Gateway Gatherings Winter Final by jennyyingdi


									Volume 29, Issue 3                                              Winter 2010

   Inside this Issue
                              From Our President...
Certification –
  Page 4
                              Tami Knobbe, FHFMA
New Members –
                              President, Greater St. Louis Chapter
  Page 5-6
                              Healthcare Financial Management Association
Updates –
  Page 7
                              It’s January – the time of year for resolutions and looking forward to 2010!
                              How many of us are still awaiting Healthcare Reform? How many of us
Spring Conference –
  Page 8
                              truly know and understand all the items in the proposal?

Holiday Party & Pics –
                              If you are reading this article, then you are fortunate enough to have
  Page 3 & 9                  HFMA as a resource to guide you through these changes and keep you
                              informed. Healthcare is a tough industry with lots of regulations, publicity
Webinar Education &           and scrutiny. HFMA is here to help bridge the gap so we are more
Road Show Schedule –          knowledgeable and can make educated decisions for our respective
  Page 10-11                  organizations.

Awards Updates –              As you plan your 2010 calendar, take advantage of the many national and
  Page 12                     Greater St. Louis educational programs that HFMA offers. Providing qual-
                              ity education is the key to our organization’s success – your attendance to
Physicians Practice           these programs can be the key to this success. Also, take five minutes to
Management Corner –           think about how you can get involved in the GSL chapter. Each of us
  Page 13-14                  brings something unique to this industry so why not share that with other
Legal Lines Corner –
  Page 15                     I look forward to seeing you at an upcoming program or networking event!

Past Presidents Corner –
   Page 16-19
Featuring – Recognition of
Linda Davidson’s retirement
(page 18-19)

Future Events –
   Page 20
(Dates of activities, board
meetings, and webinars)
  HFMA Officers 2009-10                                                                     Committee Chairs 2009-10
        President                          From the Editor                                             (continued)

   Tami Knobbe, FHFMA                                                                       Communications Committee
          Gateway EDI                Submitted by:                            Tom Sale        Webmaster Committee                                                                     Jeff Morgan, CHFP
                                                                                                 Revenue Cycle Partners
       President-Elect               Editorial Policy – Opinions expressed in articles
         Lisa Haug                   or throughout the Newsletter are those of the
    Absolute Collection Service      author/contributor and do not necessarily reflect         Communications and       the view of the Greater St. Louis Chapter of              Webmaster Co-Chair
                                     HFMA, the Healthcare Financial Management                   Chastity Werner
       Vice President                                                                       Allergy, Asthma & Sinus Care Ctr
                                     Association, or the editor.                        
     Tracy Packingham
Consumer Collection Management        The editor reserves the right to edit material and          Financial Review
                                     accept or reject contributions for publication. All      Committee - Co-Chairs
           Secretary                 correspondence received is assumed to be a             Steve Moro, Rubin, Brown, CPAs
           Sandy Roll                                                                
                                     release for publication unless otherwise indi-
          MedAssist, Inc.         cated.                                                 Maria Lotz, RSM McGladrey, Inc.
        Treasurer                    It is encouraged that possible topic ideas be sent       Membership Committee
     Susan Richardson                for consideration prior to an article being written.      Sharon Redel, FHFMA
 Healthcare Consulting of St Louis   (Please submit via word document.)                    

                                                                                                Member Directory
       Past President                Tom Sale, Newsletter Chair & Editor –                    Committee - Co-Chairs
     Teri Reger, FHFMA               636-447-1298 –                    Diane Ortlip, Kramer and Frank
         SSM Health Care                                                                 
                                                                                                 Connie Stimpson,
                                                                                                  Kramer and Frank, PC
 Board Members 2008-09               Publication Dates and Deadlines:                  

          Bill Hamm                     Spring Issue                                           Newsletter Committee
   St. Louis Children’s Hospital                                                                    Tom Sale                                                                
                                            April 9          Deadline for articles
      Barb Smallwood                        April 30         Publication date                 Nominating Committee
   St. Anthony's Medical Center                                                                Teri Reger, FHFMA                                                                       SSM Health Care
     Laura Holt, FHFMA               Newsletter Thank You – I want to thank the
       St. Luke’s Hospital
                                     members of the Newsletter Committee for their              Program Committee                                                                     Barb Smallwood
                                     help in making each issue a success, as well as           St. Anthony's Medical Center
           Tom Sale                  improving the content and quality each time.
                                     Newsletter Committee members are: Jerrie Weith,
                                     Sondra Denk, Paul Doelling, Dennis Lambert, and           Social Committee
         Dawn Crump                                                                         Dawn Crump, SSM Health Care
       SSM Health Care               Chastity Werner.                                 
                                                                                            Social Committee Co-Chair
     Amy Richter, CHFP
    Hospice of Southern Illinois                                                                   Kelly Konradt
                                              Membership Directories                            Partners Financial Services

Committee Chairs 2009-10             Submitted by:                    Connie Stimpson        Sponsorship Committee -
    Archive Committee                The printed directory is distributed once annually     Don Rapp, The Outsource Group
       Bob Salmo                     and uses HFMA National's membership records.        
      St Louis Connect Care          The cut-off date for this edition was October 1,                                                                           Kathy Hughes
                                     2009. These have been mailed out to our mem-              St. Anthony's Medical Center
    Awards Committee                 bership. There are a few extra directories avail-
   Jerrie Weith, FHFMA               able to new members and those who never re-                 Strategic Planning
   Anders Minkler & Diehl LLP        ceived a directory.                                                                               Lisa Haug
                                                                                                Absolute Collection Service
  Certification Committee            If anyone needs one, please contact Connie at  
Rebecca Welker, FHFMA, CIA           314-754-6137 or                      Yerger Committee
   CHAN Healthcare Audiitors                                                                    Joseph Salmo, MedAssist
  CORPORATE               Holiday Party Pictures   CORPORATE
  SPONSORS                     (Story on page 9)   SPONSORS

      DIAMOND                                        SILVER



Please see the story
and additional pictures
on page 9.

                                    Certification Committee
Certification Update                                                       Submitted by: Rebecca Welker

                     Achieve a New Year’s resolution early by getting HFMA-certified

Look for upcoming information on:

  •   Study sessions on the Core/Specialty Exams (convenient lunch-time scheduling)
  •   Avoid traffic and weather by staying at your desk and joining the webinar
  •   Scholarships to cover the Exam Fee will be available
  •   Spring Conference study opportunities
  •   Webinars covering the Core material will be offered throughout February
      ο Monday, Wednesday, Friday - Lunchtime, 1-hour sessions
  •   Webinars for the Patient Financial Services material to be offered throughout March
  •   Webinars for the Accounting and Finance material to be offered throughout April
  •   Designated exam dates every other Friday for next three months:
      ο February 12 and 26
      ο March 12 and 26
      ο April 9 and 23
  •   An exam day is planned as well for May 21

                          We are taking the Certification effort to the world wide web

The Greater St. Louis HFMA Chapter Certification Committee is committed to assisting you in your pursuit of
HFMA certification. Committee members include:

          Rebecca Welker (Chair)              314-994-7853   
          Elaine Watson (Co-Chair)            314-994-7972   
          Teri Reger (Past President)         314-994-7957   

If you are interested in joining or assisting the Certification Committee, please contact the Chair or Co-Chair.
You do not need to be certified to assist your fellow Chapter members.

                                  Membership Committee

 Membership Update                                                              Submitted by: Joanne Hollett

                                   New Members 4th Quarter 2009

The Membership Committee is pleased to announce several colleagues as new members of the Greater St Louis
HFMA Chapter. Please welcome the following people to HFMA and our Chapter.

               Matthew Kinsella, Senior Financial Analyst – SSM Health Care

               Jacqueline Forbes, Assistant Director Revenue Cycle – SLUCare St. Louis University

               Debbie Roberts, Horizon Engineering Associates, LLP

               James Farmer, National Accounts Manager – Allsup

               Mark Krieger, Vice President and CFO – Barnes-Jewish Hospital

               Loretta Ford, Director Business Operations – Apollo Information Services Inc.

The Membership Committee would like to share some interesting information on some of our new members under
“New Member Bios” following this page. We would also like to welcome other new members who were unable to
respond to our questionnaire. (Please note that at the time of the newsletter publication date, the new member
information from January was not available.) If you see any of our new members at HFMA events, we would like
you to reach out to them to make them feel welcome to our chapter and share your own personal HFMA stories.

                                  New Member Bios
Matthew Kinsella, Senior Financial Analyst – SSM Health Care

   Undergrad – Truman State University – B.S. Health Science
   Graduate – St. Louis University – Master of Health Administration
   Golfing, Traveling, Exercising
Why did you join HFMA?
   Expand my network in the healthcare finance field as well as getting more involved in the broad field. I have
   been in healthcare for 7 years, but I have only been specifically working in finance for about 3 years. I wanted
   to be able to get to know more about people in this field because I was not specifically trained to be in finance
   operations in my education.
Tell us something about yourself that most people do not know:
   I am pretty outgoing once I get to know people. There is probably a lot that most people don’t know about me,
   but for those that do know me, I would say that there are few things they wouldn’t know.
                                     New Member Bios

Jacqueline Forbes, Assistant Director of Revenue Cycle – St. Louis University

Education: St. Louis University – Senior status, Major in Organizational Leadership & Technology
Hobbies: Dancing, Reading, and Traveling
Why did you join HFMA?
    I joined HFMA to become more involved and educated in the financial field of the healthcare industry, while
    enhancing my revenue cycle management skills.
Tell us something about yourself that most people do not know:
    Most people do not know I love to sing.

Debbie Roberts, Senior Project Coordinator – Horizon Engineering Associates, LLP

Tell us about your job responsibilities:
    I’m responsible for the day-to-day project-related incoming/outgoing documentation, regional tracking of pro-
    ject cost, regional marketing coordination, business development, executive assistance, office management.
Education: Associates Degree in Computer Systems & Networking Technology
Family: 2 daughters, 1 grandson
Hobbies/Interests: Flea Markets, Auctions, Wine Tasting, Sporting Events
Why did you join HFMA?
    Connections for business development.
Tell us something about yourself that most people do not know:
    Hands-on interior renovation/remodeling.

Mark Krieger, Vice President and CFO – Barnes-Jewish Hospital

Tell us about your job responsibilities:
        Financial Statements, Operating & Capital Budgets, Decision Support, Planning, Patient Financial
        Services, Health Information Management, Administrative Compliance
Education: BA Math, MBA Finance
Hobbies/Interests: Golf, sports, current events
Why did you join HFMA?
        Stay current on how our Barnes-Jewish Hospital Finance Team can help our organization develop, as a
        core competency, the ability to continuously improve performance in a dynamically changing healthcare

Loretta Ford, Director Business Operations – Apollo Information Services Inc.

Tell us about your job responsibilities:
    Responsible for 15+ hospitals in Missouri & Illinois regions. Oversee the ER chart flow process from hospi-
    tals to the corporate billing office in Fort Myers Florida. Manage new contractual start-ups; Negotiate Man-
    aged Care Contracts on behalf of ED Physicians. Liaison between provider enrollment, billing and patient
    Bachelor Arts Degree in Communications – Lindenwood University
    Masters Degree HR-Management – Lindenwood University
    Mini MBA – University of MO St. Louis
Hobbies/Interests: Writing-Volunteer Community Outreach/Roller Skating
Why did you join HFMA? Professional networking and valuable up-to-date health care information
Tell us something about yourself that most people do not know:
    Founded two non-profit community organizations in St. Louis.
                                Program / Education Updates

Medicare 101 Wrap-Up                                                     Submitted by: Barbara Smallwood

Medicare 101- Elizabeth A. Urage – Outreach Analyst
WPS Medicare Provider Outreach and Education

First of all, we would like to thank our speaker, Elizabeth Urage. This presentation had a great deal of information.
The attendees were able to take a CMS & WPS website tour and identify where important information can be
found. Discussion included National Correct Coding Initiative edits, Medically unlikely edits, Medicare Secondary
Payor Questionnaire and billing. Elizabeth had a wealth of information to share. The program was a BIG success
with 88 attendees.

The evaluations from our members and non-members show the success of this program. Just a few of the com-
ments included:

        “Elizabeth was very informative and funny.”
        “Elizabeth was very easy to understand!”
        “Subject was Great.”
        “Speaker was fantastic.”
        “Speaker was very knowledgeable.”

Government Affairs – Legislative Update                                               Program Announcement
Date:       February 17, 2010

Place:      St. Luke’s Hospital Education Center

Time:       12:00 pm – 3:00 pm
            (Lunch is being sponsored by Kramer and Frank, P.C.)

Space is limited – Registration deadline February 15.

The Greater St. Louis Chapter HFMA is offering this program at NO CHARGE.

Speaker: Daniel Landon, Senior Vice President of Governmental Relations – Missouri Hospital Association

Daniel Landon is Senior Vice President of Governmental Relations for the Missouri Hospital Association
(MHA). He joined MHA in August 1993. His responsibilities include managing the association’s federal and state
advocacy functions and performance measure programs.

Prior to joining MHA, Mr. Landon worked for the House Research staff of the Missouri House of Representatives
for nearly ten years. The House Research staff provides nonpartisan research, policy analysis, and bill drafting
services to the House of Representatives, its committees, and individual legislators.

                  Chapter Website —
                                 Annual Spring Conference

Program Announcement                                                   Submitted by: Barbara Smallwood

               Spring Conference – SAVE THE DATE
                                              May 19-21, 2010

                          Healthcare Financial Management Association

                     The Greater St. Louis & Show-Me of Missouri Chapters

                                          Are Proud to Present

                                The Annual Joint Spring Conference

Hotel Accommodations:
A block of hotel rooms have been secured at the Embassy Suites, attached to the Saint Charles Convention
Center until 4/18/10. HFMA rate is $139/night (includes a made-to-order breakfast, plus 2 hours of cocktails in
the evening)

Embassy Suites St. Louis-St. Charles/Hotel & Spa
Convention Center Plaza, St. Charles, MO – 636-946-5544

Questions ???
At this point, you may have questions concerning programs, vendor fair, facilities and the social events. Please
direct any questions to the following committee members:

          Programs                    Barbara Smallwood
          Vendor Fair/Registration    Jennifer Ogden
          Dinner & Entertainment      Dawn Crump    

The Spring Conference Committee is working hard to bring you an educational & fun-filled conference. We will
be sending additional information regarding the conference via email in the near future. So, please mark your
calendars today, and on behalf of the 2010 Spring Conference Committee, we hope to see you there!!
                   Holiday Party/Program Wrap-Up

Social Update                                                                   Submitted by: Dawn Crump

Greater St. Louis HFMA Holiday Party: WHAT A PARTY!

Tears were shed on December 3rd at the GSL HFMA holiday event, but not out of sadness, tears of joy. We prom-
ised a side splitting good time and followed through on that promise. Everyone had a great time as we took over
Season’s Restaurant in Chesterfield. Buzz Southerland had us laughing hysterically with his unique insights on
life, family, and succeeding in the business world. Thanks to the Season’s staff for accommodating our ever in-
creasing crowd (over 60), to Buzz for reminding us that laughter is the best medicine, to Keith Bull from Medical
Recovery Specialists for the attendance prizes, and to Kelly Konradt for helping arrange the event. Our events just
keep getting better, but that is to be expected with the members that we have.

Our first Happy Hour of the year was held at Helen Fitzgerald’s following the Medicare 101 seminar January 14.
As always at Helen’s, we had a good crowd. You just have to love getting together with 40 or so of your peers for
some enjoyable networking. Even other HFMA chapters are scoping out our Happy Hours now and not wanting to
leave. Thanks so much to Tracy Packingham from Consumer Collection Management and Lana Mead from
Cardon Healthcare Network who sponsored the event so everyone could relax and mingle.

So what do we have to look forward to next? Greater St. Louis and Show-Me of Missouri Chapters are working
hard on another fabulous entertainment package for the annual Spring Conference. We will shake it up a bit with a
little different entertainment event, so don’t miss out. We hope you have already saved the date for May 19-21.

Stay tuned for more details on what kind of changes you can expect this year! 2010 promises to be another great
year for the social committee. Keep a watch out for more Happy Hours, a new and exciting walleyball outing,
and...since Summer can’t get here fast enough...start looking forward to another WARM River City Rascals game.
Lastly, don’t forget to mark your calendars for the golf outing on September 13, 2010.

Thank you to all of our sponsors and members for a great year in 2009. We are looking forward to an even better
year in 2010.

Below, Buzz pokes fun at/with anyone he can.

                                                                                            More holiday pictures
                                                                                            on page 3. It looks
                                                                                            like all in attendance
                                                                                            had a good time. If
                                                                                            you missed it, please
                                                                                            join us next year.

                                   Webinar Education

 Webinar Announcements                                                    Submitted by: Tracy Packingham

           HFMA Greater St. Louis is proud to announce our Webcast Road Show.
Our first broadcasts are February 10 and 16. These webinars target everyone in your office. It is a great opportunity
to give back to our staff by providing topics such as:

                       Navigating the Day-to-Day Issues of Stress and Change
                       Communicate to WIN (Look for more information to follow)
                       and much more…

For more information regarding the Road Show or for topic ideas, please contact Tracy Packingham at Please visit our website at for more webinar information.

                                              Region 8 Webinars
The webinars for Region 8 are going well. These webinars are the second Tuesday of each month. Thank you to
everyone who has participated in this educational opportunity that is being offered in our Region.

                                Upcoming Region 8 Webinar schedule

                                February 9, 2010    RAC Updates and Panel Discussion

                                March 9, 2010       Physician Supervision Requirements

                                April 13, 2010      To Be Announced
                                May 11, 2010        To Be Announced

                                          Webcast Road Show
                       Navigating the Day-to-Day Issues of Stress and Change
                        Presenting Linda Nash – February 10, 9:30 am–10:30 am

Please join us as we are privileged to have Linda Nash present timely information to us on how to
deal with everyday stress and change in the workplace as well as in our personal lives.

Event Description
All of us cope daily with the setbacks, changes, and “curveballs” that life inevitably throws our way. The key is how
well we handle them. In this timely webinar, you’ll learn sensible strategies and tips to reduce your stress, cope
with issues, and bounce back with greater courage, confidence, and a positive perspective.

This webinar will include:
• Making choices and taking control in times of change
• A proven process to more effectively deal with emotional issues
• Understanding the transition curve – where you are – and what to do about it
• Analyzing your stress with three key questions
• Keys to reducing personal stress and finding balance in a wobbly world
• Communicating during change and transitions
• Identifying your inner strengths and leveraging them for greater resilience
                                    Webinar Education

Webinar Announcements                                                        Submitted by: Tracy Packingham

                                         About the Webinar Speaker
Linda Nash, MBA

Linda has gained an international reputation as a leading expert on organizational development, change manage-
ment, and workforce motivation. She has guided both small and multi-national organizations through the chaos of
change and transformation. Her clients call her a lighthouse -a catalyst –an energizer.

Linda has written for or been featured in articles in the Wall Street Journal’s National Business Employment
Weekly, Chicago Tribune, San Diego Union Tribune, San Francisco Chronicle, St. Louis Business Journal, and
many other newspapers and magazines. She regularly writes for HR Insights Magazine, serves on the editorial
advisory board, and does national audio and web based programs. Linda has authored five books.

Linda’s strength and resiliency assessment tools, the Bounce Back Quotients® are used by organizations and
consultants internationally and endorsed by the International Association of Public Management for Human
Resources. She has coached or consulted with more than 2,000 individuals, and dozens of organizations point to
her as the turning point to their success. Her clients range from Fortune 500s to start ups, associations, and
government agencies.

She is a frequent keynote speaker at national conferences and a workshop/seminar leader in corporate and
association venues. Her practical tools coupled with her enthusiasm, quick wit, great stories and motivational style
really connect and inspire audiences to find fun and joy in life while achieving stellar results. Linda’s clients attest
that her programs, consulting, and coaching have helped them focus on the “right” issues, bounce back from
challenges, and move forward with greater control, confidence, and courage.

For five years she served as an adjunct professor in the ILR School at Cornell University in New York and she
currently teaches in the graduate program at Webster University in St. Louis. She is a professional member of the
National Speakers Association, past chapter president, and alumna of Greater Missouri Leadership.

For information on Linda’s programs, books, assessments, and availability:
Phone: 314-872-8787 Toll free: 1-800-701-9782 Email:
Web site: Help yourself to free articles.

Who Should Attend

Healthcare CEOs, CFOs, financial directors and leaders, patient financial service directors and managers, HIM
directors, compliance officers and consultants that work within healthcare finance and the revenue cycle,
Registration, billing, AR representatives, and office staff.

Registration Fee

$50.00 per dial-in connection for each facility
$10.00 for students per dial-in connection
Please see website for registration information.

This program will be live on February 10 at 9:30 am. There will be time for a question and answer session. This
session will be recorded and played back on February 16 at 1:30 pm to accommodate your schedules and staffing
                                            Awards Updates

Awards Committee                                                              Submitted by: Jerrie Weith

                        Founders Awards are for Special Contributions!
HFMA Founders Awards are presented to HFMA members for their individual contributions to the success of
HFMA. Individual contributions considered include committee leadership, board service, authorship and presen-
tations. The awards presented each fall represent cumulative service for the period ending the previous May.

The Greater St. Louis Chapter of HFMA is proud to honor the following individuals for their Founders Awards

                                     Tracy Packingham           Follmer Bronze
                                     Don Rapp                   Follmer Bronze

                                     Joanne Hollett             Reeves Silver
                                     Becky Welker               Reeves Silver

                                     Sharon Redel               Muncie Gold

Congratulations to each of our members for their achievement. Not only is our chapter proud, but the founders
for which the awards were named would be proud, too.

                       Awards Celebration Night – Time For a Shout Out!
It's time for the Greater St. Louis HFMA Chapter to recognize its superstars for the 2009-2010 year. SAVE THE
DATE now to join us at the Second Annual Spring Awards Program when we distribute the President's Awards,
Certified Member Sponsor of the Year, Recruiter of the Year, Committee Member of the Year, Committee Chair
of the Year, New Member of the Year and other special recognitions.

The Spring Awards Event is just around the corner. April 28 to be exact. Do you know someone who deserves
to be considered as New Member of the Year? Committee Member of the Year? Who has inspired you to be
Certified? If you have recommendations, email Jerrie Weith by February 1 with the person’s name and why you
think they should be recognized. None of us should be working hard in HFMA for the recognition, but if you’re
going to work hard, you might as well be recognized!

                                      Make Your Reservation now!

                                          Wednesday, April 28
                                              Cocktail Party
                                                4:30 - 6:30
                                        Pujols 5 at Westport Plaza

Well drinks and appetizers. $20 per person. (Awardees’ reservations are complimentary.)

Please RSVP no later than April 20. Payment can be made at the door, but please let us know you are coming.

For questions, contact Jerrie Weith – 314-655-5558 –                               12
                        Practice Management Corner
                                        Submitted by: Jerrie K. Weith, FHFMA

             Physician Practice 102 for Hospital Execs – Planning for Success
In the first of this three-part series, we explored the current healthcare environment and the challenges faced by
hospital executives and physicians. At the 30,000-foot-level, we explored the “new again” trend of hospital-physician
integration and the pitfalls from previous attempts. We left with the WIIFM question – what’s in it for me?

This edition will help us understand how physicians and hospitals are alike and different. Understanding these simi-
larities and differences is critical to effectively managing the newly-acquired physician practices operating in health
systems and hospitals across the nation and in our region.

What do physicians and hospitals have in common?
Patients! Both are committed to delivering high quality medical care in a timely and effective manner. Both agree that
appropriate utilization of resources is fundamental to that effort.

There are also several common management philosophies. Both parties agree that continuous attention to perform-
ance improvement will help their organizations sustain themselves. Hospitals and physicians know the revenue cycle
is the lifeblood of the business side of their organizations, and that a successful enterprise is directly related to service
quality and management effectiveness.

Then why aren’t these endeavors more successful? It’s all in the definition. A physician’s idea of appropriate utiliza-
tion of resources may vary drastically from that of a hospital executive. A hospital executive’s concept of timely deliv-
ery may be different from that of the physician charged with delivering that care. Reconciling expectations is impor-
tant in the physician-hospital integration strategy.

What about the differences?
Physicians and hospitals have similar philosophies; it is the differences in relationships and processes that usually
cause the friction. Here’s a quick comparison of some of the differences between physicians and hospitals:

            Area                          Hospitals                                          Physicians
 Patient Choice         Usually quality driven, but not relationship   Usually relationship driven first, then quality driven
                        driven                                         (patients think it’s the same thing)
 Care                   Episodic                                       Extended period
 Staffing               Often FTE’s to beds/LOS/census; can be         FTE’s to providers; rarely interchangeable with other
                        portable between areas                         areas
 Charge capture         Multiple sources and entry points              Generally single source
 Coding and billing     DRG’s, revenue codes                           CPT, ICD-9, HCPCS (service by service)
 Claims value           Claims often $100,000+                         Claims rarely exceed $20,000
                        Generally integrated with financial systems
 Patient accounting                                                    Rarely integrated with financial systems
                        such as GL
 Managed care           Multiple components to the contracts; can      Generally only one service line to negotiate; MCO’s
 contracting            withstand a “loss leader”; MCO’s likely to     unlikely to negotiate with 20 or fewer doctors in a
                        negotiate                                      group
 Accounting             Accrual basis                                  Modified cash basis
 Expense allocations    By department/service line                     By physician production
 Organizational chart   Tiered                                         Flat
 Board of directors     Community members and physicians               Physician-owners
                        Successful hospital executives are manager-
 Management                                                            Successful physicians are entrepreneurs by nature
                        leaders by nature

 Politics               Politically savvy and good communicators       Excellent clinics not often minding the politics 13
                     Practice Management Corner
                                    Submitted by: Jerrie K. Weith, FHFMA

  Physician Practice 102 for Hospital Execs – Planning for Success (continued)

Quite a few differences!

Many of these items are generalities. And, we can all identify exceptions. However, these are typically the differences
that are often discounted by both parties when they want the integration process to take place.

While the next article will dig into details as to how to improve the effectiveness of hospital-physician integration
strategies, the basic steps are easily identifiable and do take into consideration the differences outlined above:

1. Each party should independently draft a simple strategic plan that describes what they expect to benefit
   when participating in the integration. Be honest. If the hospital’s primary intent is to gain market share and the
   physician’s primary intent is to slow down his/her practice – are these two ideas compatible? It’s better to find out
   at the onset than one year into the arrangement.

2. Establish expectations between the parties. Discuss openly with each other the clinical requirements, service
   delivery parameters, community responsibilities, non-clinical obligations.

3. Set goals to which both parties can agree. Include production, management input and responsibility, patient
   care, and profitability in these goals. Contrary to conventional wisdom, it isn’t okay for the hospital to expect to
   lose “only x dollars annually” unless there are truly extenuating circumstances.

4. Monitor the goals and expectations on an on-going basis with regular communication.

Coming Soon
The final article will discuss how to get the integration right so the goals and expectations of both parties are met and
the bottom line result is achieved; ultimately resulting in improved and more comprehensive patient care in a fiscally
responsible delivery system.

Jerrie is Director of Health Care Services with Anders Minkler & Diehl LLP. She is an experienced and successful
hospital-physician integration consultant, working with hospitals and doctors to form mutually rewarding relationships.
Jerrie can be reached at and 314-655-5558. For more info visit

                                             Legal Lines Corner
                          Submitted by: Gerald J. Bamberger, Attorney at Law, Saale & Bailey, LC


In the July, 2009 issue of Gateway Gatherings my Legal Lines article was entitled “Limitation Of Evidence
of Amounts of Medical Expenses in Personal Injury Cases. The article discussed the pertinent statute,
Section 490.715 RS Mo which creates a rebuttable presumption that the value of the medical care received
by the injured party plaintiff is the amount actually paid by the patient, insurer, Medicare or Medicaid in full
satisfaction of the charges. But personal injury attorneys want the jury to know what the full amount of the
charges were, believing the lesser amount actually paid is not indicative of the severity of the injury and the
extent of the treatment. After enactment of the above statute in 2005 most courts accepted the lesser
amount actually paid as the amount to be presented to the jury. But more recently plaintiff’s attorneys
have been more aggressive in attempting to have a larger amount of the medical bills presented to the jury
by filing a motion to rebut the statutory presumption. Thus the question before the court is what evidence
is required from the plaintiff to overcome the presumption that the amount paid in full payment of the
charges is the usual and customary charge for the services.

Recently the Missouri Court of Appeals, Eastern District, in James Berra vs. Charles E. Danter, No. 92279
addressed that issue. This was the case before Judge Timothy Wilson discussed in the July 2009 issue of
Gateway Gatherings. In Berra, the plaintiff attempted to rebut the presumption that the amount actually
paid by Medicare in full payment of the charges was the amount of medical damages to be submitted to the
jury. This motion was heard by the court outside the hearing of the jury. The plaintiff presented to the court
the actual bills totaling $118,015.61, supporting affidavits, and supporting testimony. Although the court’s
opinion did not state the nature of this evidence, who made the affidavits, what testimony was presented
and the qualifications of the affiant and supporting witness, the trial court determined the amount of the
plaintiff’s medical damages to be $90,062.52 and presented that sum to the jury. The appellate court
affirmed the trial court’s ruling. I spoke to plaintiff’s counsel and was advised that he obtained an affidavit
from a member of the patient accounting department of the treating hospital that the full charges before
payment by Medicare was the reasonable value of the services and that the witness testified that if no
payment had been made by Medicare the hospital would have pursued the patient and any other responsi-
ble party for the full amount of the hospital’s charges.

Based on this ruling I would expect plaintiff’s attorneys to regularly request the patient account representa-
tives of treating hospital as well as the treating physician to execute affidavits pursuant to Section 490.525
RSMo and present testimony that the full amount billed is the reasonable value of the services. Of course
this would subject the witness to cross examination regarding the negotiating process with health insurers.
But from the Court’s ruling it is likely that in most instances the court will permit the presentation to the jury
of charges greater than the amount paid, though not necessarily the full amount billed.

                  Chapter Website —
                                          Past President’s Corner
                         Teri Reger, FHFMA – President 2008-2009
HFMA Background
    How long have you been an HFMA member? Since 1989 – wow, over 20 years!
    Why did you join HFMA? My CFO at the time was Brian Spillers, past president of the Greater St.
Louis Chapter, and he encouraged me to join.
    What led you to become an officer and eventually the President of the HFMA? My boss at SSM in
2001, who was Chapter Secretary at the time, volunteered me for the redesigned Program Committee.
As I became more and more involved, learning how the chapter and HFMA work, I felt the pull to continue in a leader-
ship role. It was infectious, meeting and working with such great people, I wanted to be right in the middle of things!
    What hurdles did you overcome as President? I don’t recall anything I would consider a hurdle. All of the many
requirements, due dates and emails from National were challenging, all what I considered part of my responsibilities.
    What is your greatest accomplishment as President? I won’t take credit for anything personally because I could not
have done any of it alone. I was very fortunate to be part of a great group of leaders.
    If you had to do it over again, would you and why? Absolutely! I encourage all of our up and coming leaders to
consider the officer rotation. Start off on the Program Committee, run for the Board, learn how the chapter functions,
and then everything will start to click. I had such a wonderful leadership team! We worked together to meet our
strategic goals for the chapter, and of course, make sure everything was turned in to National on time!!

Professional Background
    How long have you been in healthcare? I started my career in health care in 1982 as a Medicare auditor for Blue
Cross Blue Shield of Missouri. Now there’s something they don’t teach you in college!
    Why did you get into healthcare? By happenstance, that was my first job out of college, newly married and I
needed to work. It didn’t hurt that my dad was on the Board at Blue Cross. He promised me that he only got me the
interview and I did the rest. That’s my story!
    Who do you work for and for how long? I worked for Blue Cross from 1982-1989. My daughter was born in 1988
and I wanted to cut down on the travel. I began working for St. Luke’s Hospital in Chesterfield in 1989, and stayed with
them through the Unity/post-Unity years until 2001. That’s when I started working for SSM Health Care.
    What is your current position/title and major responsibilities? I am the Corporate Manager – Revenue Cycle in the
Corporate Finance Dept. of SSM Health Care. My major responsibilities generally cover system-wide initiatives relating
to revenue cycle, third party reimbursement and performance improvement.
    What has been your career path? Since I started out as a Medicare auditor, yes doing cost report reworks by hand,
I developed a knowledge base in Medicare reimbursement. I took that to St. Luke’s and expanded it to include addi-
tional Finance department responsibilities. Then after joining SSM, I expanded a bit more to delve into revenue cycle
and now performance improvement.
    What other professional organizations besides HFMA do you belong to? That’s it – it keeps me busy!
    Any other comments to add? I am pleased and honored to have been selected as the Region 8 Regional Executive
for HFMA 2011-2012. I will be learning all about the position as Regional Executive Elect beginning June 1, 2010.
Thanks to the Greater St. Louis Chapter for all of your support! I am looking forward to serving Region 8 (nine chapters
in Missouri, Kansas, Iowa, Nebraska, Minnesota, North Dakota and South Dakota).

Personal Background
    Are you married? I am married to Rich Reger (16 years), of the famous northeast Missouri Regers! While I was
Chapter President, we designated him First Gentleman. I think he kind of liked that title!! Do you have kids? We have
three kids – Rich has two – Nate (24) and Mallory (21), and I have one – Elizabeth (21). All have some level of
“significant others” so we’ll see what the future holds. No kids together. Grandkids? Pets? No grandkids yet, and no
pets for now.
    Have had any special traveling trips? Rich has won two trips through his work so I happy to tag along with him. I
am the spouse on those trips so get to help him wine and dine his customers. We went to Maui in January 2009 and
are going to Ireland in May 2010.
    What are some of your hobbies? Love to play golf, watch movies, go to wine tastings, and try new restaurants
    What do you like to do in your spare time? For now, I have lots of homework as I am working on my Masters in
Management degree at Fontbonne. I graduate in May 2010, and after that I hope to relax, play golf and enjoy my
summer! Mom and Dad have a house at Lake of the Ozarks (41mm), so that helps!                                  16
                                      Past President’s Corner

                             Kathy Hughes, FHFMA – President 2007-2008
HFMA Background

    How long have you been an HFMA member? As long as I have been in healthcare – 33 years.
    Why did you join HFMA?
My first boss in healthcare – Dave Seifert – suggested it. I was naïve and so thrilled to be given this
membership! Then I later learned that he was an officer on the Board and needed help with the
newsletter. I still laugh about it to this day, although HFMA has been wonderful for my career.
    What led you to become an officer and eventually the President of the HFMA?
I had been a Director on the chapter Board twice and had considered being an officer before. My career and young
children at home made the additional duties of an officer seem impossible. Now that both boys are grown up and out
of the house (usually), I felt that it was an additional role that I could take on.
    What hurdles or obstacles did you overcome as President? I guess the biggest one was that National HFMA was
moving to reviewing chapter performance based on a balanced scorecard with points assigned for achievement of
certain goals. My year as President was the transition year.
    What is your greatest accomplishment as President?
It was really building on what our other chapter Presidents had started – the financial turnaround of the chapter in the
form of increased sponsorship $ and building up a reserve so that we could offer better programming.
    If you had to do it over again, would you and why?
Yes, it offers even more networking opportunities, both at a local and national level, than members that are less
involved get a chance to have. In addition, it put my leadership skills to the test in an environment that was different
from work.
    Any other comments to add?
HFMA has really proved to be very important in my career path and the different jobs that I have had.

Professional Background
     How long have you been in healthcare? 33 years
     Why did you get into healthcare?
I lived close to St. Anthony's Medical Center. I was home for the summer between my junior and senior year in college
(where I was a business major) and looking for a job that my Mom could drop me off at on the way to work – or I could
take a Bi-State bus. I didn’t own a car. Dave Seifert hired me as a summer temporary in the Finance department,
helping the outside auditors with various tasks. At the end of the summer, he told me that if I took some more account-
ing classes my senior year in college, he would have a job waiting for me when I graduated. (Thanks Dave – and I
mean that!!) I didn’t know what industry I wanted to go into – and this seemed as good as any!
     Who do you work for and for how long?
Although I left St. Anthony's Medical Center after 12 years and went to work for other companies, I am now back at St.
Anthony's Medical Center and have been for 8 years.
     What is your current position/title and major responsibilities?
I am Director of Patient Accounts.
     What has been your career path?
After leaving St. Anthony's Medical Center, I worked as VP of Marketing for RC Wilson Company – a collection agency
located in St. Charles. Then I worked for BJC and SSM and now I am back here at St. Anthony's Medical Center.
     What other professional organizations besides HFMA do you belong to? None.

Personal Background
    Are you married? Do you have kids? Grandkids? Pets?
I have been married to Mike for 30 years, but have known him for 38 years. We dated in high school. We have two
wonderful boys and Max, the dog. John is 24 years old and a lieutenant in the Army, currently deployed in
Iraq.    Steven is 18 and just graduated from high school last May. He is still trying to “find” himself and what he wants
to do – he is a drummer in a band, works at Burger King and at a video game store.
    Have had any special traveling trips?
Our whole family likes to travel. We’ve been to Europe and various places in the US. John has had the most extensive
travel experience when he was at West Point and now in the Army. He has been to Spain, Germany, France, Iraq, and
South America.
    What are some of your hobbies?
I have more time for hobbies now than I ever did before—reading, cooking, more time to travel, etc.               17
                                   Past President’s Corner

                           Linda Davidson – President 1993-1994

               Special Feature – Linda Davidson’s Retirement
(Editor’s Note – In honor of Linda Davidson’s retirement from Mallinckrodt Institute of Radiology
at Washington University, we wanted to recognize Linda for her many years of faithful service to
the Greater St. Louis Chapter of HFMA, as well as to healthcare overall. Several of her co-
workers and friends, including numerous past presidents, attended her retirement party last
Spring. Many of the questions below revolve around this, along with the pictures as well.)

    How did the retirement party come about?
I retired in January; my husband retired in April. This was several years earlier than we had expected (we are
quite young retirees, you know!!). I had a health scare in 2007 following gastric by-pass surgery. That sort of
thing makes you reconsider your priorities and I had to admit what I have denied for so many years - I, too, am
a mortal human! The good news was that after a long recovery, I have lost 170 pounds and now have more
energy and feel better than I have in years. We crunched the personal numbers and decided that we would be
able to retire and still give our now 203(b)'s a chance to recover. So, we both retired. We were excited and felt
blessed to be able to do so. Alen was a chemical engineer and I was the executive administrator at Mallinck-
rodt Institute of Radiology for over 20 years. This is what we knew! So what to do first? Our bucket lists were
long. The choice was easy. First, we would throw a big party to thank family, friends, coworkers, mentors, and
others who helped us along the way. The theme of the party was to be our retirement theme: live well, laugh
often, love much! We rented a hall, had food and drinks catered, got a DJ, designed a personalized trivial pur-
suit game and I made up baskets for a few lucky winners of attendance prizes. It was so much fun preparing for
that party. The hard part was the guest list. Hall size was pretty limiting. In retrospect, I would have gotten a
bigger place and had more people. We had a blast!
    Who were some of the people who attended your party?
I was so pleased with how many of my HFMA family showed up. Included among the guests were Don Stone,
who came down poem-in-hand from Wisconsin, John McGuire who helped me get my first shot at a National
HFMA position, Janet Montgomery, Jackie Bonness, Jerry Garrett, my first healthcare boss, Don Fitzgerald with
whom my family shared a great time in Cozumel for a HFMA Prez meeting, Bob Salmo, Chris Buckley, and my
good friend Sherry Ridings, Unfortunately, Marty Sorenson, who first got me involved with HFMA was unable to
attend for health reasons, but he was there in spirit!
    Was it a surprise?
No, it was pretty well planned out, although my daughter and her husband surprised us with a caricature of
Alen and I traveling down Route 66 that all our guests signed. (see page 19)
    Where was it?
The party was held in April at the Hearth Room in Webster Groves. Very secluded, pretty spot. Quiet, until we
got there! Close to Don Fitz's house in case he had trouble getting home.

                                     Past President’s Corner
                                                      (Linda continued)

    What had changed over the years while you were involved with HFMA?
Gosh, so many things changed. And, while change is challenging, change is also good. There was a definite
division among membership when I started. It was frowned upon for "vendors" to be leaders in HFMA, and
everyone wore similar hats. You could tell back then what a person did by their title. Not so any more.
    What do you miss most or least about your time with HFMA?
I miss the people, but I don't miss seeing the stress that everyone is going through in this economy. It impacts
    Any war stories you would like to share (fit for a newsletter)?
When I was sworn in as President of the Chapter, Mary Sorenson and Don Stone were there presenting me
with roses on bended knee. You have to know those two to appreciate it! Don and I once did a Karnak act - I
was Ed McMann to his Johnny Carson. And I remember when HFMA proudly elected John McGuire as Na-
tional Chairman we gave him a bright red cummerbund that lit up with the letters HFMA. I can still picture him
dancing away in that thing. I remember the fun times the most.
    Is there anything you would like to say to your friends at HFMA (that is fit for the newsletter)?
HFMA is such a wonderful organization. I became a member to learn more about healthcare, I became active
because Marty said I had to, I became engaged because the people are awesome. In the end, it helped my
career immensely, and added so much to my life. I wonder if I hadn't been involved in HFMA if I would have
realized what I missed out on.
    Any suggestions for new members on how to maximize their utilization of HFMA?
You absolutely have to get involved. It's not as hard as you might think. It's fun if you let it be. And it is oh, so
worth it! If you are ever given the opportunity to serve at the national level, do so. It is also a great experience. I
served on the Matrix and the National Board and it was so much fun, and so rewarding. But HFMA is only what
you make of it.

My year as President was one of the most challenging and rewarding years of my career. Thanks to the efforts of
some great people - Janet Montgomery (programs), Jayne Singleton (membership) and Don Stone (newsletter)
and many others, we had an extremely successful year. We even one a BNA (big national award, a term coined
by Bob Salmo for the previously unachieved top chapter awards given out by national.) Our chapter came in sec-
ond place overall that year.

I am so grateful to everyone who helped me along the way in my career, in my HFMA duties, and in my personal
life. I want to extend a sincere thank you to each of you (and you know who you are!) who made it possible to
live well, fun to laugh often and easy to love much!

                                                                                            (From left to right)

                                                                                            Alen Davidson,

                                                                                            Don Stone, and

                                                                                            Linda Davidson

                 Greater St. Louis HFMA
                   Upcoming Events
February 18             Legislative Update – 12:00-3:00 (lunch is provided) FREE PROGRAM
                        Daniel Landon, Sr. VP of Govt. Relations – MO Hospital Association
                        St. Luke’s Hospital (Chesterfield) – Education Center

March 18                RAC Panel (location and time to be determined)

April 28                Annual Awards Event – 4:30-6:30
                        Pujols 5 – Westport Plaza

May 19-21               Spring Conference – (Greater St. Louis and Show-Me Chapters)
                        St. Charles Convention Center – St. Charles, MO

      For more info on our programs, visit the website –

                                  Webinars Scheduled
February 9          Region 8 Webinar Series – 12:00–1:30
                       RAC Updates and Panel Discussion
                    Moderator: Tanja Twist, National AAHAM Finance Chairperson
                       Director, Financial Services – Methodist Hospital of Southern California
                       Cindy Matson, CHC – Sanford Health, Sioux Falls, SD
                       Mike Tretina, CPA, MBA, FHFMA – Mary Greeley Medical Ctr., Ames, IA
                       Denise Bloch, J.D. - RehabCare Group, Inc., Saint Louis, MO

February 10         Webinar Road Show – 9:30–10:30
                      Navigating the Day to Day Issues of Stress and Change
                      Presenter: Linda Nash, MBA
February 16         Webinar Road Show – 1:30–2:30 (Feb 10 Webinar to be repeated)

March 9             Region 8 Webinar Series – 12:00–1:30
                       Physician Supervision Requirements
April 13            Region 8 Webinar Series – 12:00–1:30 (topic announced soon)
May 11              Region 8 Webinar Series – 12:00–1:30 (topic announced soon)

       Region 8 has come together to offer a webinar to our region every 2nd Tuesday of each
       month from 12:00 – 1:30 through May 2010. Please mark your calendars accordingly.

                                 Board Meeting Dates
                                   (Location to be determined)

March 19 – Friday, 2:30-4:30 PM                             May 14 – Friday, 2:30-4:30 PM

       (Please print this page for an easy reference to have these event dates handy.)


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