2011 I just wanted to remind you that the RHC Update seminars are starting next Thursday, April 7th in Nashville and April 8th in Knoxville. The seminars start at 9:30 AM in the morning so it is easy to drive in to them without paying for a hotel. The seminar in Nashville is really getting full, so let us know soon if you want to go. Also, cost reporting is in full swing, so get your information into me as soon as possible. I am looking forward to seeing you at the seminars this spring. You may want to check our website (www.ruralhealthclinic.com) in the next few days to view some of the presentations that will be made next week. If you missed the NARHC conference in San Antonio last week you missed Susan Harr, MPR, CPHIMS, program director of the Iowa Foundation for Medical Care (the Iowa Regional Extension Center) rave about the service of SuccessEHS based in Birmingham, AL. If you want to know more about their product and about EHR stimulus payments attend our Nashville meeting and hear Adele Allison, National Director of Government Affairs from SuccessEHS speak. Additionally, the Nashville seminar will feature Julie Rogers, Marsha Holman, and Greg Hawkins from the Comptroller’s office discussing how to properly complete the Tenncare Quarterly Reports. This is very important for Tennessee RHCs as a very large majority of the benefit of being a rural health clinic is derived from these reports and there are no written instructions. This is your chance to ask questions regarding this important subject. Great news for clinics that have Cahaba as your MAC. Cahaba mailed out P S and R reports last week, so look for them in the mail soon. The IACS system is still causing problems for providers and very few are able to retrieve their reports. Thankfully, Cahaba recognized this problem and mailed the reports. Hopefully, the other MACS will follow suit. Bad news is that the $505 fee went into effect on March 25, 2011 for new RHCs and recertification (you will be recertified every 5 years and have to complete an 855A in some cases). Clinics will uSorry, I did not get every 855A completed by the deadline. We gave it a good effort; but, the NARHC meeting in San Antonio got in the way.Washington is the rules for Accountable Care Organizations (ACOs) will be released today. I would review those regulations closely before you are purchased by a hospital or physician group, just to make sure the merger still makes sense.
2011 RHC Spring Update Seminar Brochure Page 1.pdf 2011 RHC Update Seminar Spring Brochure Page 2.pdf 2011 RHC Update Seminar Registration Form.pdf Healthcare Business Specialists is pleased to announce that the RHC Spring Update seminars have been scheduled for 2011. The dates and locations are Nashville, Tennessee on April 7, 2011, Knoxville, Tennessee on April 8, 2011, Indianapolis on April 22, 2011, Columbia, SC on April 29, 2011, and St. Louis, MO on May 6, 2011. We will start at 9:30 and run till noon. We will have 1 hour break for lunch which will be provided from 12:00 to 1:00 pm. The seminar will then run from 1:00 to 3:30 pm in the afternoon. Orange Juice, Coffee, and soft drinks will be served at the seminars. Each seminar will have special guests invited to talk about relevant topics for the State that we are in. For example, Greg Hawkins, Julie Rogers, and Marsha Holman from the State of Tennessee are confirmed as speakers for our meeting in Nashville on the preparation of the Quarterly Tenncare Settlement Reports. Glen H. Beussink, Director of Clinic Development & Research from Midwest Health Care, Inc. will be presenting on Tenncare Settlement Reports with the State as well. We will update you on any additional speakers that we may have at the meetings. If you would like to speak or sponsor a meeting, please let me know as we can arrange for you to sponsor the meeting and will provide some time to discuss your product with the seminar attendees. The price of the seminar will be $250.00 per person for the full day The printed materials including full color slides is not a part of the fee and if you want to obtain the Workbook the cost is $125 per notebook and the notebook will include a DVD with all the presentations and additional information related to RHCs. Again, the Workbook is an additional fee from the seminar fee. Payment can be made to la_vita_nouva@hotmail.com using PayPal or by sending a check to Mark Lynn, Healthcare Business Specialists at Suite 214, 502 Shadow Parkway, Chattanooga, TN 37421. You can sign up online and pay with Visa, Mastercard, and Discover credit cards. We do not accept American Express. What you missed last year. Here are some of the presentations that we presented at the 2010 RHC Update Seminars. Much of the information is still applicable so you may find it helpful. This year's seminar will be completely updated with new information. We do expect new regulations for RHCs be finalized by the time the seminars are conducted this year so much of the seminar will be dedicated to quality improvement, potential loss of RHC status and potential safeguards, and all the provisions that may change due to the new final conditions of participation. Here are the presentations:
2010 RHC Update Presentation on Healthcare Reform, ACOs, and PCMHs 2010 Electronic Health Records Stimulus Payments for RHCs Presentation as of December 10 2010.pdf 2010 RHC Billing 101 Presentation in Boise Idaho on November 3 2010.pdf 2010 RHC Billing 102 Presentation for Boise Idaho presentation on November 3 2010.pdf If you want sign up for the seminars, here are the hyperlinks RHC Update Seminar in Nashville, TN on April 7, 2011 RHC Update Seminar in Knoxville, TN on April 8, 2011 RHC Update Seminar in Indianapolis, Indiana on April 22, 2011 Atlanta, Georgia RHC Update Seminar on April 28 2011 RHC Update Seminar in Columbia, SC on April 29, 2011 RHC Update Seminar in St. Louis, MO on May 6, 2011 The St. Louis seminar will feature Carolyn Duncan, BS, CPC, CPC-H, from Health Care Consulting Services in Shawnee, Kansas. Carolyn will present from 8:00 AM to 9:30 AM on CPT Coding for Rural Health Clinics. This session is an add on to our normal update seminar and is an additional charge of $75.00 to attend. You are not required to sign up for this session to attend the RHC Update Seminar, nor do you have to attend the CPT Coding for Rural Health Clinics session to attend the RHC Update seminars. In other words, if you only want to attend one of the seminars there is no requirement to attend both. If you want to contact Carolyn regarding her services or the content of the seminar here is her contact information. Carolyn Duncan, BS, CPC, CPC-H Health Care Consulting Services 21019 W 61st St. Shawnee, KS 66218 913-422-0342 or 816-797-1753 cell Again, this session is only in St. Louis and is from 8:00 am to 9:30 and additional cost to attend the session is $75.00. Carolyn and I will be doing an RHC billing session in Kansas City, Missouri on Thursday, September 29th. The morning session will be CPT coding for rural health clinics by Carolyn and will cost $150 and the afternoon session from 1:00 pm to 4:00 pm with RHC Billing with Mark Lynn being the instructor and the cost is $150 for this as well.
HBS Update Newsletter Dated February 15, 2011 The latest issue of HBS Update which includes new proposed regulations for RHCs, a new MAC for Ohio and Kentucky, Medicare cost reporting information, Electronic Health Records and More. Here is the Table of Contents.
Here is the link to the file: 2011 HBS Update Newsletter Dated February 15 2011.pdf The new seminar brochure is complete and is being mailed to 2,400 RHCs next week. Look for it in the mail. 2011 RHC Spring Update Seminar Brochure Page 1.pdf 2011 RHC Update Seminar Spring Brochure Page 2.pdf
HBS Cost Reporting Information for 2011 February 15, 2011. The RHC Cost Report Notebooks have been mailed for 2011. If you do not receive your notebook in the next couple days, please let me know. Here is some of the information that was mailed to our cost report clients this week. 2011 Cover Letter for Cost Report Notebook on February 11 2011.doc 2011 RHC Cost Report Checklist.pdf 2011 RHC Cost Report Medicare Workpapers New Information for 2011.pdf 2011 RHC Spring Update Seminar Brochure Page 1.pdf 2011 RHC Update Seminar Spring Brochure Page 2.pdf Here is form from Blue Cross that describes the UB-04 Form Locators http://www.ibx.com/pdfs/providers/npi/ub04_form.pdf
HBS Update Newsletter Dated February 7, 2011 Here is our latest newsletter as of February 7, 2011. 2011 HBS Update Newsletter Dated February 7 2011.pdf Here is the Table of Contents NARHC Technical Assistance Phone Call .. ……….. … . Page 2 New information on RHC Update Seminars ………… . ...Page 3 Billing Information…………………………………..………… … Page 4 New regulations regarding Compliance and Fraud …… ..Page 5 ` RHC Cost Report Checklist for 2011…………………………..Page 6 NCQA issues patient centered medical home standards. .Page 7 RHC Update Seminars………………………………................. Page 8 RHC Seminar Registration Forms for 2011…………… ….Page 11 Website Changes……………………………………………………. .Page 13
RHC Cost Report Checklist for 2011 February 7, 2011. The RHC Cost Report Notebooks will be Fed Exed (2 day) on Wednesday, February 9th. If you can not wait to get started on the cost report, here is the checklist that will be included in the cost report notebook. RHC Cost Report Checklist for 2011 If you want to sign up for our 2011 RHC Update Seminars, here is the new registration form. 2011 RHC Update Seminar Registration Form.pdf NARHC Technical Assistance Phone Call on February 10, 2011 February 7, 2011 Date of Phone Call: Thursday, February 10, 2011; 2-3pm ET If you are like most RHCs, small rural hospitals, or critical access hospitals, you have many patients who are uninsured. Sometimes these uninsured patients cannot afford insurance because they have little or no income even though they are relatively healthy. But sometimes, it is because they have a medical condition that causes them to be classified as “high risk” making the cost of health insurance prohibitive or making the individual “uninsurable.”
Call-in information: Thursday, February 10, 2011; 2-3pm ET
New Information on the RHC Update Seminars February 7, 2011 The St. Louis seminar will feature Carolyn Duncan, BS, CPC, CPC-H, from Health Care Consulting Services in Shawnee, Kansas. Carolyn will present from 8:00 AM to 9:30 AM on CPT Coding for Rural Health Clinics. This session is an add on to our normal update seminar and is an additional charge of $75.00 to attend. You are not required to sign up for this session to attend the RHC Update Seminar, nor do you have to attend the CPT Coding for Rural Health Clinics session to attend the RHC Update seminars. In other words, if you only want to attend one of the seminars there is no requirement to attend both. If you want to contact Carolyn regarding her services or the content of the seminar here is her contact information. Carolyn Duncan, BS, CPC, CPC-H Health Care Consulting Services 21019 W 61st St. Shawnee, KS 66218 913-422-0342 or 816-797-1753 cell Again, this session is only in St. Louis and is from 8:00 am to 9:30 and additional cost to attend the session is $75.00. Carolyn and I will be doing an RHC billing session in Kansas City, Missouri on Thursday, September 29th. The morning session will be CPT coding for rural health clinics by Carolyn and will cost $150 and the afternoon session from 1:00 pm to 4:00 pm with RHC Billing with Mark Lynn being the instructor and the cost is $150 for this as well.
We have added an additional site for the RHC seminars. Atlanta, Georgia will be on April 28, 2011. The sign up information for the seminar is in the link below: Atlanta, Georgia RHC Update Seminar on April 28 2011 2011 RHC Update Seminar Registration Form.pdf
2011 RHC Update Seminar Registration Form.pdf Billing Information February 7, 2011. Here are a couple of links to interesting items that will help you with rural health clinic billing. The first is a link to a Medlearn Matters article on Timely Filing of Claims from Noridian: https://www.noridianmedicare.com/provider/updates/docs/MM7270Timely_Filing_Changes.pdf Noridian also has a MSP form that RHCs can use. This is a one page form. https://www.noridianmedicare.com/macj3a/claims/msp/msp_form.pdf Noridian has provided a list of the questions that need to be asked to Medicare patients to satisfy Medicare Secondary Payer requirements. https://www.noridianmedicare.com/macj3a/claims/msp/admission_questions.pdf Mississippi’s First Nursing-Home Based Rural Health Clinic Opens in Greenwood is the title of an article in this link. http://www.msrha.org/files/mrha%20newsletter%20jan%202011.pdf Medicare has released a Medlearn Matters Article that indicates clinics can no longer have the patients bring drugs from the pharmacy and the clinic administer the drug. This places RHCs at a large disadvantage as some drugs cost 8 to 10 times the maximum independent RHC reimbursement rate. Here is the link to the Med Learn Article. New Regulations regarding Compliance and Fraud On January 24, 2011, CMS finalized a rule to implement significant anti-fraud provisions of healthcare reform. The final rules emphasizes fraud prevention. The majority of the rules are effective on or after March 25, 2011. A summary of the regulations are provided by Alston + Bird LLP Additional rules were published on February 2, 2010 requiring providers to make available to Medicare beneficiaries information about their right to file a written complaint with the Quality Improvement Organization (QIO) in the State where healthcare services are being or were provided about the quality of care they are receiving or have received.
If you are confused by these new
rules, the Office of Inspector General (OIG) of the Department of Health and
Human Services is hosting six free OIG compliance training sessions for
local health care providers, compliance professionals, and their legal
counsel. According to the OIG, the sessions are designed to help
attendees:
The sessions will be held over the next few months in Houston, Tampa, Kansas City, Baton Rouge, Denver, and Washington, D.C. Space at each training session is limited. More information (including how to enroll for one of the sessions) can be found on the OIG’s website http://compliance.oig.hhs.gov/.
HBS Update Newsletter for January 21, 2011 January 21, 2011. I finished a 21 page newsletter on rural health clinics tonight. Here is the Table of Contents. If you would like to read the newsletter, just click on the hyperlink 2011 HBS Update Newsletter Dated January 21 2011.pdf
RHC Update Seminars for spring, 2011 Announced – Page 2 We’re not in Kansas anymore………………………………… . Page 5 Medicare Preventive Services for 2011……………………....Page 8 Rural Health Open Door Session next week………………Page 13 Helpful information from Trailblazer………………………..Page 14 RHC Reimbursement Rate increased by .4%.................Page 15 Application fee for Provider enrollment and re-valid…..Page 16 New Medicare Administrative Contractor jurisdictions. Page 17 Website Changes……………………………………………………..Page 20
Atlanta, Georgia RHC Update Seminar on April 28 2011 2011 RHC Update Seminar Registration Form.pdf Healthcare Business Specialists is pleased to announce that the RHC Spring Update seminars have been scheduled for 2011. The dates and locations are Nashville, Tennessee on April 7, 2011, Knoxville, Tennessee on April 8, 2011, Indianapolis on April 22, 2011, Columbia, SC on April 29, 2011, and St. Louis, MO on May 6, 2011. We will start at 9:30 and run till noon. We will have 1 hour break for lunch which will be provided from 12:00 to 1:00 pm. The seminar will then run from 1:00 to 3:30 pm in the afternoon. Orange Juice, Coffee, and soft drinks will be served at the seminars. Each seminar will have special guests invited to talk about relevant topics for the State that we are in. For example, Greg Hawkins, Julie Rogers, and Marsha Holman from the State of Tennessee are confirmed as speakers for our meeting in Nashville on the preparation of the Quarterly Tenncare Settlement Reports. Glen H. Beussink, Director of Clinic Development & Research from Midwest Health Care, Inc. will be presenting on Tenncare Settlement Reports with the State as well. We will update you on any additional speakers that we may have at the meetings. If you would like to speak or sponsor a meeting, please let me know as we can arrange for you to sponsor the meeting and will provide some time to discuss your product with the seminar attendees. The price of the seminar will be $250.00 per person for the full day The printed materials including full color slides is not a part of the fee and if you want to obtain the Workbook the cost is $125 per notebook and the notebook will include a DVD with all the presentations and additional information related to RHCs. Again, the Workbook is an additional fee from the seminar fee. Payment can be made to la_vita_nouva@hotmail.com using PayPal or by sending a check to Mark Lynn, Healthcare Business Specialists at Suite 214, 502 Shadow Parkway, Chattanooga, TN 37421. You can sign up online and pay with Visa, Mastercard, and Discover credit cards. We do not accept American Express. What you missed last year. Here are some of the presentations that we presented at the 2010 RHC Update Seminars. Much of the information is still applicable so you may find it helpful. This year's seminar will be completely updated with new information. We do expect new regulations for RHCs be finalized by the time the seminars are conducted this year so much of the seminar will be dedicated to quality improvement, potential loss of RHC status and potential safeguards, and all the provisions that may change due to the new final conditions of participation. Here are the presentations:
2010 RHC Update Presentation on Healthcare Reform, ACOs, and PCMHs 2010 Electronic Health Records Stimulus Payments for RHCs Presentation as of December 10 2010.pdf 2010 RHC Billing 101 Presentation in Boise Idaho on November 3 2010.pdf 2010 RHC Billing 102 Presentation for Boise Idaho presentation on November 3 2010.pdf If you want sign up for the seminars, here are the hyperlinks RHC Update Seminar in Nashville, TN on April 7, 2011 RHC Update Seminar in Knoxville, TN on April 8, 2011 RHC Update Seminar in Indianapolis, Indiana on April 22, 2011 RHC Update Seminar in Columbia, SC on April 29, 2011 RHC Update Seminar in St. Louis, MO on May 6, 2011
RHC Update and Billing Seminars
We are sending out a postcard next week on our rural health clinic and billing seminars so look for it in the mail. We have added dates in Dallas, Orlando, and Sacramento so look for those dates as well. Here is the link to the postcard that will be in the mail. The update seminars will feature information on medical homes, bundled payment, and accountable health organizations as well as the latest information on the Electronic Health Records Stimulus payments. The morning session will be all legislative changes and Electronic Health Records and the afternoon sessions are related to RHC Billing, Cost Reporting, and Annual Evaluations. If you would like to only attend the morning session, the fee is $150.00 or the afternoon session the fee is $150.00 as well. You do not have to be a rural health clinic to benefit from the information presented in the morning session. Here is the link: 2010 RHC Update Fall Seminar Brochure Page 1.pdf 2010 RHC Update Brochure Page 2.pdf Here are the links to register for the seminars. Let us know if you have a problem with any of them. Thank you. RHC Update Seminar in Nashville, TN on September 16, 2010 RHC Update Seminar in Knoxville, TN on September 17, 2010 RHC Update Seminar in Birmingham, AL on October 8, 2010 RHC Update Seminar in Sacramento, CA on November 12, 2010 RHC Update Seminar in Dallas, TX on November 19, 2010 RHC Update Seminar in Orlando FL on December 10, 2010 Kansas City, MO RHC 101 Billing Seminar on September 30, 2010 Reno, NV RHC 101 Billing Seminar on October 19, 2010 November 1, 2010: Sorry, I have not been on the site for a while. I have been to the National Association of Rural Health Clinics meeting in Reno, NV and the National Rural Health Association in Kansas City meeting over the last month, plus I have been doing our Update and Billing Seminars. Tomorrow, I head out West to Boise, Idaho and will be speaking at the Idaho and RHC & CAH Conference on RHC Billing 101 and 102. If you want to look at the presentations that we will be giving here are copies for you to review. We will be going over material like this in our RHC Update Seminars. Remember we have Sacramento, Dallas, and Orlando still to go in 2010. 2010 RHC Billing 101 Presentation in Boise Idaho on November 3 2010.pdf 2010 RHC Billing 102 Presentation for Boise Idaho presentation on November 3 2010.pdf 2010 Rural Health Clinic Billing 101 Outline for Boise Idaho on November 3 2010.pdf A couple of resources that you may be interested in. Encore presentations on Billing from Trailblazer: Trailblazer Encore Presentations This is a really nice document from the Colorado Office of Rural Health. It is a two page billing summary for rural health clinics. http://www.coruralhealth.org/programs/rhc/documents/billingreference.pdf The NCQA has released proposed standards for Accountable Care Organizations with a comment period through November 19, 2010. If you are interested in ACOs and their formation, you may want to look this over and comment. http://www.ncqa.org/portals/0/publiccomment/ACO/ACO%20Criteria_Public_Comment.pdf Here is some information on Tobacco Cessation services from Medicare: http://www.cms.gov/MLNMattersArticles/downloads/MM7133.pdf
September 14, 2010: More documents for the RHC Update Seminars that start this week. I was going to only release this information at the seminar; but, I changed my mind and here it is. This is the benchmarking report from the 2009 cost reports that includes information on physician compensations, visits per provider, and other valuable information. 2010 Cost Reporting Benchmarking Report for Fall RHC seminar.pdf September 13, 2010: I am working on some documents for our RHC Update seminars this week and completed this summary of questions and answers from a Q and A session sponsored by HRSA last week. It was conducted by the NARHC and the document summarizes the questions and answers. Here is the link: 2010 Questions and Answers from September 8 2010 Q and A session from HRSA September 1, 2010: I am working on the Health Reform section of the presentation and found a great resource with lots of links to videos and information on health reform. Here is the link to a 18 page PDF dated June 17, 2010. http://www.allhealth.org/publications/Uninsured/Reporting_on_Health_Reform_99.pdf August 28, 2010: We have started a blog located on Wordpress.com were you may make comments on this information. Here is the link: Healthcare reform is pushing the creation of entities called medical homes, accountable care organizations, and bundled payments. If you want to learn more about these organizations or how to establish one, here is a good website. Accountable care organizations, electronic health records, economic pressures, and health reform is placing much more pressure on solo practices and small rural health clinics. So far the percentage of doctors practicing solo dropped from 41 percent in 1983 to 25 percent in 2008, and the portion of physicians in groups of six or less fell from 53 percent in 1997 to 42 percent in 2005. More and more young physicians, in particular, are going to work for hospital-owned groups. According to an oft-quoted study from the Center for Studying Health System Change, the percentage of physicians who are solo practitioners or are practicing in groups of fewer than 6 physicians fell from 53% in 1996 - 1997 to 42% in 2004 - 2005. Here is an article on this Rural health clinics were notably left out of the Medicare electronic health records stimulus payments and Senator Cantwell from Washington State has written a letter addressing this inequity. Here is the link. http://cantwell.senate.gov/news/record.cfm?id=327283 August 26, 2010: We have a sample of the presentation on healthcare reform and some of the slides we will be using in our Fall RHC Update Seminar Series. This is a 31 page PDF and has lots of interesting information in it. Let us know of any ways to improve it or if we are missing something that you are interested in. Here is the link: 2010 Legislative Healthcare Reform presentation For RHC Update Seminar in Fall 2010.pdf Another update on the seminar in Nashville. Glen H. Beussink, Director of Clinic Development & Research from Midwest Health Care, Inc. will be presenting on Tenncare Quarterly Settlements and some interesting information and tips he has for completing these important reimbursement forms. In addition, Dale Rothenberg of Doctors Management, Inc will be attending the Knoxville, Tennessee seminar and will provide assistance and sponsorship of the meeting in Knoxville. We will be revealing our 2010 Benchmarking Report from our 2010 RHC Cost Report clinics which includes average number visits by provider, charges, and compensation data. This information is only available to attendees of the seminar and our clients. We will not post this information on the website or in a newsletter form. The only way to find this information out is to attend the seminars or be our client. August 25, 2010: This is an old OIG Report that includes information about an RHC visit and a hospital visit on the same day. Here is the link: 2001 Hutchinson OIG Report with RHC Visit information on page 21.pdf August 20, 2010: The American Medical Association released a very good summary (4 pages) of the Electronic Health Record Incentive payment regulations. Here is the link: http://www.ama-assn.org/ama1/pub/upload/mm/472/ehr-medicaid-incentive-summary.pdf Another good document on EHR and healthcare reform. These are slides from a presentation in Tennessee. www.tamho.org/tamho-admin/cms_pushdoc.php?fileId=107 August 19, 2010: On August 17th CMS issued guidance to State Medicaid Directors regarding implementation of section 4201 of the American Recovery and Reinvestment Act of 2009 (the Recovery Act), Pub. L. 111-5, and recently published regulations at 42 CFR Part 495, Subpart D. Section 4201, allowing the payment of incentives to eligible professionals (EPs) and eligible hospitals to promote the adoption and meaningful use of certified electronic health record (EHR) technology. The Recovery Act provides 100 percent Federal financial participation (FFP) to States for incentive payments to eligible Medicaid providers to adopt, implement, upgrade, and meaningfully use certified EHR technology, and 90 percent FFP for State administrative expenses related to the program. To view a copy of this 19 page letter, please follow the link: https://www.cms.gov/smdl/downloads/SMD10016.pdf August 19, 2010: If you are not familiar with the regional extension center (RECs) which provide Electronic Health Records consulting services to physician clinics, hospitals, and rural health clinics and are funded from Recovery funds, thus providing either free or minimal cost consulting services here is a listing of the centers. These Centers provide excellent information on the implementation of the Electronic Health Records Stimulus payment program as for example, this form developed by the Iowa REC (http://www.IowaHITREC.org). These regional centers should be one of the first places you look for information as you move towards implementing Electronic Health Records.
August 19, 2010: Here is a listing of CMS Regional Rural Health Coordinators that can be used when starting RHCs and can be found in our 2010 RHC Update Seminar CD in the Annual Evaluation Tab: http://www.cms.gov/OpenDoorForums/Downloads/CMSRuralHealthCoordinatorsMay2009.pdf August 18: Our latest newsletter has a comprehensive table of health care reform implementation dates. For a copy of our latest newsletter follow the link: 2010 HBS Update Newsletter Dated August 18 2010 with health reform timetable 2010 HBS Update Newsletter Dated August 11 2010.pdf 2010 RHC Update Fall Seminar Brochure Page 1.pdf 2010 RHC Update Brochure Page 2.pdf Electronic Health Records Stimulus Payments Information
August 18, 2010. There are two teleconferences on Electronic Health Records Stimulus payments in the next week. One is this afternoon at 1:00 Eastern and the other is on August 25, 2010. If you have not signed up for our RHC Update seminars we will spend 1 hour and 1/2 or so on this very important subject and provide important handouts that will help you with your EMR Stimulus Payments. Here is the notice for teleconferences:
"ONC Overview of the Temporary
Certification Program for Electronic Health Record (EHR) Technology: The
Office of the National Coordinator for Health Information Technology (ONC)
within the U.S. Department of Health and Human Services is hosting a series of
informational calls the purpose of which is to provide an overview of, and
answer questions related to, the temporary certification program for electronic
health record (EHR) technology. In this ONC-hosted event, participants will hear
an overview of the program and be able to ask questions. Recordings and
transcripts for each call will be made available on the ONC web site. See the
Health IT/Certification program link below for more information. If you missed the previous phone calls, here are handouts and training provided by CMS.
August 11, 2010 Training for Hospitals [PDF, 285KB]
August 17, 2010: Here is the latest RHC Update Brochure for our seminars. Please take a look and sign up for one of our seminars. 2010 RHC Update Fall Seminar Brochure Page 1.pdf 2010 RHC Update Brochure Page 2.pdf Please note that the Reno Billing 101 Seminar is on October 19th, 2010 instead of October 12th as indicated on the Postcard that was mailed last week. Sorry about the error on the date that we missed. August 15, 2010: Here is a link to the most recent CMS Provider Update which is a 5 page listing of regulations issued or pending: https://www.cms.gov/quarterlyproviderupdates/downloads/Regs-3Q10QPU.pdf August 13, 2010 Here is a link to a Excel spreadsheet that will help with Coding: http://www.physicianspractice.com/e-m/content/article/1462168/1633136 Here is a link to the Regional Extension Centers for Electronic Health Records Incentive Payments:
Here is a link to the “Frequently
Asked Questions” section on the CMS website:
August 12th RHC Technical Assistance call regarding EHR Incentive Payments Just a quick note that there is a Teleconference tomorrow at 2:00 PM (Eastern) on Electronic Health Records Stimulus payments. Here is the notice from the National Association of Rural Health Clinics (NARHC) and the meeting is sponsored by HRSA.. If you want to see the Powerpoint slides for the meeting follow this link: 2010 EHR_Meaningful_Use Presentation by NARHC for August 13 2010 Teleconference.ppt Website Changes July 24, 2010: Here is a link to our latest newsletter with lots of PECOS, EHR Incentive Stimulus payment, and health reform information in it. 2010 HBS Update Newsletter Dated July 24 2010.pdf July 24, 2010: You will notice big changes to our website today. I have filed all the information that was previously on the home page and resulted in one long scroll of unrelated information. All the information has been categorized by subject and can be located on it's corresponding page. I have included a blog page that is where I will continue to provide updates. The home page will also include the most recent posts; however, the information will be quickly filed to their appropriate page. I hope this makes the site more useful to you and easier to find content that is of interest to you. If you have problems with tool bars on the side that help you navigate to the proper content, here are the hyperlinks to get you there. Additionally, we have started a new website called www.healthcarebusinessspecialists.com and we have a new email address which is marklynn@healthcarebusinessspecialists.com. (we will still use la_vita_nouva@hotmail.com for personal purposes so you may continue to use it if you prefer. Links to Information on Rural Health Clinic.com
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