Societies Urge SGR Repeal in Lame-Duck Congress

Healthcare Legislation Proposed Requires “Cook Book” Medicine

According to CMS, physicians who provide care to Medicare and Medicaid recipients would be granted increased liability protection “if they can demonstrate that they followed Established clinical guidelines based on a bill introduced in Congress recently”.

“The Saving Lives, Saving Costs Act” would create a “Safe Harbor” for physicians who “follow best practice guidelines”.  This Safe Harbor provision would also allow physicians to request that state-level malpractice suits be moved to federal courts.

Should Hospitals Take Coders Offline for Training in ICD-10-CM/PCS?

Many of HSMN’s clients have decided that they needed to take their coders off line and put them into intensive training for ICD 10-CM/PCS.  In order to do that HSMN’s clients needed to know whether they could find a group who could in every way replicate the quality and productivity of the internal staff.

What CEOs and CFOs Need to Know About the ICD-10 Transition

What is the difference between ICD-9-CM and ICD-10-CM? It’s a huge one, and it’s one that requires a marriage between critical thinking skills and the thinking that goes into medical decision making. In other words, the clinical staff will need hands-on efforts to master the new scenario which requires a level of specificity never required by Medicare or any other entity.

SPOTLIGHT: EPIC Systems Workflow Analysis. Is your organization live or soon to be live with EPIC? HSMN has worked closely with many organizations to conduct comprehensive Post-EPIC Workflow Assessments and Billing Quality Reviews after Go-Live. Let us help you. read more

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September, 2014

Hospital Consulting, Billing, Health Services Management by HSMN

 "The best revenue cycle company in the country" is the way one CFO of a prestigious academic medical center referred to us. For our clients, hospitals and physician practices, we have improved overall financial performance, restructured the revenue cycle on both Pro fee and hospital sides, and essentially made our clients much more financially successful in the delivery of healthcare services. HSMN’s hospital consulting experience is deep and its client list long.

 Our proven methodology for the last 27 years always begins with a thorough assessment of each organization, its culture, history and value system, because we know each client is unique. Our hospital consulting strategies work because they come from a synergy of your organization's values and our many years of experience. HSMN utilizes advanced analytics at the macro and micro levels to uncover clues to the real issues in your processes, systems and clinical services. In shaping solutions, we define the new mission and help structure roles to carry out the new approaches. We often pilot these new approaches and then incorporate them into your workflows to optimize efficiency.

 HSMN Inc. is proud to announce that our clients have now requested that we do interim coding and billing on both sides of the equation. Technology has made it possible for us to code and bill remotely, and more importantly, help our clients monitor the quality of the documentation, the coding interpretation and the purity of the claim. The addition of claim scrubbers has created yet another layer of delay in the billing process and HSMN has worked to clean up the process and reduce the number of claims that do not meet edit standards. Clients have also asked us to do rebilling projects that involve going back into hospital data to find cases that were not billed.

 This is not uncommon and many large organizations are not aware that both on the hospital side and professional fee billing there are procedures that were never billed. Hospital Billing Resource Reclamation or HBRC is our term. Perhaps it is time to take a look at the data and determine whether there is opportunity to reclaim resources for services rendered. HSMN has worked for years comparing Hospital billing data bases of what was billed and comparing it to what should have been billed. Our success rate at finding opportunity has pleased our client base. Recently for an academic medical center we have been able to rebill 8 million net dollars. It is important to note that there are time constraints for rebilling. Perhaps this is the time to find out if there is Hospital billing that should be taking place before filing deadlines have passed.

 HSMN’s hospital consulting is one in which we do not do 35,000 feet flyovers, but rather take the time to understand in depth the opportunity for improvement and the ways in which the hospital client can accept and implement the recommendations of our assessments.

         Let us know how we can help you today.