2004/2005 ISSUE FOUR
Chapter Sponsors

Platinum Club
Deloitte & Touche, LLP
Ernst & Young, LLP
Fenner Consulting
Fifth Third Bank
Human Arc
J P Recovery Services, Inc.
KPMG
Long - O'Shea & Co., LLC
MD-X Solutions, Inc.
NatCity Investments Inc.

Gold Club
Center for Health Affairs/CHAMPS Management Services
Squire, Sanders & Dempsy
Wise Management Services Inc.

Silver Club
Eclipsys Corporation
Engelhardt & Emrhein
HRSI/FirstCredit International Corp.
McDonald Hopkins Co., LPA
OSI Strategic Receivables
Professional Receivables Control
State Credit Financial Management Group
Quadax

Bronze Club
Advantium
Bruner - Cox, LLP
Calfee, Halter & Griswald, LLP
IntergraSolutions
HMC Group
Howard Wershbale & Co.
NCO Group
NOVUS Financial Services, Inc.
Strategic Reimbursement, Inc.
The Wellington Group, LLC
Wolfskill & Associates, Inc.
United Collection Bureau Inc.
Vorys, Sater, Seymour & Pease, LLP





HFMA Northeast Ohio
Chapter Officers 2004-2005

President
Barry L. Franklin

President-Elect
Maureen A. Wood

Vice President
Christopher Milligan

Secretary
Suzanne M.Tschetter

Treasurer
William J. Bogdan

Chapter Coordinator
Kathleen A. Much


Board of Directors
2004-2005


Chairperson
Julia T. DiFrancesco
Susan R. Flaherty
Neil Freer
Charles S. Josey
James F. O'Donnell
Allen R. Tracy



Visit HFMA National at:
www.hfma.org


Visit HFMA Northeast Ohio at:
www.neohfma.org





Click here for Past Newsletters


HFMA Northeast Ohio
Newsletter
Committee

Co-Chair
Mary Jayne Reedy

Human Arc

Co-Chair
Anna Sulewski

The MetroHealth System

Maureen Campbell
Bottom Line Systems

Jennifer Hahn
Robinson Memorial Hospital

Laurie Hammer-Rauser
JP Recovery Services

James Hutchison
UHHS Laurelwood Hospital

David Kilmer
Robinson Memorial Hospital

Steve Rybka
United Collections Bureau

Steve Thome
Ernst & Young, LLP

Email the Committee

Dave Kilmer

President's Message

Dear Fellow HFMA Members:

Greetings and welcome to the fourth issue of VISIONS, the award-winning newsletter of the Northeast Ohio Chapter of HFMA. I hope you're having a great summer!
The Chapter's spring highlight was its signature educational event, the Gerry Haggerty Annual Leadership Institute (GHALI). Held at the Glenmoor Country Club just north of Canton, this event was co-sponsored by the Central Ohio Chapter and featured new highs in attendance and program offerings. The conference theme was "Leading Healthcare into the Future" which featured national healthcare futurist Brett Trusko, Ph.D. as the keynote speaker. Glenmoor again proved to be a wonderful site for this year's GHALI, with excellent food, facilities and, of course, golf. I hope you had a chance to attend this outstanding event. Congratulations to Chuck Josey and David Pletcher, co-chairs of the GHALI Committee, and all the Committee members and volunteers who put in the long hours to make this program such a success; and thanks also to our sponsors for their support of GHALI this year. Look for a feature article on this year's GHALI in the next issue of VISIONS.
      In This Issue?
      click or scroll to see as article


Another excellent educational and networking opportunity came at the end of June, when HFMA hosted its Annual National Institute (ANI): The Healthcare Finance Conference in Las Vegas, Nevada. As always, ANI provided a broad range of topics, ideas, and tools for all aspects of an organization's financial operations. Next year's event will be held in Orlando, FL. Be sure to mark next year's ANI on your calendar.

I hope you are having a happy, healthy, and successful 2005; and I hope to see at an HFMA event soon.

Sincerely,

Barry L. Franklin, C.P.A.
President


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New Members - Welcome to NEOHFMA!

By Jim Huchinson

New members are the lifeblood of our organization. In the spirit of "making it personal", please welcome our newest members to HFMA. Look for them at our next meeting and welcome them to our organization.

R. Andrews-Brothers
Humility of Mary Health Partners
Angela Cancilla
University Hospitals Health System
Brian G. Francesangelo
Ernst & Young
Joseph V. Gioffre, III
Ernst & Young
Amanda M. Nemeth
Ernst & Young, Llp
Lisa Parish
Humility of Mary Health Partners
Jerry Peiffer
Clinical Specialties, Inc
Candis Posey
Humility of Mary Health Partners
Traci Susong
Dan Tadiello
University Hospitals Faculty Services LTD
Mark Wobrak
Cleveland Clinic Foundation
Richard J. Wood
Barberton Citizens Hospital


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Committee Corner - The Special Placement Committee

By Steve Rybka

Have you looked through the HFMA Chapter Directory recently? Hidden among all the obvious committee's like Membership, Networking, Newsletter and GHALI is a little known Committee that really goes "beyond the numbers". It's called the Special Placement Committee and at the core of its responsibility is giving assistance to members seeking employment.

Have you seen this committee in action anywhere? Probably not and that's just the way the committee likes it. Working behind the scenes, they meet or talk with members who have lost their position or are thinking about changing their position. Recently, Co-Chairperson Bill Keckan explained that the committee of Co-chair Richard Fox, along with Rich Benedict, Rhonda Ridenour and Brad Smith frequently meet with members for lunch to discuss possible moves with everything kept strictly confidential. While records are not kept on the number of positions filled or members who have benefited from the Committee's services, Bill and Rich estimate that they directly assist 10-20 members each year.

Another service of this committee is to list positions presently open on our web site. Have you visited there lately? If not, go to neohfma.org and check it out. If not for you, maybe you can help someone looking for that specific position. It's updated on a monthly basis and includes job postings for our area and surrounding states.

One area that this committee is just like others - - it needs caring volunteers for the coming year. As Bill mentioned, he's been in the organization for over 25 years, has served in almost every leadership role, and thinks that this committee is the heart of HFMA. How can you argue with a Past President, Muncie Gold Award winner, Founder Medal of Honor winner, and Dale W Reed Award winner? Thanks Bill Keckan for the insight.

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Gerry Haggerty Annual Leadership Institute Bigger and better than ever!

By Steve Rybka

Over 220 people attended this year's Gerry Haggerty Annual Leadership Institute (GHALI) making it the best attended event in recent years.

Several chapters in the area were invited to make this a regional meeting. Eleven chapters responded and were represented at the leadership institute.

Some highlights of the institute were:

  • A half day, pre-conference workshop kicked off the beginning of GHALI. New this year, the pre-conference workshop was well attended and generated rave reviews.
  • Cerner sponsored the welcome reception at the Pro Football Hall of Fame. Members had food, drinks, fun, and many experienced their first visit to this nationally acclaimed site.
  • Twenty one companies were represented at the vendor fair. The exhibition area was well designed to accommodate GHALI's large attendance.
  • Bill Bogdan was the big winner on the Casino night. Bill won the $1,000 drawing for visiting all the vendors at their booths.
  • Even though the skies were threatening, members finished the golf scramble on a Jack Nicklaus designed course. A group from Parma Hospital ran away with $400 prize.


The GHALI committee is already planning next year's event. Look for information on next year's event in upcoming newsletters!



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Kudos to You!

By Laurie Hammer-Rauser

The Northeast Ohio Chapter of HFMA would like to express "kudos" to the following Chapter members.

Leslie Szabla, RN, BA, CPHQ - Leslie has been named Principal at Phoenix Rising Health Care Strategies, LLC ("Phoenix") effective March 31, 2005. Leslie joined Phoenix in June 2004. Leslie brings to Phoenix expertise in care and quality management processes, the Leapfrog Patient Safety Initiative, medical necessity denial prevention and length of stay management. Phoenix Rising Health Care Strategies, LLC was formed by Sherry Aronson in 2003 to deliver hospital consulting services in the areas of revenue cycle and financial management, anesthesia and other physician contract analysis, negotiation and support, and operational/ strategic planning.

Cindy Hoyt - Cindy was named Director of Patient Accounting at Wadsworth-Rittman Hospital. She is responsible for overseeing admitting, registration, billing and collections.

Brent Carson - Brent was promoted to Vice President, Managed Care for UHHS Managed Care Department.

Laurie Rauser - Laurie recently joined MetroHealth Medical Center as Coordinator of Reimbursement for the Department of Contract Performance and Denial Management.

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Upcoming Events

Listed below are the events planned for in the 2005/2006-program year. Details and dates will be announced as soon as they are available.

Date Event
October 27, 2005 Legislative update
November 17, 2005 Medical group practice
December, 2005 Holiday party
February 23, 2006 PFS
March 16, 2006 Educational program
April 27, 2006 Post Acute Care
May 24-26, 2006 GHALI/Quail Hollow
June, 2006 Managed care program


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Article
Consumer-Driven Plans Gain Popularity among Employees

More employees than ever are enrolling in consumer-driven plans, according to a Hewitt study released Feb. 9.

On average, more than half (56 percent) of all employees at each company who were offered a consumer-driven customized design plan for 2005 enrolled in it, up from 50 percent in 2004, according to the study. In some companies, enrollment in this type of plan, which allows employees to build their own plan by choosing from a variety of medical and prescription drug coverage levels at different price points, was as high as 90 percent. However, while health savings accounts continue to garner attention, only 3 percent of those who were offered an HSA-based plan chose to enroll in it.

Employees are not leveraging all resources available; however, enrollment in healthcare flexible spending accounts continues to be low at 16 percent. The average healthcare FSA contribution for 2005 was $1,188.

More employees used online tools to make healthcare decisions. Forty-six percent of those who used at least one tool chose a different medical plan option this year. This percentage increased to nearly 60 percent when two or more tools were used. Additionally, tool usage was higher for those enrolling in consumer-driven plans, and those who used tools were more likely to enroll in a consumer-driven plan. The most popular tools were health plan comparison charts, provider directories, healthcare cost summaries, and a healthcare spending account estimator.

To read about the survey on consumer-driven plans, go to www.hewitt.com and click on "Press Releases" (under "Newsroom") and "More Employees Enroll in Consumer-Driven Plans for 2005."

Source: http://www.hfma.org/publications/HFM_Magazine/industry_scan.htm

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Article
Health Services Discount Cards for Self Pay Patients

By Tamira J. Kennedy, Consultant Bottom Line Systems, Inc.

The presentation of Health Service Discount cards is beginning to be more commonly seen in hospital registration departments and doctor's offices. Some of the discount cards and issuing companies may not be offering valid discounts and should be researched thoroughly by the healthcare provider's insurance verification department. A legitimate discount is supported by a managed care contract and the payer actually provides medical benefits to a covered group or individual. If the card lists a contracting network, the provider should look for the definitions of "payer" and "subscriber" in the Participation Agreement to determine their obligations to accept the discount card. A questionable discount card may list an affiliated network but the payer is the individual patient, not an insurance benefit plan. Many cards even state: "This is not an insurance plan," but it may be in very tiny print. Ultimately the patient is responsible for the payment of the claim. These companies are not insuring these individuals for major medical benefits; rather they are selling them a discount card, which in some cases may not deliver the promised advantage.

The language used on these discount cards and on pricing summaries may mislead providers by appearing to indicate that a payer is responsible for receiving the claims and that benefits are being issued. After the pricing company receives the claim and applies their savings, they send a re-pricing sheet to the patient and provider. This will tell the patient what savings he has been awarded by purchasing this card and gives the amount the provider may bill him for. Some companies will label their re-pricing sheet as an "Explanation of Benefits", which suggests to providers that benefits have been issued, when in fact they have not. The patient's savings is not a network discount nor any other negotiated rate agreed upon by the provider, and is not supported by a managed network or insuring company offering benefits. If there is a contracted network implicated on the discount card, the definitions of "payer" and "subscriber" in the Participation Agreement must be loose enough to allow a non-covered individual to access their network in some way. Otherwise, the provider is not bound by any agreement or contract, to offer such discounts to these self-pay individuals. This is why it is important for providers to review their Participation Agreements and to negotiate for specific and direct definition language. The subscriber terms should only allow covered groups or individuals to access the network and the payer terms should clearly identify a list of insurance companies and plan administrators that are able to access the negotiated discounts.

The Health Service Discount card poses a multitude of problems for providers and for the individual whom has purchased it. At the point of registration, most intake representatives see the cards and believe they are registering an insured patient. From that point on, until the patient receives his first statement, there are financial assistance opportunities missed for the self-pay patient. Most providers have a process designed to assess eligibility for financial assistance programs for self-pay patients. This process must start at the point of registration for many available assistance programs. The reality is that many people who purchase these cards believe they are purchasing health coverage and are devastated to learn that they are ultimately responsible for the full cost of their treatment. The key to handling these consumer discount cards is the proper education of intake representatives so that the cards are recognized at the time they are presented. At that point, the patient can be identified as self-pay, and the best arrangement for settling the account in an advantageous manner can be implemented, with both parties clearly understanding the funding.

Tamira J. Kennedy is a Managed Care Consultant with Bottom Line Systems, Inc., 541 Buttermilk Pike, Suite 401, Crescent Springs, KY 41017, (877) 613-4373.

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Puzzle

By Jennifer Hahn

How Old is the House?
Gretchen and Henry were looking to buy a house together and finally found one with a beautifully landscaped yard, plenty of bedrooms and a beautiful tree out front. They asked the owner how old the house was and this was his reply:

"I planted that tree when the house was built. It was 7 feet tall at the time. It has grown 3 feet each year and at the end of this past full year, it was four times its original height."

"But how old is the house?" asked Henry.

Gretchen said, "Don't be so dense. He just told us."

So how old is the house?

Email your answer to Jennifer Hahn at Robinson Memorial Hospital at neohfmacalendar@yahoo.com. All correct entries will be included in a drawing and one lucky entrant will receive a $25.00 gift certificate to Target.

Issue 3 puzzle: Hours of Sleep
Answer: The parents have slept the same amount of time asleep as their three children have been alive, 30 years.
Winner: Brad Barlow of MedCentral Health System won a $25 gift certificate to Ruby Tuesday's.


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