Print Jan HFMA Newsletter

					                                                            Iowa
 Volume 60 | Issue 4
 April 2008




Network
                                                                                                      SERVING THE MEMBERSHIP OF THE
                                                                                                      IOWA CHAPTER OF HEALTHCARE
                                                                                                      FINANCIAL MANAGEMENT ASSOCIATION




Editor:
Stephanie Hultman, CHFP,
                                                            WPS Meeting - Successful
CPAT, CCAT                                                  SUBMITTED BY: Mike Dewerff, FHFMA, CPA

                                                                                  On Thursday, March 13, 2008 a record crowd of over 220
Inside this Issue                                                                 attended the HFMA-sponsored meeting, “Are You Ready for
                                                                                  the Big Medicare and Medicaid Changes Ahead?” The large
Directors & Officers. . . . . . . . . . 2                                         audience was an indication of the major changes ahead.
Treasurer’s Report. . . . . . . . . . . . . . . . . 2
From the President . . . . . . . . . . 3                                          The day started off with a presentation by Iowa’s new
Winter Meeting Photos . . . . . . . . . . . . . 5                                 Medicare Administrative Contractor (MAC), Wisconsin
Sponsor Spotlights . . . . . . . 6 & 8                                            Physician Services (WPS). Paul Hula, Senior Manager
New Members . . . . . . . . . . . . . . . . . . . . 9                             Regional Audit, gave an overview of the Medicare MAC
Member Spotlight. . . . . . . . . . . 10                    reform process, WPS Company information, transition information, and audit top-
Upcoming Programs . . . . . . . . . . . . . . 11            ics. The main goal for WPS is a seamless transition with their new Iowa providers.
Certification Goal . . . . . . . . . . . 14                 Their recent transition with the state of Kansas has gone smoothly. WPS is look-
Guidelines . . . . . . . . . . . . . . . . . . 15 & 25      ing forward to having open communication with Iowa providers, starting with an
How to Select an Agency. . . . 21                           April 3rd meeting organized by IHA with a group of Iowa hospital CFO’s,
                                                            Business Office Managers, and Reimbursement Directors.
IRS 990. . . . . . . . . . . . . . . . . . . . . . . . 22
Certification Q&A . . . . . . . . . . . 23
                                                            The purpose of the new Medicare MAC jurisdictions is to balance the allocation of
                                                            workload, promote competition, account for integration of claims processing activ-
                                                            ities, and mitigate the risk to the Medicare program during the transition to the
                                                            new contractors. Iowa’s MAC jurisdiction also includes Nebraska, Kansas, and
                                                            Missouri. CMS will rebid the MAC contract every five years.
Take a Look!
                                                            WPS is a not-for-profit company that administers Part B benefits for 4.5 million
Check out all the great things you can                      seniors in Wisconsin, Illinois, Michigan, and Minnesota. Effective in November,
do on the IOWA Chapter website at:
                                                            2007, WPS purchased the assets of Mutual of Omaha Medicare Part A
www.hfmaiowa.org                                            Operations to administer Part A and Part B Medicare claims. WPS handles 11%
                                                            of the national Part A claim workload, or 20 million claims representing nearly
Sponsor Listing                                             $35 billion. They also process 10% of the national Part B claims workload, or 100
                                                            million claims representing $7.9 billion. In total, WPS handles 2.6 million tele-
see pages 16&17                                             phone and written inquiries while earning a high ranking for provider satisfac-
                                                            tion. WPS will be transitioning 390 hospitals over the next few months. Iowa
                                                            transitioned to WPS on February 1, 2008 for Medicare Part B, and will transition
                                                            May 1, 2008 for Medicare Part A.
                                                                                                                  article continues on page 4...


                                                                                                                               IOWA NETWORK   1
                                                                                                                                           Treasurers
2007/2008 HFMA Iowa Chapter—Officers, Directors, Committees
                                                              OFFICERS:
                                                              President           Susan E. Searcy
                                                              President-Elect
                                                              Vice President
                                                                                  Renee A. Rasmussen
                                                                                  Michael J. Dewerff
                                                                                                                                           Report
                                                              Secretary           Paul R. Baumert                                          SUBMITTED BY:
                                                              Treasurer           Christy M. Des Jardins                                   Christy Des Jardins, FHFMA. CPA
                                                              Past President      Shaun M. Magill

                                                              BOARD MEMBERS:
                                                              Term expires 2008                             JUNE 2007 - JANUARY 13, 2008
                                                              Stephanie Hultman
                                                              Randy Rubin                                   INCOME                                      ACTUAL         BUDGET
                                                              Matt Ives
                                                                                                            Other Meeting Income                           (130.00)
                                                              Term Expires 2009                             Meeting Summer                                14,340.00      13,000.00
                                                                                                            Meeting Fall                                  25,275.00      26,000.00
                                                              Bruce Barnes
                                                                                                            Meeting Winter                                               12,000.00
                                                              Tim Huber
                                                                                                            Meeting Spring                                               11,000.00
                                                              Shawn Steffen                                 Meeting Boot Camps                           101,750.00     101,000.00
                                                                                                            Meeting Joint Chapter                                        15,000.00
                                                              COMMITTEES:                                   Other Meeting Income                        $141,235.00    $178,000.00
                                                              Attendance              Luke Gruber           Dues Rebate                                    8,818.80       8,500.00
                                                                                                            Interest Income                                2,858.91         250.00
                                                              Audit                   Jerry Heinzler
                                                                                                            General Sponsorship                           41,600.00      35,000.00
                                                              By-laws                 Tracy Warner
                                                              Certification           Paul Baumert          Total Income                                $194,512.71    $221,750.00
                                                                                      Chris Chartier
                                                              Credit and Collection   Susan Searcy          EXPENSES
                                                              Directory               Sandy Chesshire
                                                                                      Pam Brindley          Meeting Summer                                13,713.14      17,000.00
                                                                                      Stephanie Hultman     Meeting Fall                                  16,361.45      22,000.00
                                                              Founder’s Points        Randy Rubin           Meeting Winter                                               12,000.00
                                                                                                            Meeting Spring                                               11,000.00
                                                              Historian               Tracy Warner
                                                                                                            Meeting Boot Camps                            92,770.57     101,000.00
                                                              Hospital                                      Meeting Joint Chapter                                        15,000.00
                                                               Association Liaison    Heather Hulscher      Leadership Trg Mtg Exp                           575.00       2,500.00
                                                              Job Referral            Paul Mangin           Leadership Trg T&E                             4,209.85      16,000.00
                                                              Membership              Tim Huber             Newsletter Expenses                              707.50       2,000.00
                                                                                                            Directory Expenses                             5,815.27       6,500.00
                                                                                      Kara Dunham
                                                                                                            Member Recog Awards                              479.12       1,500.00
                                                              Networking              Liz Stufflebeem       HFMA Web Site                                  2,601.24       3,500.00
                                                              Newsletter              Stephanie Hultman     Office Supplies/Copying                           95.37
                                                              Nominating              Susan Searcy          Postage                                          116.27
                                                                                      Michael Dewerff       Telephone                                         87.01
                                                                                                            Insurance From National                          944.23          1,000.00
                                                                                      Paul Baumert
                                                                                                            Bank Service Charge                               43.00            200.00
                                                                                      Christy Des Jardins   Credit Cards                                   1,280.36          1,000.00
                                                              Photographer            Stephanie Hultman     Other Expenses                                    50.00          1,800.00
                                                              Programming             Michael Dewerff
                                                              Publicity               Susan Searcy          Total Expenses                              $139,849.38    $214,000.00
                                                              Sponsorship             Susan Searcy
                                                                                                            Net Operating Income                         $54,663.33      $7,750.00
                                                              Strategic Plan          Susan Searcy
                                                              Website                 Shawn Steffen         Net Income                                   $54,663.33      $7,750.00




                                                              2    IOWA NETWORK
From the President: Chapter Surveys-Who Cares?
SUBMITTED BY: Susan E. Searcy, FHFMA, CPA


                          In October 2007, HFMA               interest you. We are always looking for good speakers
                          President Dick Clarke sent an       and new ideas. If you hear a speaker or get a brochure
                          online chapter survey to a sam-     that would be a good program topic, please pass it on to
                          ple of the Iowa members. One        the programming chairman.
                          hundred thirty-seven of our
                          members responded to the sur-       Location…Location…Location…
                          vey. First, I’d like to say thank   As a statewide chapter, the location for holding meet-
                          you to all of those that did take   ings is a challenge. We had summer meetings in Iowa
                          the time to complete the sur-       City a few years ago. We are doing multi-state chapter
                          vey. Second, I’d like to answer     programs in Omaha. Unfortunately, the meetings that
                          the question – who cares? - the     are not held in Des Moines are not well attended. We
officers, board members and committee chairs of the Iowa      would like to be able to move meetings around and still
Chapter care!                                                 be able to maintain the same level of participation, but
                                                              that has not been our reality. We do try to have our
A significant portion of the board/planning meeting on        meetings at facilities that are easily accessible from the
February 1st was spent reviewing the survey results and       interstate and offer reasonable room rates in considera-
discussing the comments. We celebrated some significant       tion of your budgets.
improvements from the survey that was conducted two
years ago. We spent more time reviewing areas for             Overall, the Iowa Chapter enjoys a high level of mem-
improvement, topics you wanted addressed and comments         ber satisfaction and participation. We are in the top
on exceeding your expectations. These can be summarized       10% of chapters for the measurement of educational
into two items – education and meeting location.              hours per member. Our membership base is strong and
                                                              continues to remain constant or grow slightly. We are
Education                                                     blessed, but we can’t be complacent. We are interested
Education was a top priority to the respondents and to        in your thoughts and ideas – you don’t have to wait for
the board. Educational programming is the biggest             the next chapter survey. If you have an ideas that would
value of your HFMA membership. Based on the recent            make the chapter better, please let me or one of the
attendance at meetings, we are covering the topics that       other officers know. I


                                                              Improve patient care.



                                                              Increase revenue.




                                                               Visit the Resources section of Cassling.com and download one of our case studies to learn




                                                                                                                   13808 F Street Omaha, NE 68137-1102
                                                                                                                        800.228.5462 www.cassling.com




                                                                                                                                 IOWA NETWORK              3
WPS Meeting - Successful, continued...
Mr. Hula also discussed cost report audits. WPS is cur-           Finishing up the day was Jeff Marston, Manager in
rent with all cost report types for providers currently           Provider Audit and Rate Setting Unit with Iowa
with WPS, and will be assessing and prioritizing any new          Medicaid Enterprise. Mr. Marston discussed IME’s
non-finalized audit workload as it arrives. Any cost              change in reimbursement methodology for outpatient
reports currently under appeal will also transition to            hospital services from APG’s to APC’s, which is effec-
WPS. Important dates and timelines were discussed and             tive July 1, 2008. He discussed the “IP Only” list, the
can be reviewed at the WPS website :                              APC codes and their Status Indicators, how they will
www.wpsmedicare.com.                                              pay, and the fee schedule codes where applicable. All of
                                                                  these items will be available on the IME website at
Lastly, a redesigned PS&R was discussed. The imple-               http://www.ime.state.ia.us/ in the near future.
mentation is currently on hold, but it promises to use
more current technology, provide user-friendly reports,           Mr. Marston also announced that Critical Access
and will be easier to access and maintain.                        Hospitals will be reimbursed for outpatient services on
                                                                  an interim rate based on the hospital’s cost-to-charge
Next, Aileen Sigler, Outreach Analyst with WPS, pro-              ratio, with a year-end settlement process. This is a
vided an overview of the WPS website, and education               change from the previous plan which was to include
and outreach services available. She encouraged everyone          CAH’s in the APC methodology. Inpatient services will
to sign up for their “Medicare e-News” newsletter in              remain on a DRG basis. This change in OP payment
order to receive important information that needs to be           methodology for CAH’s is effective July 1, 2008, pend-
communicated. Questions regarding LCD’s and the                   ing CMS approval.
enrollment process were discussed and Ms. Sigler asked
that the website be used as a starting point for that com-        In conclusion it was a very good kickoff with Iowa’s new
munication and research.                                          MAC and a good update on the big Medicaid changes
                                                                  this year. There promises to be more significant changes
Next on the agenda was a presentation by Garry Keute,             in the months and years to come and we look forward to
Business Development Manager with VisionShare.                    bringing HFMA members more educational opportuni-
VisionShare and IVANS are currently the two CMS-                  ties as they arise. I
approved vendors for connecting with the Enterprise
Data Center (EDC) in order to access the FISS and DDE
System. Effective May 5, 2008, DDE users will no longer
be able to access the FISS DDE System through Cahaba.




                                                                  Resourceful. Reliable. Responsive.




Shelly Foxworthy, Aileen Sigler, and Paul Hula, speakers from
Wisconsin Physician Services (WPS) - “Are You Ready for the Big
Medicare and Medicaid Changes Ahead?”                                                         1500 Woodmen Tower • Omaha, NE 68102
                                                                                              402.344.0500 • www.bairdholm.com
(Photo submitted by: Deanna Gray, CHFP, CPAT, CCAT)

4     IOWA NETWORK
Winter Meeting Photos:
Jan. 31-Feb.1, 2008
                              ,
PHOTOS BY: Steph Hultman, CHFP CPAT, CCAT




                                                        Tim Wh
                                                               alen, Dea
                                                                         nn
                                                              at the ho a Gray and Scott
                                                                        spitality
                                                                  by R & B        sponsore Knode
                                                                             Solution     d
                                                                                      s.
                                       esents a
                         (President) pr
          Susan Searcy             Amy Olson
                           Polo to
             Certification        awn during th
                                                e
          after her  name was dr      at the
                              Session
                Certification         ting.
                  Januar y HFMA Mee




    Will you be sitting for the                           Paul Baumert hosted a Q & A team
                                                        building exercise during the Certification
    HFMA certification exam                              Session. The winners were at the table
                                                              in the upper left hand corner!
    during the Spring Meeting?
    If you will be taking the certification exam dur-
    ing the meeting, please contact Cris Chartier
    at 515-362-5186, or charticr@ihs.org to
    make appropriate arrangements.

    The Member taking the exam is responsible
    for payment to the national organization for
    all certification fees and completion of all
    paperwork related to the certification exam,
    prior to taking the test. I




                                                                                                 IOWA NETWORK   5
                          S P O N S O R S P OT L I G H T:

                          Johnson Financial Strategies Group
                          The Johnson Financial Strategies Group of Wachovia Securities consists of three partners
                          including Chet Johnson, Craig Johnson, and Jim Gibbons. They, along with their assistant, EJ
                          Lillwitz, provide financial and investment services for individual and corporate clients. Two
                          of the main areas of focus include providing corporate retirement plan consulting and serv-
                          ices as well as endowment and foundation investment structure and advice. With their vast
                          array of expertise and experiences the group is eager to expand their existing Iowa Health
                          Care clientele. Referrals and testimonials are available upon request.




6   IO WA N E T W O R K
                                                           Winter Meeting
                                                                                         ,
                                                           PHOTOS BY: Steph Hultman, CHFP CPAT, CCAT




                                         aska Health
                              CFO at Mah
           Susan Horras, new              ,IA.
                              in Oskaloosa
                  Partnership




                                                             Welcom
                                                                   e
                                                           from Bu new HFMA Mem
                                                                  rgess Me
                                                                          morial H ber, Shawn Gosc
                                                                                  ospital in         h
                                                                                             Onawa, IA
                                                                                                      !




Record January attendance with 131 registered
           for the Winter Meeting!




                                                                Speaker, James FitzPatrick, President/CEO,
                                                                Mercy Medical Center - North Iowa with
                                                               Laura Olander following his presentation on,
                                                                                                            ty:
                                                            "A Proven Relationship Between Cost and Quali
                                                            Understan ding Premier's Performance Pays Study."



             Friday, February 1st started off with a hot
           breakfast for everyone attending the meeting.
                 Beth Watson waits for her omelet.




                                                                                                           IOWA NETWORK   7
                   S P O N S O R S P OT L I G H T:

                   Commerce Bank
                   Commerce Bancshares, Inc. (NASDAQ: CBSH), is a $16 billion regional bank holding com-
                   pany with headquarters in Kansas City and St. Louis, Missouri. Commerce Bank N.A., a
                   subsidiary of Commerce Bancshares, Inc., has been meeting the financial service needs of
                   individuals and businesses for more than 140 years. With over 40 years of experience issu-
                   ing credit cards, Commerce Bank has been offering Purchasing Cards since 1995 and is a
                   top ten Visa Purchasing Card issuer nationwide.

                   Commerce Bank is also a leader in the automated A/P payment movement as they take A/P
                   processing to the next level with the PayMe option of ControlPayTM Advanced. This solu-
                   tion pushes approved invoice payments directly into your supplier’s account. Not only is this
                   process completely automated, but Commerce does the legwork to get the suppliers
                   enrolled.This seamless A/P solution allows you to pay your invoices using the Visa network
                   without changing your current policies or procedures. Not only does this process enable
                   you to reduce costs associated with vendor payables, but it also gives you an opportunity
                   to earn revenue share dollars for your organization.

                   For more information on how to turn your A/P department into a profit center, please call
                   Denyse Scott at 641-446-6630.




8   IOWA NETWORK
New Members:                                                  Mark Your Calendars
SUBMITTED BY: Stephanie Hultman, CHFP, CPAT, CCAT

DECEMBER 2007                                                 and Plan to Attend:
New
Michelle B.Tweed – The CBE Group, Inc.,Waterloo, IA                 July 23-25, 2008
Perry J. Meyer – Iowa Hospital Association,
  Des Moines, IA                                              Summer Meeting & Golf Outing
Charlotte M. Beck – Wellmark BCBS, Des Moines, IA                   Hilton Garden
Sonja Sievers – Buena Vista Regional Medical Center,
  Storm Lake, IA                                                     Johnston, IA
Tony Fortmann – Mercy Medical Center, Cedar Rapids, IA
                                                                    October 22-24, 2008
Reinstated
Jay R. Quick – Iowa Health, Des Moines, IA                    Fall Meeting - Annual Institute
Dustin C.Wagner – Iowa Hospital Association,                          Hilton Garden
   Des Moines, IA
                                                                       Johnston, IA
Transferred
Kathleen L. Heckman – St. Luke’s Hospital, Rock Island, IL          January 29-30, 2009
J A N U A RY 2 0 0 8                                                  Winter Meeting
New                                                                   Hilton Garden
Melinda M Alt, Guthrie County Hospital,                                Johnston, IA
  Guthrie Center, IA
Susan M Keiser,Trinity Regional Health System,
  Rock Island, IA                                             April 23-24, 2009: Spring Meeting
Glena Reichert, ICE Technologies, Illinois City, IL                     Hilton Garden
Melissa D Walter, Decatur County Hospital, Leon, IA
Gary A Jensen, Jr., AAMS,West Des Moines, IA                            Johnston, IA
Leann Kai, Iowa Health System, Des Moines, IA

Reinstated
Mark Raven,Wayne County Hospital, Corydon, IA
Barbara K Bell, Ottumwa Regional Health Center,
  Ottumwa, IA
Patti Weiland, Cedar Rapids Physicians Hospital
  Organization, Cedar Rapids, IA

F E B R U A RY 2 0 0 8
New
Jennifer Eubanks, St. Luke’s Hospital, Cedar Rapids, IA
Michelle A Wood, St. Luke’s Hospital, Cedar Rapids, IA
Leah Knapp, St. Luke’s Regional Medical Center,
  Sioux City, IA

Transferred
Michael A Creary, Knoxville Hospital & Clinics,
  Knoxville, IA
Ken L. Fisher, University of Iowa Healthcare, Iowa City, IA


                                                                                      IOWA NETWORK   9
New Member Spotlight: Michelle Woods SUBMITTED BY: Nancy Kort, FHFMA
Why did you join HFMA and what do you hope to get out of your membership?
I joined HFMA in order to gain greater knowledge of healthcare financial issues and to learn about changes that affect the
this industry. I hope HFMA will help me network with others in the industry and stay abreast of changes.
How long have you been in your current position ? How long in healthcare?
I have been in my position for about one year and in healthcare for four years. I have held other accounting positions
here at St. Lukes in the accounting areas such as GL, budget and now business planning and reimbursement.
What do you see as Iowa’s biggest asset?
It’s people. They are really friendly willing to help each other and are compassionate and caring for their neighbors.
What do you see as healthcares biggest challenge?
I see healthcare’s biggest challenge being the current insurance and reimbursement payment mechanisms. How providers
can be adequately paid and keeping third party relationships fair to the insured.
Who is you hero?
One of my heroes is Oprah Winfrey. She is such a good role model for today’s women. She is so generous and
does a lot of good.
What do you do in your spare time?
In my spare time I like to garden and play with my dogs.   I




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                                                                        Credit Reporting           Bad Check Recovery
                                                                        Self-Pay Billing            Clean-Up Projects
                                                                        Litigation/Legal Support   Contract Pmt Monitoring
                                                                        Insurance Billing &         Credit/Collection
                                                                          Follow-up                    Education & Training

                                                                               For additional information contact:

                                                                          Pam Brindley, CCAE, CHFP, CPAT, CCAT
                                                                                       Account Executive
                                                                                         515-669-9396

                                                                           Stephanie Hultman, CHFP, CPAT, CCAT
                                                                                       Account Executive
                                                                                         319-240-5306
                                                                                    http://www.hraccounts.com


10     IOWA NETWORK
Upcoming Programs                                                                      ,
                                                  SUBMITTED BY: Stephanie Hultman, CHFP CPAT, CCAT


Iowa HFMA Spring Meeting                                    Competitive marketplace conditions will be character-
                                                            ized in terms of the number of competing opportunities
April 24 - 25, 2008
                                                            in Iowa in the major medical specialties. Mr. Tracy will
Hilton Garden Inn
                                                            recommend specific recruitment strategies and delineate
                                                            the elements of recruitment packages being offered by
Thursday, April 24, 2008                                    employers today. The attendee will:
Physician Recruitment Strategies in Iowa                    • Gain an understanding of the workforce trends that
Presented by: Roger Tracy, Adjunct Associate Professor,        are influencing efforts to recruit and retain physicians
University of Iowa College of Public Health Mr. Tracy          in Iowa.
has been with the University of Iowa College of             • Assess the degree of competition in the Iowa market-
Medicine for the past 36 years, and Is Assistant Dean of       place for specific specialties.
the College of Medicine, Director of the College’s          • Recognize the recruitment and retention strategies
Office of Statewide Clinical Education Programs, and           being used by physician employers.
Director of the Iowa Network of Family Medicine
Residency Programs. He has consulted nationally in sev-     Ten Questions Leadership Should Be
eral fields, including graduate medical education, rural    Asking About Their Revenue Cycle
medical services, physician recruitment, and workforce      Presented by: Robin Bradbury, CEO, re|solution
tracking.                                                   Robin Bradbury is the founder/CEO of re|solution
                                                            (www.ereso.com), a Broomfield, Colorado based rev-
Awarded the John F. Sanford award by the Iowa Medical       enue cycle optimization organization providing solu-
Society for his work in physician recruitment and com-      tions for the business challenges faced by health care
munity service, and has received two distinguished serv-    providers. A graduate of Brigham Young University
ice awards from the Kidney Foundation of Iowa. Mr.          (BS) and the University of Utah (MBA), he began his
Tracy has his Masters Degree in Health Care                 career and spent eight years as a Certified Public
Administration from the University of Iowa.                 Accountant with Deloitte Touche in Colorado.

Mr. Tracy will discuss physician workforce trends as they
relate to recruitment and retention of physicians.                                     article continues on next 2 pages...




                                                                                                      I O WA N E T W O R K   11
Mr. Bradbury is an accomplished speaker, author, entre-       Office of the Florida Attorney General; Chief Major Case
preneur and though leader having presented at several         Unit, Medicaid Fraud Unit; and State Attorney for the
VHA regional and national conferences and many                Eleventh Judicial Circuit, Office of Janet Reno, Florida.
HFMA chapter conferences. To contact Mr. Bradbury,
or learn more about revenue cycle optimization, call          Keith and David will present a scenario that combines,
(800) 355-0410 or visit www.ereso.com.                        while slightly exaggerating, several real-life cases. You
                                                              will definitely be able to relate to the lively cast of char-
Hospital CFO’s and CEO’s have tremendous work-                acters and events presented. There will be opening argu-
loads, directly overseeing many aspects of the hospital.      ments by both attorneys, witnesses will testify, the attor-
With so many responsibilities, these executives often         neys will present their closing arguments to you—the
find it difficult to closely and effectively monitor the      jury—and you will deliberate and reach a verdict. The
department that has the most direct impact on the orga-       session will conclude with a wrap up of lessons learned.
nization’s fiscal health: the Business Office, particularly
in a rural Iowa where healthcare knowledge may be lim-        Iowa Cubs Baseball
ited. Learning objectives for attendees are:                  (Sponsored by Medical Recovery Specialists)
• An understanding of key revenue cycle indicators
   from a CAH perspective
• Tools to utilize in motivating revenue cycle                Friday, April 25, 2008
   employees in a rural environment
• Improving performance of inexperienced personnel            Make a Difference
• Black holes in the revenue cycle – Where is the money?      Presented by: Mary Beth Briscoe, HFMA National
• Measuring and accountability are keys to success in         Board of Directors Chairperson
   the CAH revenue cycle.                                     Mary Beth is the voluntary Chairperson of the Board of
                                                              Directors of the Healthcare Financial Management
False Claims Mock Trial                                       Association (HFMA) during the 2007-08 term, begin-
Presented by: Keith Barber and David Honig, Hall              ning June 1, 2007.
Render Killian Heath & Lyman
Keith Barber, Esq. Keith has a Masters Degree in Health       Ms. Briscoe is CFO, University Hospital, UAB Health
Administration from Baylor University with 11 years           System, Birmingham, Alabama.
experience in health administration as a Medical Services
Corps Officer in the U.S. Army. His practice is concen-       A member of HFMA since 1984, Ms. Briscoe’s involve-
trated in Medicare and Medicaid reimbursement, appeals,       ment with the National Association includes serving on
compliance and fraud and abuse. He has represented            the Managed Care Forum Advisory Council (1996-99),
hundreds of hospitals and other healthcare providers          the National Advisory Councils (1999-00), the Strategic
responding to government allegations of fraud and abuse.      Planning Committee (2000-01 and 2006-07), serving as
A frequent presenter at HFMA meetings, his courtroom          chairman in 2006-07, the Board of Directors (2000-03
style in the Mock Trial is always fun, and educational.       and 2005-08), the Audit & Finance Committee (2005-06
                                                              and 2007-08), serving as chairman in 2005-06, the
David Honig, Esq. David’s practice areas include litiga-      Executive Committee (2001-03 and 2005-08), serving as
tion and risk management, regulatory and compliance,          chairman in 2007-08, and the Governance Committee
and reimbursement. He was Senior Attorney in the              (2006-09). Ms. Briscoe also served the Alabama




12    IOWA NETWORK
Chapter as Vice President, Treasurer, Secretary,
President-Elect, and President. She has received the        HFMA President and CEO, Richard L. Clarke says,
Follmer Bronze, Reeves Silver, Muncie Gold, and Medal       “Mary Beth’s theme urges our members to not be com-
of Honor merit awards.                                      placent with the status quo, but rather to become involved
                                                            – to be willing to ‘give back’ of our time, talents, and gifts
Ms. Briscoe, a Fellow of HFMA, a Fellow of The              for the benefit of our communities, our organization,
American College of Healthcare Executives, and a            our profession, and ultimately ourselves.”
Certified Public Accountant, earned her BS degree in
Accounting from the University of Alabama,                  Installation of Iowa Chapter Officers and
Tuscaloosa, and her MBA from the University of              Board of Directors
Alabama, Birmingham.
                                                            Certification Review
Mary Beth Briscoe’s theme challenges HFMA members
to embrace the power of the individual to contribute to
their organizations by becoming engaged, involved, and      Iowa Hospital Association Update:
passionate about making a difference in healthcare.         Presented by: Shannon Strickler

Most of us can remember a person who made a differ-         Payer Updates:
ence in our lives. This person helped us make the right     • Medicare
decision when we were at a crossroad. It was someone        • Medicaid
who urged us to recognize our own worth and to use our      • Wellmark
skills and abilities to make a difference in the lives of   • United I
others.




                                                                                                     IOWA NETWORK      13
Certification - Goal for 2008
SUBMITTED BY: Cris Chartier, CHFP


Are you struggling to come up with a New Year’s                     order, but both need to be successfully completed with-
Resolution that you can accomplish this year? A resolu-             in 24 months of each other. Study guides are available to
tion that will truly benefit your future?                           check out for 3 month periods. There is currently a
                                                                    waiting list for the Core exam study guide.
We have the perfect solution for you – become a certified
member of HFMA!                                                     Exams are administered via the Internet on a date mutu-
                                                                    ally convenient for you and your proctor. Proctors are
Successful completion of a core and one specialty exam              always available to administer exams on Fridays after
is a requirement for HFMA certification. The specialty              each quarterly HFMA meeting. An application must be
exam options are Patient Financial Services, Accounting             submitted at least 10 business days prior to the exam
& Finance, Physician Practice Management and                        date and includes the name of the proctor, the scheduled
Managed Care. You can complete the exams in any                     date of the exam, and the appropriate fee. The fee is
                                                                    $125 for the Core exam and $100 for each specialty
                                                                    exam. The chapter will reimburse members for the test-
                                                                    ing fee when the exam is passed. An application form
                                                                    and list of proctors is available at hfma.org under
                                                                    Certification.
                                      4100 121st St

       Mail                           Des Moines, Iowa 50323-2334
                                      (515)246-1313
                                      Kate Koenig, Sales
                                                                    All exams are a multiple choice format. You are allowed
                                                                    up to 4 hours to complete the 166 questions on the core
        Services                      (515)727-7752                 exam and up to 2 hours for the 83 questions on special-
                                                                    ty exams. The exams are graded using scaled scores. The
                 The Print to Mail Experts                          score is based on total questions answered correctly.
                                                                    Unanswered questions are scored as incorrect. The min-
     Statement Processing, Laser Printing and Mailing               imum passing score is 21. You will receive your results
           Patient Statements                                       immediately after completing the exam. An overall
           Collection Letters and Past Due Reminders                score is provided, but no detail of your performance on
                                                                    individual questions or sections. Exam results are confi-
           Informational, Promotional, and Other Communications
                                                                    dential information and it is HFMA policy not to dis-
                                                                    close exam score or results to anyone other than the can-
     Electronic Documents
                                                                    didate. If you are unsuccessful, you must wait 90 days
           Electronic Statement Delivery and On Line Payment        to retake the exam. The application process, including
           On Line Statement Preview, Edit, Search and Re-Print     the fee, is the same for repeat exams.

                     Proud Platinum Sponsor of the HFMA             For more information about HFMA certification, please
                                                                    contact Cris Chartier at 515-362-5186 or Paul Baumert
                                                                    at 402-212-6646. I




14      IOWA NETWORK
Guidelines for Non-Payment of Serious
Adverse Events Approved SUBMITTED BY: Heather Hulscher
                       The Iowa Hospital Association          • The error or event must be clearly and precisely
                       (IHA) Board approved hospital            defined in advance.
                       guidelines for non-payment of
                       serious adverse events at its          The guidelines adopted by the Board are being applied to
                       February 27 meeting. IHA is            eight specific events because these events are preventa-
                       encouraging hospitals to incorpo-      ble, cause harm and are within control of the hospitals:
                       rate these guidelines into their       • Surgery performed on the wrong body part
                       payment policies. The guidelines       • Surgery performed on the wrong patient
                       provide five guiding principles to     • Wrong surgical procedure on a patient
help hospitals in the identification of serious adverse       • Unintended retention of a foreign object
events that would qualify for non-payment:                    • Patient death or serious disability associated with
• The error or event must be preventable. Hospitals              intravascular air embolism that occurs while being
   should not be held accountable for something that
                                                                 cared for in a health care facility
   could not be reasonably prevented by the hospital in
                                                              • Patient death or serious disability associated with a
   the first place.
                                                                 medication error
• The error or event must be within the control of the
   hospital. Hospitals should not be held accountable         • Patient death or serious disability associated with a
   for errors that may have occurred, for example, in            hemolytic reaction due to administration of
   the manufacture of drugs, devices or equipment, well          ABO/HLA incompatible blood or blood products
   before the materials reached the hospital’s doors.         • Artificial insemination with the wrong donor sperm
• The error or event must be the result of a mistake made        or wrong egg
   in the hospital. The event must clearly and unambigu-
   ously be the result of a mistake made, hospital            Copies of the new guidelines have been distributed to
   procedures not followed and not something that could       hospital CEOs and nurse executives and are enclosed on
   otherwise occur.                                           page 25 of this newsletter.
• The error or event must result in significant harm.
   The list of events should be limited to those that yield
   very serious results.




                                                                                                   IOWA NETWORK    15
Thank you to our Sponsors
Platinum Sponsors                      Mail Servicces, LLC                     West Asset Management
                                       Gregg Messer                            Chris Vairo
Allied Business Accounts, Inc.         4100 121st Street                       7171 Mercy Road
Bill Carlson                           Des Moines, IA 50323-2334               Omaha, NE 68106
 .O.
P Box 1600                             515-727-7750                            888-586-9779
Clinton, IA 52733
563-242-2586                           Preferred Medical Deposits              Gold Sponsors
                                       Mark Einck
BKD, LLP                               10604 Justin Drive                      Array Services Group
Kevin Morey                            Des Moines, IA 50322                    Dawn Lehtinen
120 West 12th Street, Suite 1200       515-276-0792                            200 14th Avenue East
Kansas City, MO 64105                                                          Sartell, MN 56377
816-221-6300                           R & B Solutions                         877-272-7729
                                       Dennis Brebner
Cassling Diagnostic Imaging            860 Northpoint Blvd                     CareMedic Systems, Inc.
Lindsay Cosimano                       Waukegan, IL 60085                      Natalie Cataldo
13808 F Street                         847-887-8502                            3600 Rose Avenue
Omaha, NE 68137
                                                                               Des Moines, IA 50321
800-228-5462                           RSM McGladrey, Inc.                     515-953-5825
                                       Jon Hillmann
Commerce Bank                          220 Main Street, Suite 900
Denyse Scott                                                                   Data Systems Group
                                       Davenport, IA 52801
403 East 1st Street                                                            Jackson Morgan
                                       563-888-4000
Leon, IA 50144                                                                 2322 Capitol Avenue
515-408-5086                           Seim Johnson Sestak & Quist, LLP        Sacremento, CA 95816
                                       Brian Green                             916-143-4944, ext. 185
Credit Bureau Services of Iowa, Inc.   8807 Indian Hills Drive Suite 300
Leonard Grimes                         Omaha, NE 68114                         Emdeon Business Services
1306 South 7th Street                  402-330-2660                            Leanne Gustle
Oskaloosa, IA 52577                                                            1283 Murfreesboro Rd.
800-383-0234                           The CBE Group, Inc.                     Nashville, TN 37217
                                       Mick Staebell                           615-843-2500
AHC/CBA                                131 Tower Park Drive, Suite 100
Bruce Tichenor                         Waterloo, IA 50701                      General Service Bureau/
1101 Main Street                       319-226-5163                            Early Out Services
Peoria, IL 61606-1928                                                          Brad Uhlenhopp
800-950-2276                           The SSI Group, Inc.                     Des Moines, IA
                                       Bill Landreneau                         515-314-5998
H & R Accounts, Inc.                   3989 E. Arapahoe Road, Bld 7, Ste 204
Pam Brindley                           Littleton, CO 80122
5480 Longview Ct. #3                   877-544-7744
                                                                               Hauge Associates, Inc.
Johnston, IA 50131                                                             Charlie Cole
515-669-9396                           TRACE/The White Stone Group                    .
                                                                               2320 W 49th Street
                                       Bill Rost                               Sioux Falls, SD 57105
HRS Erase, Inc.                        2030 Falling Waters Rd., Suite 250      800-284-3131
Matt Llewellyn                         Knoxville, TN 37933
200 NE Mulberry St.                    865-531-4545                            Med Assets, HSCA Inc.
Lees Summit, MO 64086                                                          Becky Erzfeld
816-524-9477                           Vision Share, Inc.                      280 South Mt. Auburn Rd.
                                       Gary Keute                              Cape Girardeau, MO 63701
Larson Allen Weishair & Co., LLP       2829 University Avenue SE, Suite 800
                                                                               573-332-2323
Rob Schile                             Minneapolis, MN 55414
109 N. Main Street                     612-460-4325
Austin, MN 55912
507-434-7087

16     IOWA NETWORK
Reimbursement Services Group            The Midland Group                   Johnson Financial Strategies Group
Tom Dougherty                           Jeanne Thomsen                      of Wachovia Securities
401 Park Avenue S.                      5020 West 15th Street, Ste.C        Chet Johnson
New York, NY 10016                      Lawrence, KS 66047                  4601 Westown Pkwy, Suite 215
212-857-5730                            785-840-9676                        West Des Moines, IA 50266
                                                                            515-222-5242
Veracity Financial Group, LLC           Paul R. Baumert, LLC
Reike Plecas                            Paul Baumert                        Midlands Choice
974 73rd Street, Suite 15               901 S. 197th Street                 Marla Naumann
Des Moines, IA 50312                    Elkhorn, NE 68022                   1601 West Lakes Pkwy, Suite 310
515-223-1000                            402-212-6646                        West Des Moines, IA 50266
                                                                            515-440-3710
XactiMed                                Wellmark Blue Cross & Blue Shield
Ann Diamond                             Mike Fay                            ServiShare
901 International Parkway, Ste 200      636 Grand Avenue                    Dennis White
Richardson, TX 75081                    Des Moines, IA 50309                100 East Grand, Ste 100
214-382-2301                            515-245-5038                        Des Moines, IA 50309
                                                                            515-288-1955
Silver Sponsors
AIM Healthcare Services, Inc.
                                        Bronze Sponsors                     Softco America, Inc.
                                        Automated Accounts                  Michael McEntee
Bill Maly
1021 Windcross Ct.                      Management Services
                                        Luke Gruber                         United Healthcare of the River Valley
Franklin, TN 37067
                                        4800 Mills Civic Pkwy Suite 202     Rita Donovan
615-503-1333
                                        West Des Moines, IA 50265           11141 Aurora Avenue
                                        515-225-0525                        Urbandale, IA 50322
Baird, Holm, LLP
                                                                            515-727-2023
A. Kelly Clarke
1500 Woodmen Tower                      Credit Management
                                        Alan Gustafson                      U.S. Bank
Omaha, NE 68102
                                        308-382-3000 x185                   John Wieland
402-636-8204

FinCor Solutions                        Denman and Company
Jim Davis                               Jerry Heinzler
6215 West St. Joseph Highway            1601 22nd Street Suite 400
Lansing, MI 48917                       West Des Moines, IA 50266
563-271-1028                            515-225-8400

Healthcare Fianancial Resources, Inc.   Eide Bailly & Co
Bob Anderson                            Dave Scheuller
319-470-9440                            3999 Pennsylvania Avenue
                                        Dubuque, IA 52002
McKesson Provider Technologies          319-556-1790
Adam Cornwell
312-316-4347                            Gronewold, Bell, Kyhnn & Co
                                        Chris Nelson
Medical Recovery Specialists            1910 East 7th Street Box 369
Keith Bull                              Atlantic, IA 50022
866-317-5533                            712-243-1800




                                                                                             IOWA NETWORK     17
 Iowa Network                                             Don’t miss it!
                                                          Lean Six Sigma
 Publication Objective Iowa Network is the
                                                          May 5-6, 2008
 official publication of the Iowa Chapter of
 Healthcare Financial Management Association.             Physician Boot Camp
 Iowa Network is published four times a year. Our         October 7-9, 2008
 Objective is to provide members with informa-
 tion regarding chapter and national activities, with     Hospital Boot Camp
 current and useful news of both national and local       Week of Dec. 1st, 2008
 significance to healthcare finance professionals
                                                          Boot Camp Refresher Course
 and to serve as a forum for the exchange of ideas
                                                          December 8, 2008
 and information.


 Editorial Policy Opinions expressed in articles
 or features are those of the author and do not
 necessarily reflect the views of the Iowa
 Chapter of Healthcare Financial Management
 Association or the editor. The editor strongly
 encourages the submission of material for pub-
 lication. The editor reserves the right to edit
 material and accept or reject contributions
 whether solicited or not. I




                                                        1283 Murfreesboro Pike
                                                          Nashville, TN 37217
                                                         Office: 615.565.2428
                                                           Fax: 615.564.4789

                                                        www.emdeon.com




18   IOWA NETWORK
And the Minutes Read... Board Meeting,
October 26, 2007 SUBMITTED BY: Paul Baumert, FHFMA, CPA
                      Attending: Renee Rasmussen,             NEW BUSINESS:
                      Susan Searcy, Stephanie Hultman,        Attendance: Luke reported that we had a total of 113
                      Tim Huber, Pam Brindley, Christy        attendees for the October 2007 meeting, of which 13
                      Des Jardins, Tracy Warner, Mike         were walk-ins during the meeting.
                      Dewerff, Randy Rubin, and Bruce
                      Barnes, Heather Hulcher, Shawn          Education Programming: Dewerff presented upcoming
                      Steffan, Todd Nelson, Kara              January 08 meeting agenda and future educational offer-
                      Dunham, Shaun Magill, and Paul          ings. Dewerff discuss October 2007 meeting survey and
                      Baumert.                                that positive results on programming and facilities were
                                                              noted. Searcy discussed past and future Medicare boot-
Call to Order: President Susan Searcy called the meet-        camp offerings. Searcy discussed Tax education offer-
ing to order at 12:05 pm.                                     ings for membership, such as lunch webinar or telecon-
                                                              ference.
Past President Report: Shaun Magill presented the
sponsorship report and discussion followed.                   Hospitality: Searcy reported on future hospitality activ-
                                                              ities and possible future committee member support.
President Elect Report: Rasmussen reported on inter-
nal control policy changes recommended by the internal        Newsletter: Hultman reported on the October 2007
control committee and discussion followed. Warner             newsletter that was sent. A new member spotlight was
discussed change in travel policy as a result of the inter-   added in the October 2007 newsletter.
nal control policy changes. Motion to approve internal
control policy as presented and update travel policy sec-     Website: Steffan discussed new website and reaction
tion on reimbursement made Steffan, seconded by               from members. Also discussion regarding additions to
Hultman, motion carried unanimously.                          website followed.
                                                                                       article continues on next page...
October 18, 2007 Financial Report: Des Jardins pre-
sented the October 18, 2007 financial report and discus-
sion followed. Motion to approve October 18, 2007
financial report by Rasmussen, seconded by Magill,
motion carried unanimously.

Presidents Report: DCMS, Balanced Scorecard, Fall
President’s Meeting. Searcy discussed DCMS report
and new National HFMA Balanced Scorecard. Searcy
reviewed balance scorecard targets and essential metrics
establish by National HFMA and the Iowa chapter’s sta-
tus on the measurements. Searcy discussed highlights of
the Fall Presidents meeting. Searcy discussed possible
Yerger application awards due in April 2008 and suggest-
ed selected Yerger applications be submitted by January
2008 meeting. Searcy informed attendees of the LTC
conference in San Antonio, TX in April 2008 and rec-
ommend taking seven leadership members to attend
LTC. Searcy discussed the recommendations of the
nominating committee for new leadership roles in 2008.




                                                                                                       I O WA N E T W O R K   19
And the Minutes Read, Continued...
Directories: Brindley and Hultman reported that the         Credit and Collections Manual: Motion to eliminate
directory is coming along as planned and discussed due      credit collection manual as a chapter resource made by
dates.                                                      Baumert, seconded by Rasmussen, motion carried unan-
                                                            imously.
Certification: Baumert reported that we had 3 passed
exams to date and had 3 people taking exams at the          Job Referral: No report.
October 2007 meeting. Discussion regarding proctoring
exams and that there will be an email to all Iowa chapter   Other Business: Discussion regarding the three new
proctors next week reminding proctors about procedures.     committees created at annual planning meeting, which
                                                            includes photographer, past presidents, and senior finan-
Founders Points: Rubin reported on the awards pre-          cial executive. Motion to not have past presidents and
sented the October 2007 meeting.                            senior financial executive committees by Huber, second-
                                                            ed Rubin, motion carried unanimously. Discussion
IHA Liaison: Hulcher reported on upcoming education-        regarding timing of 2008 annual planning meeting took
al offerings with IHA.                                      place. Nelson discussed price transparency and recom-
                                                            mended resolution by the BOD of Iowa HFMA.
Operations Manual: Warner reported no changes.              Motion to approve resolution on the Transparency in
                                                            Medical Device Pricing Act of 2007 by Dewerff, second-
Constitution and By Laws: Warner stated that were no        ed by Barnes, motion carried unanimously.
changes.
                                                            Adjournment: It was moved by Rasmussen and second-
Membership: Huber reported on the status of the             ed Huber that the meeting adjourns at 1:55 PM. Motion
member drop list and the list was reviewed by those in      Carried unanimously. I
attendance. Huber discussed the new member break-
fast during October 2007 meeting.




20   IO WA N E T W O R K
How to Select an Insurance Agency
WRITTEN BY: Erroll Imre, Editor, FinCor Solutions
SUBMITTED BY: Teagan Drayton, FinCor Solutions


Selecting the right insurance agency      can make certain there are no gaps in     understand your interests. Obtain a
may turn out to be one of the most        your insurance coverage package.          clear understanding of exactly how
important decisions you make. After                                                 they will come to understand your
all, your assets, your livelihood, and    An agency type that is seen most          individualized insurance needs, how
your future may well be at stake, and     often serving a specialized niche         they will present insurance quotes to
while they say you can’t buy love, at     industry segment is the hybrid            you, and, perhaps most importantly,
least you can buy some peace of           agency. This is an agency that offers     how they will provide service for
mind.                                     specialized professional liability cov-   your continuing needs after the sale.
                                          erage on a direct and often exclusive     Regular reviews of coverage adequa-
There are three types of insurance        basis with a particular insurance com-    cy, premium comparisons, and seam-
agencies, direct, independent, and        pany, and may also offer professional     lessly facilitating claims handling are
hybrid—combining the direct and           liability coverage from a limited         a three key factors to consider in this
independent agency approach. A            number of other carriers. The hybrid      regard.
direct agency, sometimes called a         agency also rounds out complete
captive agency, represents a particular   insurance protection for businesses       It is also a good idea to check with
insurance company and only sells          in the niche served by offering other     your state’s insurance bureau to con-
that company’s policies. While this       lines of commercial and personal          firm that the agency has all the prop-
may appear somewhat limiting at           lines coverage, i.e. coverage for         er and current licensure, and also to
first blush, a direct agency represent-   Directors’ & Officers’ liability,         find out whether any complaints may
ing a larger insurer may well offer a     employment practices liability, prop-     have been filed against the agency.
wide range of insurance products          erty damage, auto, home, life, and        Finally, make sure the insurance
that will meet most, if not all, of the   disability. This is perhaps the best of   agency you select has adequate errors
insurance requirements for a typical      both worlds for insurance consumers       and omissions insurance coverage of
consumer. On the other hand, a            employed in a professional field          their own, just in case. I
direct agency may have a much nar-        requiring liability insurance, as they
rower focus and specialized knowl-        not only receive the highly special-
edge in a particular line of insurance,   ized care and service demanded by
such as professional liability coverage   their profession, they receive the
for doctors or lawyers.                   benefits of one stop shopping for
                                          their other lines of insurance as well.
An independent agency represents
many different insurance companies        The selection of an insurance agency
and sells policies from a variety of      will be driven in large part by your
companies to meet a client’s various      needs. It is vitally important that you
insurance needs. A potential advan-       look for an agency that understands
tage with independent agencies is         your particular situation, and for this
that they can shop around to obtain       you can often turn to colleagues or
the best price or coverage in a partic-   trade associations for referrals. Once
ular line of insurance, auto or home      you have identified some potential
for example, and also provide “one        agencies, ask them for the credentials
stop shopping” to meet all of the         of the insurance professionals you
other typical insurance needs for         would be working with and compare
their clients. An additional advantage    them. Speak with the insurance pro-
to having all of your insurance           fessionals informally, paying strict
requirements placed by a single           attention to the type of questions
agency is the comfort in knowing          they ask you, as this will be a very
that a trained insurance professional     good indication of how well they
                                                                                                         I O WA N E T W O R K   21
IRS Releases Final Form 990
WRITTEN BY: Mike Engle, Senior Manager, BKD LLP
SUBMITTED BY: Kevin E. Morey, CPA/Partner, BKD LLP


The Internal Revenue Service (IRS) issued its final ver-     Schedule D – Supplemental Financial Statements. This
sion of Form 990, Return of Organizations Exempt             schedule contains a compilation of various financial
from Income Tax, December 19, 2007. Form 990 is the          statement attachments, most of which are required on
annual return tax-exempt organizations are required to       the 2006 Form 990. A noteworthy addition is a FIN 48
file to report information about their operations. The       footnote disclosure. (FIN 48 is the new accounting
new Form 990 will be used for 2008 tax years filed in        interpretation that provides revised and expanded
2009. The IRS expects to release draft instructions for      requirements for recognition, measurement and disclo-
the new form and 990 schedules in early 2008.                sure of uncertain tax positions.)

While there are some exceptions, most tax-exempt             Schedule G – Supplemental Information Regarding
organizations must file “exempt” annual information          Fundraising or Gaming Activities. The IRS designed
returns, generally met by filing Form 990, the IRS’s pri-    this schedule to assist with identifying abuses in the area
mary tax compliance tool. However, the current Form          of gaming and fundraising.
990, last redesigned in 1979, has not kept pace with
changes in the tax-exempt sector.                            Schedule H – Hospitals. This schedule will be required
                                                             for organizations that operate a facility providing hospi-
The IRS says it based Form 990’s redesign on three guid-     tal or medical care. The schedule would require infor-
ing principles:                                              mation on community benefit and charity care, collec-
                                                             tion practices, management companies and joint ven-
• Enhance transparency to provide the IRS and the            tures, exempt activities and community needs assess-
  public a realistic picture of the organization             ment and identification of all facilities an organization
                                                             operates for the provision of hospital or medical care.
• Promote compliance by accurately reflecting the
  organization’s operations, improving the IRS’s             Schedule K – Supplemental Information on Tax-exempt
  efficiency in assessing the risk of noncompliance          Bonds. The IRS designed this schedule to help correct
                                                             noncompliance with recordkeeping and record retention
• Reduce the filing burden on exempt organizations           requirements related to tax-exempt bonds issued by or
                                                             for the benefit of 501(c)(3) organizations.
The final Form 990 is comprised of an 11-page core form
each filer must complete, including a summary page of        Schedule L – Transactions with Interested Persons.
the organization’s identifying information, i.e., a snap-    The IRS designed this schedule to assist in identifying
shot of the organization’s key financial, governance and     loan arrangements between exempt organizations and
operational information, including a summary of mis-         disqualified persons that may be used to disguise com-
sion or activities. The final Form 990 also includes a 16-   pensation or for improper purposes.
schedule series designed to require information report-
ing only from those organizations that conduct particu-
lar activities.

Public charities generally will continue to complete cer-
tain schedules, e.g., Schedules A and B. Schedules A
through R are available via irs.gov/charities/article/
0,,id=176637,00.html. Below is a summary of the fol-
lowing schedules:




22   IO WA N E T W O R K
Certification Q & A:
Physician Practices Management
                                 ,
SUBMITTED BY: Steph Hultman, CHFP CPAT, CCAT


This 10-question test is designed to provide a sample of      B. Mail receipt of insurance correspondence should
the type of questions on the 83 question, two-hour               be coordinated with rebilling requests.
Physician Practices Management certification examina-         C. Charges should be posted for every patient with
tion. To best replicate the testing experience, allow            in 60 days following rendering of services.
about 15 minutes to complete these questions.                 D. Insurance company requests for medical records
                                                                 should be logged.
Budgeting and Benchmarking
1. Revenue projections are subject to a wide range of      Information Systems
   possible errors due to which one of the following?      3. Situations that give information value and mandate
   A. Variability of patient/consumer decision-making.        security include which of the following?
   B. Flexibility required for physician income               A. A need to generate fee schedules.
      expectations.                                           B. Natural disasters where information is destroyed.
   C. Major assumptions built into the revenue                C. Data that is provided to a public database.
      projections.                                            D. Non specified data on patient treatment.
   D. Uncertainty about marketing efforts by
      competing groups.                                    Encounter Processing
                                                           4. Potential fraud within encounter processing requires
Accounts Receivable: Collections, Policy                      the use of internal control procedures such as:
and Evaluation                                                A. Routine reconciliation of daily charges against
                                                                  postings.
2. Which of the following is a key control point for
                                                              B. Routine reconciliation of charges, fee schedules
   internal control of accounts receivable?
                                                                  and payments.
   A. Write-offs should require two signatures or
                                                              C. Multiple levels of authorizations for refund
       written authorization.
                                                                  checks, write-offs and disbursements.
                                                              D. Monthly reconciliation of accounts receivable.

                                                           Contracting, Negotiating and
                                                           Reimbursement Methodologies
                                                           5. Physicians who organize into an independent
                                                              practice association (IPA) to provide patient services:
                                                              A. Increase profitability as IPA contracts will
                                                                  increase patient volumes.
                                                              B. Retain their independent practices and will treat
                                                                  patients outside of the health maintenance
                                                                  organization (HMO) beneficiary list.
                                                              C. Retain their independent medical practices but
                                                                  lose financial control to health maintenance
                                                                  organization (HMO) fiscal services.
                                                              D. Lose their independent practice autonomy and
                                                                  may treat only IPA patients.

                                                                                      article continues on next page...




                                                                                                    I O WA N E T W O R K   23
Certification Q & A, Continued...
Cost Analysis and Management                                              Physician Compensation and Leadership
6. A major use of breakeven analysis is to identify the                   9. Which of the following should be considered when
   level of operations at which revenues equal:                              developing a physician compensation plan?
   A. Step-incremental costs.                                                A. A plan that favors one physician in the group.
   B. Total costs.                                                           B. A plan that does not consider changes in
   C. Variable costs.                                                           reimbursement.
   D. Fixed costs.                                                           C. The culture of the physician group.
                                                                             D. Input from the support staff.
Insurance and Risk Management
7. Malpractice insurance is sold in two basic forms                       Physician Coding and Payment Systems
   related to when the insurer is responsible for                         10.What are some applications of International
   coverage, these are:                                                      Classification of Diseases (ICD) code information?
   A. First year and fifth year.                                             A. Used to document procedures done by
   B. Occurrence and claims made.                                               physicians to request payment.
   C. Time benefit and insuring event.                                       B. Provides supporting documentation to the
   D. Expected litigated and projected litigated.                               service or procedure performed by non- physicians.
                                                                             C. Supports correct coding initiatives, supports data
Legal and Regulatory                                                            requirements for residency program accreditation,
8. Stark I and Stark II laws prohibit which of the                              and can provide a means of identifying cases that
   following types of physician activity?                                       fit the criteria for research protocols.
   A. Receiving gifts and cash and other perks from                          D. Provides data to support credentialing agencies,
       patients who want preferential treatment.                                Health Plan Employer Data and Information Set
   B. Referring patients to the physician’s colleagues                          (HEDIS) reporting, and state licensure requirements.
       and friends who own ancillary services.
   C. Referring patients to external ancillary providers
       in whom the physician has a financial interest.
   D. Referring patients to external ancillary service
       providers who also refer patients to the physician.


  of identifying cases that fit the criteria for research protocols.
  ments for residency program accreditation, and can provide a means
  10. C. Supports correct coding initiatives, supports data require-
  9. C.The culture of the physician group.
  the physician has a financial interest.
  8. C. Referring patients to external ancillary providers in whom
  7. B. Occurrence and claims made.
  6. B.Total costs.
  ary list.
  outside of the health maintenance organization (HMO) benefici-
  5. B. Retain their independent practices and will treat patients
  and disbursements..
  4. C. Multiple levels of authorizations for refund checks, write-offs
  3. B. Natural disasters where information is destroyed.
  zation.
  2. A.Write-offs should require two signatures or written authori-
  1. C. Major assumptions built into the revenue projections.
                                                        Answers




24   IO WA N E T W O R K
Guidelines for Non-Payment of
Serious Adverse Events
SUBMITTED BY: Heather Hulscher




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