metro ny hfma fall 2018 volume 48 , issue 4 past...

Metro NY HFMA Fall 2018 Volume 48 , Issue 4

www.hfmametrony.org

PAST PRESIDENT’S DINNER

Honoring Immediate Past President

MARYANN J. REGAN

President’s MessageMario Di Figlia, FHFMA .....................................................................................................................

Editors’ Message Alicia A. Weissmeier, Esq., CHFP and Christina Milone, Esq.. ....................................................Page 4

Chapter Officers and Board of Directors ........................................................................................Page 5

Corporate Sponsors ...........................................................................................................................Page 6

Calendar of Events .............................................................................................................................Page 7

New MembersRobin Ziegler .......................................................................................................................................Page 8

Take Our Survey .................................................................................................................................Page 9

2018 HFMA Volunteer Leadership Gala .......................................................................................Page 10

HFMA Metro NY Educational Roadshow ......................................................................................Page 11

Mid-Year Accounting and Reimbursement Update Seminar .....................................................Page 12

Denied!Joe Hoban ..........................................................................................................................................Page 13

Mentor Program ...............................................................................................................................Page 17

Marvin Rushkoff Scholarship .........................................................................................................Page 19

HFMA Metro NY Annual Golf Outing 2018 .................................................................................Page 23

CMS Price Transparency RequirementFred Stadolak, Mark Spehar, Henry Gutierrez..............................................................................Page 29

Frontiers in Healthcare Innovation ................................................................................................Page 34

Metro NY Spotlight on Juby George Vaze, RN, CCM, MBA ......................................................Page 36

Fifty-Second Annual Past President’s Dinner Dance ................................................................Page 37

How a Hospital-to-Hospital Transfer Policy Impacts Billing and CodingMary Devine ......................................................................................................................................Page 43

HFMA’s Online Membership Directory .........................................................................................Page 45

Committee Listings 2018-2019 ....................................................................................................Page 46

www.hfmametrony.org Page 1

CONTENTS

As we enter into the Fall season, it seems like a good time to reflect on the first five months of my Presidency of the HFMA Metropolitan NY Chapter. The Chapter leaders spent the summer months planning many seminars and networking events. The Annual Golf Classic at North Hempstead Country Club on September 24th was a success with perfect weather! Many thanks to Kiran Batheja, John Coster, John Mertz, Wendy Leo, Diane McCarthy, Robin Ziegler and the entire Golf Committee volunteer group for coordinating such a premier event. Next up we had the Annual Past Presidents Dinner Dance honoring Immediate Past President Maryann J. Regan and all other past presidents on September 29th at the Woodbury Country Club. The event was well-attended, and Maryann gave a moving speech thanking our corporate sponsors and volunteers for their devotion and attributing her success to them. All of the Chapter committees have been hard at work planning and conducting events. Our Finance Committee and the Technology Committee hosted two successful educational days in September: Mid-Year Accounting and Reimbursement and Frontier in Healthcare Innovation, respectively. The Technology Seminar was our first-ever full day seminar on the topic and was hosted by our new corporate sponsor, Accenture, followed by a networking social event. We received a lot of positive feedback. Our Special Events Committee was hard at work as they just put on the Day at the Races at Belmont Park on October 26th, which was well attended and enjoyed by all. Next up, our Community Outreach Program is coordinating the Knowledge is Power event, a Breast Cancer Luncheon on November 9th at Jewel. We have three dynamic speakers and registration is still open. We have many other events in the works. The Finance Committee is planning their second event of the year, Ethics, Accounting and Audit Update Seminar on December 6th at the E&Y Manhattan Office. E&Y is also a corporate sponsor and a networking event is planned at the conclusion of the seminar. The Revenue Cycle Committee is planning a two-day roadshow called Medicare Fundamentals, featuring presenters from National Government Services to be held on back-to-back days in January, with one session in Nassau County and the other session planned in Suffolk. The Revenue Cycle Committee is working on a Physician Revenue Cycle academy during the winter months. The Finance Committee will hold the Annual Reimbursement Seminar this winter, too. We have conducted several convenient lunchtime webinars hosted by our Metropolitan Chapter Webinar committees. These sessions, along with all of the others throughout the winter, point toward another successful year.


PRESIDENT’S MESSAGE

Our Special Events Committee has planned an Italian Cultural Night on February 23, 2019 at Memorare Caterers in Seaford. The Annual Institute Committee, led by Cathy Ekbom and James Linhart, has been hard at work organizing the 60th Joseph A. Levi Annual Institute on March 7 – 8, 2019 at the Uniondale Marriott. The program is in great shape with both traditional and new sessions scheduled. Look for timely topics and in-depth conversations with industry experts that address the challenges of our modern healthcare environment.

I am proud to serve as President of the HFMA Metropolitan NY Chapter and to lead the team of dedicated volunteers that make our organization such a success. Thank you to the Newscast editors for taking the time and care to bring forth this publication to our membership. A special thank you to all of our corporate sponsors; your continued support allows us to provide quality events to healthcare finance professionals year after year. I hope that everyone enjoys the beautiful Autumn weather and a wonderful holiday season.

Mario Di Figlia, FHFMAPresident, HFMA Metropolitan NY Chapter


PRESIDENT’S MESSAGE


EDITORS’ MESSAGE

Happy Fall!

Summer has become a distant memory and decorations are already up signaling that the holidays are fast approaching. What happened to the Fall? A lot in the Metropolitan NY Chapter of HFMA. In this Newscast you will see elaborate photo spreads of two of the best social events of the year, the Annual Golf Classic and the Past President’s Dinner Dance. The Annual Golf Classic was held on a beautiful day in September and was a big success once again. Past President Jane Clayton came all the way up from Florida to attend the event! The other photo spread is of the 52nd Annual Past President’s Dinner Dance honoring our immediate Past President Maryann Regan. As the photos reflect, everyone had a wonderful time celebrating with Maryann and her beautiful family! There were many other Past Presidents in attendance which made it a truly wonderful celebration of past Metro NY HFMA leadership. Two additional recent events, the Annual Region 2 Fall Institute, chaired by our very own Kiran Batheja, and the Day at the Races, will be featured in the next issue of Newscast. We welcomed 57 new members to our Metro NY HFMA family since our Chapter year began in May. Furthering our mission to provide top-quality education to new members as well as to all of our existing members, our Chapter has put on two amazing seminars this fall. One of the events, the annual Mid-Year Accounting and Reimbursement update (chaired by Tracey Roland and co-chaired by James Linhart and Kwok Chang), provides the consistent educational update that is so important in our industry. The other seminar was a new and exciting event, Frontiers in Healthcare Innovation (co-chaired by Juby George-Vaze and Dan Corcoran), which showed that our committees are hard at work staying on the cutting edge of educational programming. In addition to these two live events, there were several webinars for members who were unable to join us for the full day events. As you read through this issue take note of the two winners of the Marvin Rushkoff Scholarship Awards and read their essays about their journeys and what led them into healthcare finance. Also in this issue you will find an update on the Mentor Program, which continues to evolve in its second year. These are our leaders of the future and we are fortunate to be part of their journey. Finally, if you were unable to get to one of the seminars OR watch one of the webinars you can still find quality educational material right here in Newscast. This issue features articles on Denials by ARMC Financial Services, CMS Price Transparency by Panacea, and How a Hospital-to-Hospital Transfer Policy Impacts Billing and Coding by Besler. Enjoy the rest of the colorful days of Fall!

Alicia and Christina

PAST PRESIDENTS 2016-2017 David Woods 2015-2016 Meredith Simonetti, FHFMA 2014-2015 Wendy E. Leo, FHFMA 2013-2014 David Evangelista 2012-2013 Palmira M. Cataliotti, FHFMA, CPA 2011-2012 John I. Coster, FHFMA 2010-2011 Edmund P. Schmidt, III, FHFMA 2009-2010 Cynthia A. Strain, FHFMA 2008-2009 Mary Kinsella, FHFMA

EX-OFFICIOAll Past Presidents of the

Metropolitan New York Chapter, HFMABea Grause, R.N., J.D.,

President, Healthcare Association of New York StateKenneth E. Raske,

President, Greater New York Hospital AssociationKevin W. Dahill,

President & CEO, Nassau-Suffolk Hospital Council

Metro NY HFMA Newscast Winter ScheduleElectronic Publication Date 1/25/19Article Deadline for Receipt by Editor 12/28/18

OFFICERS 2018-2019President Mario Di Figlia, FHFMAPresident-Elect Diane McCarthy, CPA, FHFMAVice President Donna SkuraTreasurer Sean P. Smith, CPASecretary Wendy Leo, FHFMAImmediate Past President Maryann J. Regan

BOARD OF DIRECTORSClass of 2019

Christian Borchert, CRCP-I James Linhart Catherine Ekbom Tracey Roland Juby George-Vazé, RN, CCM, MBA

Class of 2020Leah Amante Shivam Sohan, FHFMASusane Lim Andrew Weingartner, FHFMAChristina Milone, Esq.

Newscast CommitteeEDITORS:

Alicia A. Weissmeier, Esq., FHFMA Christina Milone, Esq.

COMMITTEE VICE CHAIRS: Marty Abschutz, CPA, CGMA James G. Fouassier, Esq.

COMMITTEE MEMBERS:

Kiran Batheja, FHFMALauren Christian

Joel DziengielewskiPaulette DiNapoli

Mary Kinsella, FHFMAWendy Leo, FHFMA

Andrew NatkinPamela S. Noack

Edmund P. Schmidt, III, FHFMAJohn Scanlan, FHFMACynthia Strain, FHFMA


CHAPTER OFFICERS AND BOARD OF DIRECTORS

BDO USA, LLPBetz-Mitchell Associates, Inc.CBHV - Collection Bureau Hudson Valley, Inc.Ernst & Young, LLPJzanus, Ltd.KPMG, LLPMedical Liability Mutual Insurance

Miller & Milone, P.C.nThrivePOM Recoveries, Inc.Price Waterhouse Coopers, LLPProfessional Claims Bureau, Inc.RSM US LLPRTR Financial Services, Inc.Tritech Healthcare Management, LLC


2018-2019 CORPORATE SPONSORS

PLATINUM

AccentureCBIZ KA Consulting Services, LLCConnance Crowe Horwath LLPFust Charles Chambers LLPGroup JHealthcare Retroactive Audits, Inc.

Health/ROIJzanus Consulting, Inc.Lexmark International, Inc.PhyCARE Solutions, Inc.RSG, Inc.Washington & West, LLC

GOLD

AllscriptsAvadyneDeloitte Services LLPGarfunkel Wild, P.C.McBeeMCS Claim Services, Inc.

Mullooly, Jeffrey, Rooney & Flynn, LLPNassau-Suffolk Hospital Council, Inc.Navigant Consulting, Inc.Third Party Reimbursement Solutions, LLCVeralon

SILVER

IMPORTANT DATES

Upcoming Educational Seminars and InstitutesDecember 6, 2018 ETHICS, ACCOUNTING Ernst + Young LLP AND AUDIT UPDATE SEMINAR 5 Times Square New York, NY 10036

Events

November 9, 2018 KNOWLEDGE IS POWER - BREAST Jewel Restaurant CANCER AWARENESS LUNCHEON 400 Broadhollow Road Melville, NY 11747

February 23, 2019 SAVE THE DATE ITALIAN CULTURAL NIGHT


CHAPTER MEMBER NEWS

HFMA Seminars provide timely, in-depth strategies and metrics to help you keep pace with the healthcare finance topics you care about the most. View all upcoming HFMA Seminars and register at www.hfma.org/seminars.

The Metropolitan New York Chapter of HFMA Proudly Welcomes the Following New Members!

By Robin Ziegler, Membership Committee Chair

MetroNY HFMA is pleased to welcome the following new members to our Chapter. We ask our current membership to roll out the red carpet to these new members and help them see for themselves the benefits of HFMA membership. Encourage them to attend seminars and other Chapter events. We ask these new members to consider joining a Committee to not only help the Chapter accomplish its work, but to expand their networks of top notch personal and professional relationships. See the list of MetroNY HFMA Committee Chairs, along with their contact information, listed in this eNewsletter.

MAY 2018

Julius Derdik Cerner Corp

Yeshaye Goldberg Cerner

Theodore Krischer Cerner

Isaac Pacht Cerner

Aaron Tenenbaum Cerner

Tucker Leary Manatt Health

Bert Orlov EisnerAmper

Kunal N. Desai KPMG LLP

Jane Farris KPMG

Michael Pechersky Optimal Employee Solutions LLC

Moises Perich Catholic Health Services of Long Island

Andrew Bonacci Mount Sinai Health System

Arlette Guerrier

Krystal Raysor Catholic Health Services of Long Island

George Pakhomov KPMG

Ruth Nayko AWAC Services, A Member Company of Allied World

Yelena Sheynblyum Cerner

Ari Urbach Cerner

Gershon Weintraub Cerner Corp.

Lawrence Katzman NYU Langone Health

Roger Novoa New York City Health & Hospitals Corp

Theresa Hornberger NYC Health

JUNE 2018

Cheryl Kelly Northwell

Michael Brown Northwell Health

Don Gocinski Northwell Health

Diane Gross-Collins Montefiore Medical Center

David Pfeffer Tarter Krinsky & Drogin LLP

Charles Pierce Tarter Krinsky & Drogin LLP

Mangesh Borkar Visiting Nurse Service of NY

David Blumenthal The Commonwealth Fund

Jamie Zwang KPMG

Ricardo Gonzalez New Mountain Capital

Bilal Hashmat CureMD Healthcare

Jay Weinman NYC Health & Hospitals

Emma Dimiceli HealthFirst

Steve Rodgers Morgan Stanley Capital Partners

Brian Weis East Meadow Management Group

JULY 2018

Naomi Pemberton Mount Sinai Health System

Kevin Ostrowski IBM-Watson Health

Gabriela Marinescu Acacia Network

Meredyth Lacombe NYU Langone Medical Center

Jordan Cohen

AUGUST 2018

Kelli Vasquez Square Care MSO

Latasha McGriff Partners in Health Solutions LLC

Mary Delaney NYP-Queens

Susan Sullivan Northwell

Loraine Cincotta Hospital for Special Surgery

Alexandra Gordon PricewaterhouseCoopers

Steven Hefter BDO USA, LLP

Kevin Eaton

SEPTEMBER 2018

Kristina Mazzocco Weill Cornell Medicine

Maria Lagos Northwell Health

Sarah Ramos PricewaterhouseCoopers

Charles Weber New York Presbyterian Hospital

Jordan Solop NYU Langone Health

Amanda Kueh Veralon Partners

Mytayari Keyes One Brooklyn Health


NEW CHAPTER MEMBERS


???!!???

Matters

YourVoice

TakeOur

Survey

A note from President-Elect Diane McCarthy…………….

It’s that time of year again – HFMA has sent the annual membership survey to all ourmembers and the time to respond is now!

As your incoming president I am asking you to take the time to respond to the survey.Let us know what is working - and more important what isn’t. In the upcoming monthswe will be working on planning the 2019/2020 year, and the feedback from ourmembers will pay an integral part in our budgeting and planning. We need feedback onwhat will make your member experience a great one. What topics would you like to seecovered? Do you prefer webinars or in-person seminars? Would you like to see us offermore after work events because you have trouble getting out of the office?

All of your responses will be taken into consideration as we plan the upcoming year.But we can’t help make it a better experience for you if you don’t let us know how.

If you cannot find the survey in your email please contact Daniel Miller from thenational office at [email protected] or myself at [email protected], and we will workto get the survey resent to you. Remember, every response gets entered into a drawingfor one of several Amazon gift certificates.

Thank you in advance for your time and attention.


2018 HFMA Volunteer Leadership GalaThis year, our Chapter gained national recognition at the 2018 HFMA Annual Conference in Las Vegas, Nevada in being awarded two national Yerger awards in the areas of member service and improvement and sharing in two Region 2 Yerger awards. In the category of member service, our Chapter was recognized for its Women in Leadership Conference. The HEReinitiative is a national HFMA effort that aims to inspire individuals invested in the professional development of women leaders in the healthcare field, and supply them with the tools and resources they need to succeed.

For our award - winning innovative event, a panel of female financial healthcare leaders shared their stories of inspiration, career paths, personal support systems, and they provided advice to the attendees. A panel of female business entrepreneurs provided stories of inspiration which included giving back to individuals in need. In addition, the attendees brought in over 500 articles of gently -used business attire which were donated to the Dress for Success Program in Brookhaven

Our Chapter was also recognized for reducing the cost of providing quality educational events to our membership, one of the hallmarks of the HFMA Metro NY Chapter. Notably one of our biggest challenges is the high cost of hosting these events. In the past, the Chapter utilized hotel conference room for all events. This past year, lower cost options were successfully explored.

June 25, 2018


HFMA Metro NY Educational Roadshow The purpose of this Committee is to bring education to members by holding educational seminars on site at hospital facilities. This initiative is intended to both provide education and increase membership. We currently have one event scheduled on Thursday, November 1st at NYU Winthrop Hospital. The HFMA Metro NY Chapter continues to look for speakers willing to participate in the Roadshow program by sharing their knowledge with groups at various facilities. Speakers would commit to at least three presentations for the calendar year and the presentations should last approximately 1-1 ½ hours. The content should be current, relevant and educational (not promotional or sales) in nature. If you are interested, please submit your proposal to [email protected].


Mid-Year Accounting and Reimbursement Update Seminar

Uniondale Marriott

September 17, 2018 On September 17th the Metropolitan New York chapter held its annual mid-year accounting and reimbursement update conference at the Uniondale Marriott on Long Island. The event was chaired by Tracey Roland and co-chaired by James Linhart and Kwok Chang.

The reimbursement seminar kicked off with James Linhart opening the program and welcoming all. James extended a special thank you to all the attendees for taking the time to participate in the seminar.

After introductions were made, Lourdes M. Martinez, Partner Garfunkel Wild, P.C., provided an update on hot topics in the hospital reimbursement and compliance world from a legal perspective. During her presentation, one of the items Lourdes stressed is the need for hospitals to put aside significant dollars for compliance budgets. Next, we heard from Larry Goldberg, Senior Advisor Reimbursement Alliance Group, LLC. He provided a Medicare update on Inpatient Prospective Payment System (IPPS) final ruling. Both Lourdes and Larry provided valuable insights and best practices and shared some of their personal experiences during their presentations.

After a brief break for lunch, we heard from Wendy Darwell, VP/COO Nassau-Suffolk Hospital Council. Wendy’s presentation focused on the changes going on in Washington and Albany touching on important topics such as Affordable Care Act (ACA), removal of the individual insurance mandate, mandatory staffing ratios and singer payer healthcare.

To round out the day's training, Steven Clarke Executive Director Ernst & Young and Laura Kielczewski Senior Manager from Ernst &Young gave an informative update on the IRS Form 990 Schedule H. Tim Johnson, Executive Director Greater New York Hospital Association, provided the group with an in-depth review of affiliated group agreements, IRIS and new legislative activities. The day concluded with an audit update on HCRA, ICR and DSH by Joseph Cassano, Manager KPMG.

The training not only provided education, but equally important, offered an opportunity to network with fellow chapter leaders! Thank you to all our presenters and those who attended the seminar. We look forward to seeing you at our next event in December.


Denials are on the rise, and healthcare providers are losing money because of it. Annual losses from denial write-offs range from as much as 1 percent of total net patient services revenue (NPSR) to over 4 or 5 percent, according to The Advisory Boardi. For an average 300-bed organization, 1 percent of NPSR can equate to $2-$3 million annually. For the multi-billion dollar health alliances…well, you do the math!ii

Change HealthCare ran an analysis reviewing over 3.3 billion hospital transactions. Here are some results:iii

- $3 trillion in claims submitted annually. - Payers deny around 9% of all hospital claims. - Hospitals lost around $4.9 million due to denials. - Typical health system lost around 3.3 percent of NSPR due to denials.

With the number of expert billers working in the healthcare industry, how is it that payers are still able to avoid making so many payments? Virtually all of the recent ICD-10 and CPT coding changes have been addressed and – aside from the occasional human error – resolved. Advances in process and technology have also improved billing inefficiencies. How are denials still a problem?

There are several reasons. And providers and payers can both share some responsibility. But, from the provider perspective, what can be done to lower the denial rate – or, at least make hospital and physician groups more successful in appealing denials and getting them overturned?

DENIED!


What they know can hurt you.

For instance, do you think providers considered the possibility that their payers are using claims history against them? A review of many articles written over the last several years on denials all suggest very similar recommendations for improvement. Hospitals need to “benchmark data,” hire a seasoned analyst to locate key indicators, communicate more effectively with denials staff, increase coordination with those within the organization who negotiate contracts and those who have to bill according to the contract terms, etc. These are all strategies sure to improve the process. But how many hospitals ever consider what their payers’ strategy is?

Hypothetically, for example, let’s say an insurance company ran a denials report on a provider and saw they weren’t appealing denials less than $1,500. Might the payer then create a strategy to scrutinize these lower-balance accounts for reasons to deny them? Actually, this is probably not a hypothetical. A review of actual data on millions of dollars of denied claims reveals that low-balance, high-volume denials are becoming an epidemic. One reason for this may simply be because of the migration of many procedures and tests to outpatient settings. But there is no denying that the increase in outpatient denials is overwhelming in-house staff. And you can bet the payers know this. If a payer sees a hospital ignoring low balance claim denials and throwing them in a file drawer, then what’s stopping them from denying those?

The Clock Is Ticking!

One denials management company that specializes in follow-up and collection of denials recently ran a report on all placements they received from their clients in 2017. Of the tens of thousands of accounts they received, approximately 30% of them had already timed out! The firm simply couldn’t fight the denial because, by the time the hospital had outsourced the account for a second review, the appeal deadline had already passed!

One thing a hospital can do is to carefully review contract language regarding timely filing timeframes, they may differ from payer to payer. We also know about the Medicare’s 120-day reconsideration timeframe for denied accounts. Ensure that the process – whether it is internal, or in partnership with an outside organization – takes into account the timely filing deadlines so that appeals go out before it’s too late.

Two Take-Aways…

1. Denials are up across the board, and many of them fall into the low-balance high-volume category. Review coding, pre-certification and pre-authorization processes to make sure that you are in compliance with contract terms to avoid unnecessary administrative and technical denials. Fine-tune your follow-up process to make sure that low-balance denials get the attention they deserve. Segregate them from your simple re-submits. They require more work; don’t lump them together!


2. Timely-Filing is still a big problem. Review contract terms and internal processes to ensure that they are aligned to avoid missing appeal time-frames. If you work with an outside vendor, make sure they get a chance to take a “second-look” after in-house efforts are exhausted before accounts time-out.

Because denials represent a seemingly small piece of the revenue pie, they are often overlooked, with resources and manpower being focused elsewhere. But there is big money in that small piece! Don’t be in denial of your denials opportunities. Those providers who have aggressively addressed their denial management processes and strategies are counting the extra cash and adding, in some cases, millions of dollars to their bottom line.

Author:

i https://www.advisory.com/research/financial-leadership-council/tools/2015/2015-revenue-cycle-benchmarking ii(https://www.beckershospitalreview.com/finance/4-ways-hospitals-can-lower-claim-denial-rates.html)

iii (https://www.beckershospitalreview.com/finance/denial-rework-costs-providers-roughly-118-per-claim-4-takeaways.html)

Joe Hoban is an executive at ARMC Financial Services, a New Jersey-based healthcare revenue cycle company. He can be reached at [email protected].


Mentor Program

The first Mentor Program Committee Information Session took place on September 20th and featured the Annual Institute and General Education committees. For the 2018-2019 year, rather than pairing mentors and mentees, these monthly information sessions will allow mentees to become more familiar and involved with the committees and opportunities that the chapter has to offer, as well as to provide networking opportunities with mentors and with each other. Mentees were also invited to attend the October 10th General Education Committee meeting at Borrelli’s Pizzeria in East Meadow, and several of them were able to attend and engage in the meeting conversation. Special thanks to Bob Jacobs and Health/ROI for donating registration and a hotel room for the Region 2 Fall Institute to one of our mentees, Cecilia Bartley. The next Committee Information Session will take place on Tuesday, November 13th and will feature the Finance/Reimbursement/Audit and Innovations/Women in Leadership Committees.


Mentor Program Committee Information SessionMiller & Milone, P.C.

100 Quentin Roosevelt Blvd. Garden City, NY 11530

Thursday, September 20, 2018 5:30pm – 7:30pm


MEMBERS OF THE METROPOLITAN NY CHAPTER HFMA, SPOUSE AND/OR DEPENDENTS ARE

ELIGIBLE TO APPLY FOR THE

MARVIN RUSHKOFFSCHOLARSHIP.

By January 1st each year the Marin Rushkoff Scholarship applicationwill be posted to the Chapter’s website. Applications must be deliveredin complete form and received by the designated committee chair on orbefore June 1 to be considered for award. Two (2) $1,000 scholarshipsare awarded on an annual basis to qualified applicants. Awards are forone year only and require a new application each year to be consideredfor the scholarship.

METROPOLITAN NEW YORK CHAPTER HFMA

MARVIN RUSHKOFF SCHOLARSHIP

Eligibility Requirements:Member in good standing with National HFMA and Metro NY Chapter.Must be a member or spouse or dependent of a member.Must be attending an accredited college or university.Must provide proof of acceptance.Must be a matriculated student.

**Members of the Executive Committee/their dependents and spouses are not eligible.**Members of the Evaluating Committee/their dependents and spouses are not eligible.


We are pleased to announce

the

winners of

The Metropolitan New York Chapter HFMA

Marvin Rushkoff Scholarship awards:

Mustfa Manzur and Alyssa Markopoulos

Each recipient will be awarded $1,000 for one year at

an accredited college or university.

Winners were selected based on the following criteria:

Essay 60 %

Community/Professional Experience 25%

Field of Study 10 %

GPA of most recent semester completed 5%


In February 2013, I attended the Harvard Business School Healthcare Conference. At the time, Iwas a graduate student at Columbia University studying healthcare management. During theconference breakfast, I found myself seated across from Dr. Marc Harrison – then the CEO ofCleveland Clinic Abu Dhabi and now the CEO of Intermountain Health in Utah. I asked Dr. Harrisonthat day (and in subsequent conversations) what I should do, between completing my graduate studiesand applying to medical school, to best prepare for becoming a leader in healthcare. He suggested Iexplore opportunities to learn more about the finance, management, and delivery of healthcare froman administrative perspective because I would never have such an opportunity again after medicalschool.

With Dr. Harrison’s advice in mind, I completed various internships that would expose me toalmost every department in a health system. I spent over four years in consulting roles completingproject work for a number of healthcare organizations – both market leaders and institutions intransition. My projects spanned revenue cycle, transaction due diligence, information technology, andoperational efficiency among many other areas. Over this time, I believe I have gained a deepunderstanding of what it takes to run organizations effectively – particularly from a financialperspective. I also completed a graduate degree in medical microbiology at University of Florida tolearn about hospital quality improvement. In today’s environment, where the healthcare dollar isbeing stretched like never before, I believe a clinician with intentional training and experience acrossmany areas of healthcare management is one best prepared to help lead the health-orientedorganizations of the future.

HFMA has played an incredible role in my career. In March of 2013, I volunteered to help at theMetro-NY Chapter’s Annual Institute. Frankly, I must have made a positive impression; DavidWoods called me two weeks after the institute and offered me an interview for my first real job – tocomplete New York Eye & Ear Infirmary’s Community Health Needs Assessment. The role at NYEEhelped me begin my career in earnest and start realizing my dream. Now that I have been accepted tomedical school at Thomas Jefferson University Sidney Kimmel Medical College, being selected forthe Marvin Rushkoff Scholarship would be both an incredible honor and represent yet another wayHFMA has helped me forge my unique path towards the goal of becoming a leader within thehealthcare industry.

Mustfa Manzur


Growing up, my dad and I have been inseparable. Everywhere he went, I wanted to go too. Takeyour daughter to work day was the best holiday, in my eyes, because I could sit on his lap and spendthe day with him. Ever since this, I have envisioned myself pursuing a career in business so I couldbe just like my dad. He is the Chief Financial Officer (CFO) of the nursing home in my area. Amoment never goes by where he is not working his hardest in order to assure the best for the Nursinghome. He has a bachelor’s degree in accounting which has allowed him to become the successfulman that he is today. My aspirations for my future is to gain a bachelor’s degree in accounting and amasters in business administration. I know that my dream is possible because I have grown upsurrounded by someone who has a strong work ethic.

When I turned 16 I started working at a local diner. I began as a cashier and hostess andeventually have worked my way up to more substantial positions. Time management has been mykey to success while working 6 days a week while balancing my schoolwork, extracurriculars andsocial life. My passion, dedication, and love for helping others was soon recognized by my boss whopromoted me, the youngest worker, to the manager. I continue to walk in each and every day with asmile on face, bringing positive energy and creating an atmosphere that everyone loves to be a partof. My work at the diner has assured me that I want to pursue a passion, just like my father, where Ican be surrounded by people all day and continue to make a positive impact on their life.

Alyssa Markopoulos


HFMA Metro NY Annual Golf Classic 2018

September 24, 2018



September 24, 2018

Sometimes being with your friends and golfing is all the therapy you need…...



September 24, 2018

I’ve had a good day when I don’t fall out of the cart. – Buddy Hackett


HFMA Metro NY Annual Golf Classic 2018September 24, 2018



September 24, 2018


On August 2nd, the Center for Medicare & Medicaid Services (CMS) released the final 2019 Inpatient Prospective System (IPPS) rule, which included requirements for hospitals to “make available a list of their current standard charges via the Internet in a machine-readable format and to update this information at least annually, or more often as appropriate. This could be in the form of the chargemaster itself or another form of the hospital’s choice, as long as the information is in machine readable format.” Many healthcare industry leaders had not expected this initiative to make it beyond the proposed rule, which further underscores the ongoing CMS initiative and emphasis placed on empowering patients through better access to hospital charge information.

Industry Concerns with the CMS Pricing Transparency Requirements

Many valid arguments can be made around the imperfect nature of the final CMS pricing transparency rule:

Standard prices in the chargemaster may be confusing to patients due to the different levels of patient acuity and/or bundling of services.

Though providers already comply with the ACA requirements, consumers are simply not utilizing the processes in place to ascertain their cost information.

It would simply be better coming from the health plans, leaving hospitals to only focus on the uninsured and out-of-network patient costs.

After consideration of the public comments, CMS did not see a need to further update its guidelines beyond the updated guidelines that were previously announced would be effective January 1, 2019. Hospitals and health systems should therefore act accordingly to achieve compliance and create a plan to address their pricing processes and policies. Preparing for the CMS Requirements Many hospitals have begun to prepare for this CMS requirement by taking the following simple steps:

1. Ask Questions Sit down with the team responsible for your pricing and ask them 5 quick questions:

o Do you know the basis for your current line item prices? o Are your line item prices rational compared to other prices in your CDM and across your

health system? o Are your line item prices rational compared to other hospitals that you consider peers? o Can you defend your line item prices based on market data, payer fee schedules, or a

reasonable operating margin plus cost mark-up to cover shortfalls (i.e., Medicare, Medicaid, Charity Care, Bad Debt, or unreimbursed or under-reimbursed costs such as teaching program costs) or a hybrid thereof?

CMS Price Transparency Requirement: Steps Towards

Ensuring Compliance and Defensible & Rational Pricing


o Can your organization’s leadership articulate the rationale behind these prices if they are all made public?

If you are not comfortable with the answers to all these questions, then you may be experiencing market pricing differentiation and exposure to transparency. A thorough strategic pricing analysis may be necessary to ensure the defensibility of your organization’s pricing. However, you should never increase or decrease a line item charge without first performing net revenue modeling that considers the weighted average charge payer contribution at the line item level, payer fee caps, lesser-of-charge and stop-loss payer contract terms.

2. Consider Technology

Consider using specific software technology to develop and maintain your defensible chargemaster prices as unit costs, market data, payer contract terms, case-mix and volume, and financial and strategical objectives change every year.

3. Plan Communications

Develop both internal and external communication plans to articulate your pricing strategy and policies. The inability to articulate a clear, concise explanation on how a price is derived can cause a public relations headache for your leadership team.

4. Educate your Staff An important first part of building relationships with patients is educating your staff to effectively communicate during the patient price inquiry process. Make sure your staff know your patient demographics as well as your average charge and payment by service category and by payer. Being able to provide your patients with an anticipated payment level or range based on average charges and typical discount rates for in-network payers and separately for out-of-network payers provides them with a springboard and embraces transparency. However, be sure that such estimates provide adequate disclaimers and legal protection since estimates can be far different than the final claim an insurer or patient receives due to incomplete diagnosis and procedure information at the time of the estimate, unexpected complications during the procedure, and other reasons. 5. Decide on Level of Transparency

Determine the level of transparency your organization is comfortable with. Is posting your chargemaster enough to give patients the information they need? If your answer is no, then your hospital or health system may want to consider one or more of the following:

o Post CDM along with the approximate average discount for different payer

classifications. For example, you could include in-network and out-of-network, IP and OP, and by Medicare, Medicaid, Commercial, Managed Care, HSA, Self-Pay, etc.


o Post average charges and payments by MS-DRG, APC, ASC, Private Outpatient HCPCS, ED all-inclusive and break-out between in-network and out-of-network, and by payer category. Patient estimation systems cannot anticipate complications that may occur during a patient’s inpatient stay nor additional diagnoses or procedures required that can impact the final DRG assignment and charges. By disclosing, for example, the hospital’s average charges and payments for without CC/MCC, with CC, and with CC/MCC as described above, consumers will have advance notice of the full range of expected charges and insurance payments.

o Perform product-line profitability analysis and other analytics to help determine

reasonable discounts to offer self-pay patients, those with health savings accounts, those with out-of-network insurance who are responsible for large balances due, and any case where patients do not qualify for other financial assistance. Understanding the profitability of your current payment levels at the procedure and payer levels is imperative before deploying a comprehensive discount program.

6. Automate Publication of Charges

Establish an easy-to-use and automated mechanism to initially publish online and continuously update your website. This will make it easy to publish charges during the year as your organization updates your chargemaster and prices and adds any additional information you decide to share with consumers. In today’s data hungry world, people are accustomed to having information at their fingertips through an easy-to-use website or, more commonly, a smart phone app. Be sure to include proper disclaimers to educate consumers on the need for them to understand their insurance plan benefits and their in-network versus out-of-network status and how that could drastically impact their own out-of-pocket expense.

Those providers that fail to embrace new ways to communicate with their patient community likely will find pricing transparency to be an uphill battle.

Conclusion We recognize that this CMS initiative may not be the answer to pricing transparency. However, it should be viewed as an opportunity to proactively enhance the public’s confidence in your healthcare delivery and transparency. It provides us an opportunity to work collaboratively with patients to establish consumer loyalty in the marketplace while simultaneously maintaining rational and defensible pricing.


Written By: Fred Stodolak, Executive Vice President, Panacea Healthcare Solutions, Mark Spehar, Senior Vice President, Financial Services, Panacea Healthcare Solutions, Henry Gutierrez, Vice President, Financial Services, Panacea Healthcare Solutions

Fred Stodolak, Executive Vice President Panacea Healthcare Solutions

Mark Spehar, Senior Vice President Financial Services, Panacea Healthcare Solutions

Henry Gutierrez, Vice President, Financial Services Panacea Healthcare Solutions


Frontiers in Healthcare Innovation

September 28, 2018

Founder & CEO Richard Park of CityMD and healthcare leader Gerry Meklaus, Managing Director & National Value Based Lead from Accenture give their thoughts on Healthcare Innovation. PLUS a diverse group of panelists employed as innovators from their respective organizations speak on a wide range of healthcare innovations and immediate priorities.


Metro NY Chapter Technology Committee Frontiers in Healthcare Innovation in NY Metro

HFMA NY Metro’s Technology Committee organized and hosted a first of its kind full daytechnology focused event, Frontiers of Healthcare Innovation on September 28th. The technologycommittee, reborn two years earlier with a focus on bringing technology education to chapterevents and webinars relevant and interesting to financial healthcare leaders, took a gamble onits early success to host an entirely new event. The program complemented HFMA’s nationaltheme, “Imagine Tomorrow” with a full day of speakers and interactive conversation with avariety of experts working in the area of Technology, Clinical Practice and Finance. Speakersshared what they are working on, what is happening in the technology industry, their prioritiesand what financial leaders can expect in the near future.

The event was held in Accenture’s large training center located in midtown Manhattan with thehelp of Accenture lead team working with Tina Liu and Gala Prabhu. The day included 18speakers and panelists, ranging from physicians Michael Poon MD, FACC, FACCT, Director ofResearch, Cardiac Imaging & Clinical Transformation at Northwell Health, Richard Park, MD &CEO CityMD and Gerry Meklaus, Managing Director & National Value Based Lead at Accentureto payers represented by Rachael Jones VP Insights Analysts & Shawn Wang VP of Data Sciencea part of Anthem BCBS to a digital health expert and futurist Raj Tiwari from Johnson & Johnsonand Martin Brutscher CEO of McBee Associates our revenue cycle guru. Note the high levelgroup of distinguished health care technology experts!

It was an insightful and informative program and we have received an overwhelming responsefrom our survey filled with many positive remarks and comments. There were many positivecomments and admiration was shown for Dr. Poon’s presentation that included how he is usingArtificial Intelligence/Machine Learning, 3D printing and Virtual Reality/Augmented Reality in thecardiac imaging space to improve patient care and outcome. He also shared how he createdCPT codes for the new procedures and testing to ensure reimbursement. A few comments fromsurvey: “Very interesting perspective and highly usable information.” “Took difficult concepts andpresented clearly.”

Following the program many participants and attendees enjoyed a networking social atConnolly’s Pub. The Technology Committee encourages and welcomes others to join thisinnovative committee, to obtain more information they should contact Juby George-Vaze andDan Corcoran at [email protected] and [email protected].


MetroNY Spotlight On

Juby George Vaze, RN, CCM, MBACEO & Chief Innovation Officer

globeXHealth

What was your “Yesterday” in Healthcare?My yesterday starts with a BSN in Nursing and an MBA from Pace University. My training andexperience includes companies like Empire Blue Cross Blue Shield, McBee Associates, AtlanticHealth, and Genesis Healthcare.

What roles has HFMA played in your “Today”?I consider my years with various HFMA Chapters to be one of the best immersive learningexperiences that helped me throughout my career within hospitals and managed care.

What does volunteering with the MetroNY Chapter mean to you?I consider my current role to be paying it forward. It’s truly a great honor to bring forth an area thatis very prominent in current healthcare landscape; the merging of clinicians, finance and technologyto successfully navigate revenue and qualify patient care.

What do you hope “Tomorrow” holds for our industry?Going forward, my vision is to help develop Healthcare Technology into a viable, front-runner inthe Blockchain, Telehealth, Big Data/Analytics and Research arenas. I see a bright future fortechnology in connecting the fragmented, moving parts of the healthcare machine. ArtificialIntelligence will be an integral part of how healthcare processes function creating seamlesstransitions, with fluid technological advances. I hope to be a part of that change helping to createbetter solutions that will help patients and chronically ill.


FIFTY-SECOND ANNUALPAST PRESIDENT’S DINNER DANCE

Honoring

MARYANN REGAN

MARYANN REGANImmediate Past President

and

ALL CHAPTER PAST PRESIDENTSWoodbury Country Club

Saturday, September 29, 2018


Leaders don’t force people to follow, they invite them on a journey. “ - Charles S. Lauer


To transfer or not to transfer – that is the question. The medical decision to transfer a patient to another acute-care facility is not an easy one. While medical necessity is always at the heart of this decision, the impact to hospital and physician reimbursement are also contributing factors.

Federal Medicare regulations and each hospital’s own hospital-to-hospital transfer policy shapes the process and requirements for transferring patients to other acute-care facilities or alternative care sites. These policies are specifically focused on patient care and are intentionally designed to discourage transfers for financial purposes or convenience. Core tenants of these policies outline that the patient must be examined, have had emergency medicine, if needed, and is accepted by the facility receiving the patient.

Once the medical decision to move a patient is made and the transfer is in motion, hospitals must then ensure the claim being billed reflects the transfer. This includes both codes for facility and physician services. If either of these claims are billed incorrectly, there is risk of claim rejection and non-compliant billing.

Patient discharge status codes The patient discharge status code identifies where the patient is going at the end of care, whether it be an inpatient or outpatient encounter, or at the end of a billing cycle. This code should most accurately reflect the care being provided post-discharge to the best of the provider’s knowledge.

Types of discharge status codes When a hospital codes a discharge status of 02, it indicates the patient is being discharged to another acute-care facility for inpatient care. Many providers use an 02, whether the patient is transferring for outpatient follow up or an inpatient admission. This represents an incorrect use of the 02 code and causes an unnecessary reduction in hospital reimbursement. This is because a discharge status code of 02 combined with a DRG that is impacted by the Medicare transfer policy results in the hospital receiving a reduced per diem rate versus the full DRG.

It is clear in the Medicare inpatient transfer policy that when a patient is transferred for an outpatient procedure, the discharge status on the claim should be an 01.

Occasionally, it is unclear whether a patient transfer will result in an admission.

Consider these examples:

• An elderly patient who is transferred for a cardiac catheter procedure. This procedure is often completed on an outpatient basis, but the age and overall health of the patient may necessitate an inpatient stay. In this scenario, the hospital must code the highest level of care known at the time which is an 02 since an inpatient admission is highly anticipated.

• A patient is discharged to receive outpatient oncology services at an acute facility specializing in oncology. This patient is going for outpatient services and thus the claim should be coded an 01.

How a Hospital-to-Hospital Transfer Policy Impacts Billing and Coding


The discharge status code of 01, is not impacted by the transfer policy and the hospital is entitled to the full DRG.

Even when the Medicare inpatient transfer policy and the provider’s own hospital-to-hospital transfer policy are well understood, there is still room for error due to unknown post-discharge status as illustrated in these scenarios.

• A patient is transferred to a hospital for a cardiac catheter. The claim is coded an 02 and the patient does not get admitted. The hospital is going to receive the per diem payment in error. The discharge status should be an 01 and the hospital should receive the full DRG.

• Conversely, the patient is discharged to home (01) and ends up back in the hospital that day. This claim will be rejected until the discharge status is changed to an 02, even though the discharging physicians had no anticipation of the admission. This is a common error occurring in billing.

Physician billing Physician billing is also impacted by hospital-to-hospital transfers. Physicians may bill either one discharge code or one initial hospital care code on one day. At the receiving hospital or unit, the physician must not bill another hospital care code, but may combine the two visits as a subsequent care code to increase the complexity.

There are specific requirements that would allow a physician to bill a discharge and an initial hospital code. The transfer can’t occur the same day and the hospital record must not be “merged”, meaning it is two separate facilities. This rule applies to physician groups as well. Two physicians in the same practice are held to the same limitations.

Conclusion The safety and wellbeing of the patient should always dictate the level of care. If a patient is stable and warrants or needs a transfer to another acute-care facility, the billing must accurately reflect the transfer. Although Medicare has edits in place to determine if a hospital miscoded a hospital-to-hospital transfer on their claim, it is the responsibility of the provider to submit accurate claims.

Additionally, reflecting the highest level of care in the discharge status code is not necessarily correct.

Mary Devine is a Director of Revenue Cycle for BESLER. Her main responsibility with BESLER is to oversee the Transfer DRG product line. Mary has over 25 years of experience in healthcare financial management and has a wide knowledge of all components within the revenue cycle as well as a strong clinical background. Mary holds a Bachelors degree in Accounting from The Pennsylvania State University and is an RN.


HFMA’s Online Membership Directory

Have you visited HFMA’s Online Membership Directory lately? Login at www.hfma.org. When you select “Directory”, not only can yousearch for members of your Chapter, you can also search for all yourHFMA colleagues by name, company, and location – regardless ofChapter! Using an online directory instead of a printed directoryensures that you always have the most up-to-date contactinformation.

It’s vital that HFMA has your correct information, so please take amoment to review your record now. By doing so, you’ll ensure thatHFMA continues to provide you with valuable information andinsights that further your success.

COMMITTEENAME CHAIR CO-CHAIR VICE CHAIR 1 VICE CHAIR 2

ADVISORY COUNCIL Maryann J. Regan David Woods Meredith Simonetti, FHFMA Wendy Leo, FHFMA [email protected] [email protected] [email protected] [email protected] (516) 576-5601 (212) 256-3701 (631) 465-6877 (516) 454-0700 60TH ANNUAL Catherine Ekbom James Linhart Andrew Weingartner, FHFMA Wendy Leo, FHFMA INSTITUTE [email protected] [email protected] [email protected] [email protected] (516) 745-0161 (646) 458-2054 (516) 240-8147 (516) 454-0700 AUDITING John Scanlan, FHFMA Edmund Schmidt, FHFMA Gordon Sanit, CPA, FHFMA [email protected] [email protected] [email protected] (718) 283-3911 (718) 283-1331 (516) 918-7065

BYLAWS Wendy Leo, FHFMA Donna Skura Sean Smith, CPA [email protected] [email protected] [email protected] (516) 454-0700 (516) 349-5233 (516) 705-1937 CENTRAL Robin Ziegler Annie Lemoine Taylor Regan Chrissy Kern REGISTRATION [email protected] [email protected] [email protected] [email protected] (516) 326-0808 ext 3676 (516) 326-0808 ext 3312 (631) 831-0684 (516) 723-7525

CERTIFICATION/ Jim Petty Kiran Batheja, FHFMA CERTIFIED MEMBERS [email protected] [email protected] (516) 876-6022 (914) 593-1758 COMMUNITY Josephine Vaglio Cecilia Bartley OUTREACH [email protected] [email protected] (516) 248-2422 (516) 576-5645

CONTINUING CARE Christina Milone, Esq. David Evangelista Meredith Simonetti, FHFMA [email protected] [email protected] [email protected] (516) 296-1000 ext 223 (718) 206-6930 (631) 465-6877 CORP COMPLIANCE/ Mathew Schwartz INTERNAL AUDIT [email protected] (646) 453-1252 CPE’s John Scanlan, FHFMA Edmund Schmidt, FHFMA [email protected] [email protected] (718) 283-3911 (718) 283-1331 DCMS/ Wendy Leo, FHFMA Robin Ziegler Donna Skura Anmol Nadkarni BALANCED [email protected] [email protected] [email protected] [email protected] (516) 454-0700 (516) 326-0808 ext 3676 (516) 349-5233 (516) 712-0024 EXEC. COMM. Mario Di Figlia, FHFMA Diane McCarthy, CPA, FHFMA & PLANNING [email protected] [email protected] (516) 876-1386 (516) 349-4643


COMMITTEES 2018-2019


FINANCE/ Tracey Roland James Linhart Patrick S. Semenza, CPA, FHFMA Kwok Chang REIMBURSEMENT/ [email protected] [email protected] [email protected] [email protected] (908) 377-5122 (646) 458-2054 (212) 774-7566 (212) 979-4324 FOUNDERS AWARDS Paulette DiNapoli Brittany Loucas [email protected] Brittany. [email protected] (718) 518-2064 (516) 255-1565 GENERAL EDUCATION Shivam Sohan, FHFMA Andrew Weingartner, FHFMA Robert Braun Rachele Hashinsky, CPA, FHFMA [email protected] [email protected] [email protected] [email protected] (516) 562-6000 x7399 (516) 240-8147 718-690-6408 (646) 227-3156 INNOVATIONS/ Robin Ziegler Laurie Radler, RN, FHFMA, CIPP/US Catherine Ekbom Colleen O’ConnellWOMEN IN [email protected] [email protected] [email protected] Colleen.O’[email protected] LEADERSHIP CONF (516) 326-0808 ext 3676 (917) 286-3902 (516) 745-0161 (516) 576-1922

INVESTMENT Sean Smith, CPA Wendy Leo, FHFMA James Linhart Tracey Roland [email protected] [email protected] [email protected] [email protected] (516) 705-1937 (516) 454-0700 (646) 458-2054 (908) 377-5122 KNOWLEDGE IS Catherine Ekbom Laurie Radler, RN, FHFMA, CIPP/US Colleen O’Connell Donna Skura POWER SERIES [email protected] [email protected] Colleen.O’[email protected] [email protected] (516) 745-0161 (917) 286-3902 (516) 576-1922 (516) 349-5233

LEGAL AFFAIRS Christina Milone, Esq. [email protected] (516) 296-1000 ext 223 MANAGED CARE Robert Gucciardo Tina (HsinTing) Liu James Fouassier, Esq. [email protected] [email protected] [email protected] (631) 465-6234 (917) 452-2622 (631) 638-4012 MEMBERSHIP MSP Robin Ziegler Kiran Batheja, FHFMA [email protected] [email protected] (516) 326-0808 (914) 593-1758 MENTORING Christina Milone, Esq. Susane Lim Wendy Leo, FHFMA Maryann J. Regan [email protected] [email protected] [email protected] [email protected] (516) 296-1000 ext 223 631-465-6458 (516) 454-0700 (516) 576-5601 MIS Juby George-Vaze, RN, CCM Dan Corcoran Pamela S. Noack, PhD, FHFMA, FACHE [HEALTHCARE [email protected] [email protected] [email protected]] (914) 420-2385 (516) 576-8000 (212) 434-4926 NEWSCAST Christina Milone, Esq. Alicia A. Weissmeier, Esq., FHFMA Marty Abschutz, CPA, CGMA James Fouassier, Esq. [email protected] [email protected] [email protected] [email protected] (516) 296-1000 ext 223 (516) 296-1000 EXT. 244 (732) 906-8700 EXT 109 (631) 638-4012


COMMITTEES


NOMINATING Maryann J. Regan [email protected] (516) 576-5601 REVENUE CYCLE/ Leah Amante Susane Lim Colleen OConnell Cecilia Bartley PATIENT FINANCIAL [email protected] [email protected] Colleen.O’[email protected] [email protected] 631-723-2160 ext. 127 (631) 465-6458 (516) 576-1922 (516) 576-5645 REVENUE CYCLE Leah Amante Susane Lim Jason Gottlieb Christian Borchert, CRCP-I ACADEMY [email protected] [email protected] [email protected] [email protected] 631-723-2160 ext. 127 (631) 465-6458 (212) 297-4549 (315) 729-9555 PPDD Wendy Leo, FHFMA Maryann J. Regan [email protected] [email protected] (516) 454-0700 (516) 576-5601 WEBMASTER AND Andrew Weingartner, FHFMA Shivam Sohan, FHFMA Alyson Betz PERSONNEL [email protected] [email protected] [email protected] PLACEMENT (516) 240-8147 (516) 562-6000 x7399 (347) 277-8377 REGION 2 David Evangelista Mario Di Figlia, FHFMA Diane McCarthy, CPA, FHFMA Donna Skura COORDINATOR [email protected] [email protected] [email protected] [email protected](FALL INST) (718) 206-6930 (516) 876-1386 (516) 349-4643 (516) 349-5233 REGION 2 Mario Di Figlia, FHMFA Diane McCarthy, CPA, FHFMA Kiran Batheja, FHFMA Shivam Sohan, FHFMA COLLABORATION [email protected] [email protected] [email protected] [email protected] (516) 349-4643 (914) 593-1758 (914) 593-1758 (516) 562-6000 x7399 ROADSHOWS Diane McCarthy, CPA, FHFMA Christina Milone, Esq. Matthew Kamien Brittany Loucas [email protected] [email protected] [email protected] [email protected] (516) 349-4643 (516) 296-1000 ext 223 (516) 255-1507 (516) 656-5300 SOCIAL MEDIA Alyson Belz Taylor Regan Juby George-Vaze, RN, CCM [email protected] [email protected] [email protected] (347) 277-8377 (631) 831-0684 (914) 420-2385 SPECIAL EVENTS Kiran Batheja John Coster, FHFMA Gordon Sanit, CPA, FHFMA Mario Di Figlia, FHMFA [email protected] [email protected] [email protected] [email protected] (914) 593-1758 (516) 240-8147 (631) 495-6596 (516) 876-1386 SPONSORSHIP Wendy Leo, FHFMA Kiran Batheja, FHFMA Mario Di Figlia, FHMFA [email protected] [email protected] [email protected] (516) 454-0700 (914) 593-1758 (516) 876-1386 WEBINARS Andrew Rolih Cecilia Bartley Shivam Sohan, FHFMA Mario Di Figlia, FHMFA [email protected] [email protected] [email protected] [email protected] (516) 326-0808; 3102 (516) 576-5645 (516) 562-6000 x7399 (516) 876-1386 YERGER AWARD Dana Keefer Michele Manuel Marty Abschutz, CPA, CGMA Christian Borchert, CRCP-I [email protected] [email protected] [email protected] [email protected] (917) 561-4395 (212) 857-5269 (732) 906-8700 ext 109 (315) 729-9555


COMMITTEES


Our team of Clinicians, Attorneys, Certified Coders & Reimbursement Analysts are the foundation of our Denial Recovery Solutions.

washingtonwest.com | 1‐800‐704‐5574 | [email protected]

All Payor Recovery Support for… lower level of care • lack of medical necessity • DRG down code • DRG reassignment • re-admission non emergent service • untimely submission of claim • experimental investigational • delay in service • no notification • no authorization • penalty for no authorization late/no pre certification • benefits • exhausted • patient ineligible • policy excludes service • incorrect code • billing error • change in principal diagnosis • change in secondary diagnosis • invalid procedure code

metro ny hfma fall 2018 volume 48 , issue 4 past...

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