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Newsletter 2015 Q2

Reviewing Your Physician Compensation Plans

As the healthcare industry continues to evolve, so does the relationship between hospitals and physicians. One important aspect of this relationship is the compensation plan offered to physicians. Reviewing your physician compensation plans can help to ensure bonuses and incentives are aligned with your organization's performance objectives. 

As focus in healthcare shifts to quality of care and clinical documentation improvement, ensuring your compensation models effectively motivates providers to reach these industry objectives will be key. Being able to meet these can have an impact on your organization's ability to maintain or improve its fiscal health. 

Alta Partners can help by providing a physician compensation plan assessment to identify strengths and weaknesses in your model, conduct a productivity analysis, and perform a competitive market data analysis and benchmarking. After completing the initial assessment our team will work with you to develop a plan that is consistent with your organization's quality and production metrics as well as competitive within your market region.

To learn more about how Alta Partners can help your organization, contact Stan Kasmarcak at sjk@altapartnersllc.com or (440) 808-3647.


ICD-10 Updates & Resources

As the ICD-10 conversion date of October 1, 2015 approaches, we want to ensure our clients are up-to-date on current ICD-10 news and resources available. Below is information we thought would be helpful for our clients to know. Special updates will be sent throughout the year as new information becomes available.

CMS January 2015 End-to-End Testing Results

CMS released the results from its first ICD-10 end-to-end testing week conducted in January 2015. Approximately 600 providers and billing companies submitted nearly 15,000 test claims. Overall, 81% of claims submitted were accepted. Non-ICD-10 related errors were the primary reason for claim rejection, representing 68% of the rejected claims. 

Testing was done for the purpose of determining CMS' system readiness for ICD-10. Two more end-to-end testing weeks will be held prior to the October 1, 2015 compliance date for ICD-10 (April 27 - May 1 and July 20 - July 24).  

The following Medicare Learning Network articles provide additional information regarding CMS' ICD-10 end-to-end testing:

ICD-10 Limited End-to-End Testing with Submitter for 2015
FAQs - ICD-10 End-to-End Testing 
Medicare FFS ICD-10 Testing Approach 


Medicare Updates & Resources

Throughout the course of the year, Medicare updates its policies and procedures, publishes provider resources, and releases reports. Below are some recent changes and useful resources currently available. 

MLN Connects National Provider Calls

CMS holds educational conference calls for the Medicare provider and supplier community. These calls are a part of CMS' efforts to educate and inform participants about new policies and/or changes to the Medicare program. The calls cover a range of topics and are free of charge. Prior registration is required for upcoming calls; materials and audio recordings of past events are made available on the CMS website.

To view available calls and events, click here.

CMS Releases 2015 National Impact Report

The 2015 National Impact Assessment Report is an assessment of CMS' quality measurement efforts. The report includes research on 25 CMS quality programs and nearly 700 quality measures, examining the effectiveness and impact of these measurements. Highlights of the report include:

  • CMS programs and measures reach a wide range of patients with high-impact conditions

  • Significant improvement in quality measurement results

  • Less evident race and ethnic disparities

  • Certain programs helped to save lives, reduce adverse events, and generate significant cost savings

  • Quality measures impacted non-Medicare patients, demonstrating public-private collaboration

The report is expected to help the healthcare community to understand which measures have worked well and which have been less effective. This will help CMS to further refine its quality measurement strategies. The analysis will be repeated in the future with another impact report to be issued in 2018. The 2018 Impact Report is expected to provide more information for recently introduced programs, an analysis of data at the patient level, and a more in-depth review of health disparities.

Health Care Fraud & Abuse Report Released

On March 19, 2015, the Department of Health and Human Services (HHS) and the Department of Justice (DOJ) released the Health Care Fraud and Abuse Control Program (HCFAC) Annual Report for Fiscal Year 2014. According to the report, in FY2014 the government recovered $3.3 billion in taxpayer dollars through a mix of healthcare fraud judgments, settlements, and additional administrative impositions. Since the program's founding in 1997, more than $27.8 billion has been returned to the Medicare Trust Funds. The full report provides additional  details on how the $3.3 billion was recovered and deposited, highlights from successful criminal and civil investigations, and information on how HHS and DOJ agencies have worked together as part of the program.

Allscripts User Tips

Our staff is here to help make sure your claims are processed efficiently. Below are some tips for working in the Allscripts system.

Including Admission Date on Nursing Home Claims

It is now required to enter an admission date for nursing home claims. This feature has been added to Vision. When specific facility codes are used, an additional box will open asking for "hospital" information. This is where the admission date can be entered. If you have any problems or questions, please contact Client Support.

Ensuring Proper Release of Information

In Vision, the fields "Rls of Info" and "Signature" (boxes 12 and 13 on the CMS 1500 form) must be filled out accurately in order for the claim to be processed correctly and to be HIPAA compliant.

The "Rls of Info" field is stating that the patient has given authorization for the release of their medical information to process the claim. If this field is not marked "Y", the claim will not be sent to insurance; the responsible party on the transaction will be billed. To be HIPAA compliant, you cannot simply check the field as "Y" unless you know that the patient's signature is on file.

 The "Signature" field is stating that the patient has authorized payment for services to be sent to the provider. If not set to "Y - Signature on file", the claim will not process correctly and payment for services may be sent to the patient instead of the provider. Again, before selecting this it is important to make sure that the patient's signature is actually on file.

Vision Keyboard Shortcuts

Keyboard shortcuts can help you to navigate easier and more quickly through Vision. Click here to download a PDF with helpful keyboard shortcuts.

Send Us Your Questions or User Tips!

Do you have questions on using Allscripts Vision? How about tips or tricks you think would help others? Let us know! We're continually working to improve our newsletter and you can help by submitting your own questions or tips & tricks. The best two tips / tricks submitted will each receive a $50 gift card!

You can send your questions or user tips to news@altapartnersllc.com

Alta Partners News

The Alta Partners' team is always busy! Below is more information regarding current and future happenings at Alta Partners.

Alta Partners Exhibit at the 2015 OSMA Education Symposium

Alta Partners will be exhibiting at this year's Ohio State Medical Association (OSMA) Education Symposium on April 10, 2015. If you'll be attending the event, make sure to stop by our booth to catch up with the team and learn more about the services Alta Partners provides!

The Ohio State Medical Association's Annual Education Symposium provides physicians,  managers, and medical staff with inspiration, strategies and tools to prepare or tomorrow's health care environment. This year's theme is "Work Smarter Not Harder". For more information on the event, click here.

Alta Partners to Present at the Ohio Hospital Association's 100th Annual Meeting

Alta Partners will be presenting at this year's Ohio Hospital Association (OHA) 100th Annual Meeting held Jun 8-10, 2015 in Columbus, Ohio. Our team's presentation, "Give Your Revenue Cycle a Boost - Techniques to Improve Collections", will focus on improving collections through improving your practice's revenue cycle. There are many components of the revenue cycle that can affect collections; in an era of increased regulation and reduced reimbursement, ensuring efficient operations and revenue cycle performance is key. If you're planning on attending the meeting, make sure to stop by and hear the team present.

 The OHA Annual Meeting offers a premier opportunity for health care providers and administrators at all levels to gain valuable insight about statewide industry trends, to network with their peers and achieve a better understanding of the health care issues and policies most likely to affect their organizations. To learn more about this year's meeting, visit the OHA Annual Meeting page.

Andrea Devlin Working Towards Becoming a Certified Professional Medical Auditor (CPMA)

 Alta Partners' consultant Andrea Devlin, CPC recently completed an AAPC training course in preparation for the Certified Professional Medical Auditor (CPMA) exam. The CPMA exam is a comprehensive exam that covers compliance and regulatory guidelines, audit processes, medical record documentation standards, risk analysis, results communication, and coding and reimbursement. 

Andrea is currently a Certified Professional Coder (CPC), certified in ICD-10 coding (both general and OB/GYN). She decided to pursue the CPMA certification to complement her current certification and strengthen her skillset. Andrea works with Alta Partners' consulting team to perform medical chart reviews and coding education and training. Alta Partners is excited for her and wishes her the best of luck on her upcoming exam!