1

HFMA

Healthcare Financial

Management Association

Lone Star Express

The Lone Star Chapter

News Magazine

October 2014,

Volume 16, Issue 1

2

President’s Corner Greetings to everyone,

The 2015 HFMA year is well underway and I am honored to be your president and very excited about what the coming year

will bring.

Before we close the books on 2014, I want to take a moment to thank our outgoing President, Bill Galinsky for his leadership

and support. Bill has been a fixture (and yes, that’s a good thing) with Lone Star for many years and in various roles. The

2014 HFMA theme “Whatever it Takes” is so Bill. He kept our committees motivated and moving, served as a speaker for

us and traveled all over the Chapter to personally share his belief in the value of our organization. I was very fortunate to have

Bill as a mentor these past years. Bill, thank you for your dedication to HFMA and for setting the standard for all who follow.

Moving on to 2015….I had the opportunity to attend this year’s ANI in Las Vegas. The education, networking and venue

were outstanding and I learned something new outside of the world of healthcare finance. Have you even seen “rave festival”

attendees before? I had not and I learned I probably don’t belong at a rave festival (yes, I am old). Lest you worry, I should

make it clear that the rave festival was not on the curriculum but instead simply a hazard of a convention-rich destination.

Getting back to HFMA, one of the many excellent speakers at ANI was Dr. Atul Gawande, the author of The Checklist Mani-

festo. Gawande’s presentation reminded me that while change is rarely easy, committed and passionate leaders can accom-

plish much. During our careers, we have seen healthcare evolve, but the near future presents a challenge to us not yet seen in

our industry. I believe we must embrace the idea that the right care, at the right time, in the right place is the right thing to do.

As leaders, we have the talent and the obligation to successfully guide our organizations and communities into this new era of

healthcare. It is fitting that the 2015 HFMA theme is “Leading the Change.” It won’t be easy. We will need to work together

and the place to Start is HFMA and the Lone Star Chapter.

Start Here! – for networking. Attend one of our social events, educational meetings or join a committee. If you have a little

time or a lot, if you are just getting started or a veteran in our industry, there is an opportunity for you.

Start Here! – for knowledge. The Lone Star Chapter provides live education, webinars and publications to bring you the latest

ideas and information in the industry. Our monthly webinars are free to members and are a great way to pick up some CPE.

We have some great opportunities for you to Start with Lone Star. Find out more at www.lonestarhfma.org.

I look forward to seeing you in 2015.

Elizabeth Pulliam

Elizabeth Pulliam

3

President’s Corner Fellow members of the Lone Star chapter,

As we go through the annual hfma tradition of leadership change, every level of our organization is affected. Our new

national leader, Kari Cornicelli, has chosen as her theme “Leading the Change”. This theme is very fitting for the issues

facing our industry in a very fast-paced period of change. At ANI we repeatedly heard the charge that we in finance

need to lead the change.

Our immediate past national chair, Steve Rose, had as his theme “Whatever It Takes”. Steve’s theme was centered on

doing whatever is necessary to prepare our organizations for the coming challenges whether they be from Obamacare,

Medicare, Medicaid (expanding or not), health insurance exchanges, meaningful use, or preparing to “Lead the Change”.

Our own chapter leadership change has occurred, and our new president, Elizabeth Pulliam, comes prepared to “Lead the

Change”. Elizabeth has some great things coming, and the Red River Showdown Conference took place recently on

September 25th and 26th. We had a great turnout, great speakers, and a lot of spirit from both the Oklahoma and Lone

Star chapters.

Elizabeth mentions in her letter a rave party at ANI in Las Vegas. If you have a chance, ask her for a few more details

about that; you may learn something about our president that you didn’t know before! Or even better, ask her about the

cage.

Over the course of these letters, I’ve incorporated song lyrics that seem to support what I’m trying to say. In October,

for the launch of our electronic version of the Lone Star Express there was REO Speedwagon with…

“…So if you’re tired of the same old story

Oh, turn some (virtual) pages

I’ll be here when you are ready

To roll with the changes…”

This was followed in February with lyrics from Scar in the Lion King talking about being prepared, just as we need to be prepared…

”So prepare for a chance of a lifetime,

Be prepared for sensational news…”

So, in closing, we’ll end this lyrical adventure with an old favorite from Fleetwood Mac that is admittedly over-used,

particularly in election season, but the message is appropriate as we prepare to lead the change…

“…Don't stop thinking about tomorrow

Don't stop, it'll soon be here

It'll be, better than before,

Yesterday's gone, yesterday's gone…”

Bill Galinsky

4

HFMA Lone Star

Express Healthcare Financial

Management Association

FEATURES

DEPARTMENTS

LETTER FROM THE EDITOR

Natalie

Erchinger,

Newsletter

Chair

We are always looking for articles, pictures, and content for every issue. Please feel free to contact me or any of our committee members.

Natalie Erchinger, Chair Sherry Witzman, Co-Chair nerchinger@sw.org switzman@bkd.com

Jonathan Leazenby jleazenby@sw.org

MEMBERSHIP METER

2014-2015

Goal: 1,234

1,100

950

800

650

500

350

200

Membership Benefits Publications and Resources * Hfm Magazine

* HFMA Weekly News

* Buyer’s Resource Guide * Industry Incentives

* Premium Web Content

* HFMA Forums * Local Chapter Membership

Education and Professional

Development * Events

* Webinars

* Professional Designations * Career Development

Resources

997

Members Strong

The publications Committee reserves the right to accept or refuse contributions whether

solicited or not. All correspondence is assumed to be released for publication unless

otherwise indicated. All article submissions are requested to be types and provided in elec-

tronic format, if possible. Send all correspondence to Natalie Erchinger, Scott & White

Hospital, nerchinger@sw.org

IDENTIFICATION STATEMENT

The Lone Star Chapter “The Lone Star Express” is published quarterly by the Lone Star

Chapter of Healthcare Financial Management Association

EDITORIAL POLICY

Opinions expressed in articles or features are those of the author(s) and do not reflect the

view of the Lone Star Chapter, Gulf Coast Chapter, or South Texas Chapter of the

Healthcare Financial Management Association, or the Publications Committee. Questions

regarding articles or features should be addressed to the author(s). The Healthcare

Financial Management Association and Publications Committee assume no responsibility

for the accuracy or content of any articles or features published in the newsmagazine. The

Publications Committee reserves the right to accept or refuse contributions whether

solicited or not. All correspondence is assumed to be a release for publication unless

indicated. All article submissions are requested to be typed and provided in electronic

format, if possible.

REPRINT POLICY

The Lone Star Chapter, Gulf Coast Chapter, or South Texas Chapter of HFMA will not

reprint articles published in the “Texas Voice” newsmagazine. Individuals wishing to obtain

reprint authorization must obtain it directly from the author(s) of the article. The reprint

may not imply endorsement from HFMA, directly or indirectly.

President’s Corner—Elizabeth Pulliam……………….….....2

President’s Corner—Bill Galinsky…………………..….…...3

Membership Satisfaction………………………………...…...5

Lone Star Chapter New Members……………………….…10

Chapter Chatter…...…………………………………….…...17

Current Events………………………………………….……18

Sponsors…...………………………………………………….21

CMS Offers Solution to Help Hospitals Reduce Administra-

tive Costs of Appeals Program

By: Paula Archer……………………………………………...6

Member Spotlight—Kitty Mann……………………………..8

Time Studies: Current View

By: Jeff Kinnear………………………………………………9

Meaningful Use Final Rule in Picture

By: Michelle Holmes……………………………………...….14

5

What Have You Done for Me Lately: Encouraging Member Satisfaction Survey Participation

Dear HFMA Member,

On behalf of the Board of your Lone Star TX Chapter I would like

to thank you for your membership and support!

Lone Star TX HFMA, along with National HFMA, continually strives to

bring value to our members through our education and networking oppor-

tunities.

Each year National HFMA conducts a member satisfaction survey on be-

half of each Chapter. Information obtained from the survey is used

throughout the year to improve in areas with low scores and to ensure that

we do not change in areas where our members are most satisfied.

The 2014-2015 survey will be sent out to you via email on or around

October 21st. Please be on the lookout for your survey and PLEASE take

a moment to complete it. We encourage you to provide honest and candid

feedback and commit that we will use the information to improve your

HFMA experience and maximize your membership dollars.

Thanks in advance—we look forward to hearing from you!

Sincerely,

Elizabeth Pulliam

President, HFMA Lone Star Chapter

6

CMS Offers Solution to Help Hospitals Reduce Administrative Costs

of Appeals Program

On August 29, 2014, the Centers for

Medicare & Medicaid Services (CMS)

issued an administrative agreement to

hospitals “willing to withdraw their

pending appeals in exchange for time-

ly partial payment” of 68 percent of

the net inpatient allowable amount.

The agreement pertains to acute care

hospitals paid via the Inpatient Pro-

spective Payment System, Periodic

Interim Payment or Maryland waiver

and critical access hospitals. This

agreement excludes psychiatric, inpa-

tient rehabilitation, long-term care,

cancer and children’s hospitals.

CMS stated in its National Provider

Call (NPC) on Tuesday, September 9,

2014, this is an “all or nothing” agree-

ment. The agreement includes all cur-

rently pending appeals of claims with

dates of admission prior to October 1,

2013, that were denied by the Medi-

care contractors based on the determi-

nation that while services may have

been reasonable and necessary, treat-

ment on an inpatient basis was not

medically necessary. These are consid-

ered “eligible” claims. Note: Eligible

claims do not include those denied

based on the implementation of Rule

1599, the new “Two-Midnight Rule.”

While this solution will reduce the ad-

ministrative costs to the Medicare pro-

gram, it will create burdensome tasks

for hospitals due to the tight time

frame of submitting requests by Octo-

ber 31, 2014; CMS says providers may

request an extension if they can’t meet

the deadline.

To request an agreement, CMS re-

quires hospitals to:

Print, sign and scan a PDF of the

administrative agreements

Follow the directions to complete

the “Eligible Claim Spreadsheet,” one

per provider number

claims basis. The lump-sum payment

will be preceded by an email from

CMS containing a PDF file listing all

claims included in that payment. The

provider will not be able to collect any

deductibles or co-insurance. However,

if this reimbursement already has been

collected, the provider will not have to

refund the patient(s). The provider is

able to continue collecting payments

from patients that were on a previous

prepayment plan.

In addition, the frequently asked ques-

tions (FAQ) states the claim status will

remain as denied. Neither individual

claims nor related cost reports will be

adjusted for any reason; this includes

DSH payment, indirect medical educa-

tion (IME) payments, graduate medi-

cal education (GME) payments and

any other payments made on the cost

report. CMS says the settlement will

have no impact on the Medicare cost

report. However, hospitals will not

rebill these claims under the settle-

ment; the charges will never hit the

Provider Statistical and Reimburse-

ment Report. This could significantly

affect those providers who are close to

thresholds in DSH, large urban facili-

ties with teaching programs and IME/

GME payments, Medicare dependent

hospitals, sole community hospitals

and critical access hospitals.

During the NPC, CMS was not able to

answer any secondary payor questions,

saying this information will be availa-

ble on the CMS website’s FAQ page

in the near future. As of the publica-

tion of this article, secondary payor

information was not included in the

FAQ list. Also during the call, one

provider disputed the fairness of in-

cluding surgical claims on the inpa-

tient-only list.

In addition, CMS said the 68 percent

calculation would include add-ons for

indirect medical education and dispro-

portionate share payments and would

Send an email to MedicareAp-

pealsSettlement@cms.hhs.gov con-

taining the agreement information and

a single Excel spreadsheet of eligible

claims

The administrative agreement and in-

structions to complete the spreadsheet

can be found at the CMS website

Once a request has been received,

CMS will conduct a three-step approv-

al process:

1. CMS will validate the hospital’s

information, including discrepancies

from the eligible claims list. If the in-

formation is identical to CMS’ claims

information, payment will be provided

and the affected appeals will be settled

and dismissed. If discrepancies are

identified, the initial agreed-upon

claims by both CMS and the hospital

will be paid and settled. Where there is

disagreement, appeals will continue to

be suspended.

2. Hospitals may review the discrep-

ancies and submit a revised spread-

sheet and agreement to CMS within

two weeks of receipt. Step No. 1 will

be repeated.

3. If errors are identified by the Ad-

ministrative Law Judge or Depart-

mental Appeals Board in the agreed-

upon settlements, CMS will be in-

structed to initiate action to recover the

payment for ineligible claims in agree-

ment. CMS says it also will “pay pro-

viders the settlement amount for

claims pending appeal that were inad-

vertently omitted from the agreement.”

According to the NPC, if the provider

claims information list matches CMS’

claims information, CMS will send the

provider a final payment amount. The

provider then can confirm to either

“proceed or abandon the process.”

Once the agreement is signed by both

parties, payment will be made by the

Medicare Administrative Contractor

(MAC) within 60 days in one lump

sum, rather than on an individual

7

be net of any prior payments made by Medicare on the

claim.

While the settlement agreement clearly defines time

frames for providers to submit the initial settlement re-

quest and review and submit the Round 2 settlement re-

quest, CMS is not bound to any deadline other than issu-

ing payment 60 days from the date of the signed agree-

ment. The agreement won’t be considered “signed” until

both parties have done so. Based on an estimated timeline

CMS published in the September 9, 2014, FAQ update,

hospitals could reasonably expect final payment in ap-

proximately 100 days following the date they submit the

settlement request. However, numerous issues on the

CMS side of the process could slow final payment.

It is recommended that hospitals:

Submit questions to CMS at MedicareSettle-

mentFAQs@cms.hhs.gov

Carefully assess all appealed medical claims for

strength of appeal.

CMS Offers Solution to Help Hospitals Reduce Administrative Costs

of Appeals Program

Previously a System Director of Utilization Review and Revenue Integrity, Paula has approximately 25 years of experience in coding and billing for

both hospital and physician services. She assists hospital and physician

practice clients in increasing their net revenues through improved docu-mentation, operational, charge capture and revenue integrity practices.

Paula assists clients with denial prevention efforts by the national Recovery

Audit program by assessing physician documentation and utilization review

processes.

She provides education to both clinical and physician staff on current and

changing regulatory guidance and revenue cycle topics. Paula is a member and presenter for regional meetings of the Healthcare Financial Manage-

ment Association (HFMA) and American Health Information Management

Association (AHIMA). She previously served as a director on the board of

the Arkansas Chapter of HFMA. Paula is a Registered Health Information

Administrator (RHIA).

Paula is a graduate of Arkansas Tech University, Russellville, with a B.S.

degree in health information management.

Paula Archer, RHIA Director

Carefully assess all surgical claims in which the pro-

cedure was on the inpatient-only list. For inpatient-only

procedures with local coverage determinations, such as

knee and hip replacements, carefully assess whether

medical necessity to perform the procedures is well-

documented such as failed conservative measures, e.g.,

steroids, physical therapy or analgesics.

Evaluate the financial effects of receiving partial

payment in light of the hospital’s strength of appeal,

payor mix and cash flow.

If you have additional questions regarding the provisions

of the agreement and how they could affect your organi-

zation, contact your BKD advisor.

------

This information was written by qualified, experienced BKD professionals, but

applying specific information to your situation requires careful consideration

of facts and circumstances. Consult your BKD advisor before acting on any matter covered here.

Article reprinted with permission from BKD, LLP, bkd.com. All rights re-

served.

8

HFMA Lone Star Chapter wants to congratulate Kitty Mann on

receipt of the Chapter Life Membership award in August.

Kitty received this award on August 21. She has been deeply in-

volved in HFMA throughout her career, and many of those in cur-

rent leadership positions were inspired to serve as a result of her

leadership. Kitty has served in all of the leadership positions within

the chapter, has been involved in the HFMA-UK exchange program,

and was a Chapter Liason (predecessor to the RE). Kitty was also

one of the founding members of the Region 9 planning committee

that provides guidance to the Region 9 Annual Conference which

will have its 12th event November 14. Kitty retired from Baylor

Health Care System (now Baylor Scott & White Health) in 2013 as

VP, Corporate Finance after a career that spanned more than 40

years. Through her leadership and involvement in HFMA, Kitty has

earned all of the Merit awards.

From left to right: Phillip McCollough, William Galinsky, Kitty Mann, and Frank Anderson

We congratulate Mary K. Mann who was approved as Chapter Life Members by their chapter lead-

ership, the Regional Executive Council, and the HFMA Board of Directors at their June meeting.

We thank her for her years of service to HFMA.

MEMBER SPOTLIGHT - KITTY MANN

Receives Chapter Life Membership

9

Time Studies: Current View Institutions are all too aware of the multi-

tude of interruptions that can accompany

completing even the most fundamental of

administrative tasks. Couple this with the

ever-increasing CMS standards, resources

are at all-time premium. As a result, insti-

tutions often, to their financial detriment,

overlook alternative revenue sources. One

possible source is the implementation of a

time study process.

When discussing the importance of a time

study with senior management, responses

can be generally consolidated into two

themes: “time studies are simply too cum-

bersome,” and “all the provider’s need is

one more piece of paper to complete.” As

will be discussed, the digital age has ush-

ered in many innovations that both en-

hance the provider’s experience as well as

alleviate to a degree the “paper” associated

with the traditional time study model.

Why A Time Study

Our experiences show that not all institu-

tions utilize a time study process or

(perhaps worse) have implemented a pro-

cess that does not conform to CMS stand-

ards. As such, significant effort has been

expended with no measurable results. Con-

versely, in those instances where the insti-

tution has employed a CMS approved time

study, these institutions are realizing, on

average, that 15-20% of their physicians’

salary expenses are allowable administra-

tive costs. More to the point, categories

such as allowable Part A activities and

department administration activities (such

as meetings, quality control, and interde-

partmental liaisons) are properly being

recorded and integrated into the report by

the time study administrators. This in turn

creates the necessary foundation to justify

the Part A time inclusion in their Medicare

Cost Report.

Allowable Categories

Currently, there are two major categories

of time studies used to allocate cost back

into the cost report. First, physicians and

approved advanced practice professionals

(including physician assistants, nurse prac-

titioners, certified nurse midwives and

CRNAs) may participate in time study to

CMS standards, significant resources are

usually expended with zero reimbursement

impact.

(2) Digital Methodology. In keeping with

current trends, significant development has

occurred to enhance the time study pro-

cess. These digital tools, if developed cor-

rectly, are designed to offer a user-friendly

experience, minimize impact on partici-

pants and administrative staff alike, and

ensure uniformity across the participant

universe.

Further and perhaps most important; a well

-designed digital medium should not only

enhance the overall experience but also

meet or exceed the documentation require-

ments necessary for Medicare reimburse-

ment.

Bottom Line

Medicare reimbursement is a critical part

of a hospital’s overall budget strategy.

When coupling the Federal budget cuts

with ever-increasing regulatory require-

ments, premium should be placed on any

and all additional revenue sources. While

estimates on the potential reimbursement

impact resulting from a time study varies,

our efforts have resulted in a 15-20% in-

crease in allowable Part A time for our

clients.

The bottom line is this. If you are not cur-

rently employing a time study in your in-

stitution or your current efforts are not

achieving the desired outcome, we strong-

ly encourage you to reexamine your pro-

cesses and if necessary, seek outside ex-

pertise.

Jeff Kinnear, Consultant

Jeff is a consultant in CampbellWilson’s time study services

department; he assists hospitals in implementing Cam-

pellWilson’s unique time study experience by interacting

face to face with the participants, training them on how to

best utilize the exclusive software that is offered to clients.

He also acts as the time study administrator for several

institutions, allowing him a more in depth understanding of

the nuances involved in the time study process.

For more information about CambellWilson’s Time Study services and how you can implement it at your hospital, contact Jeff Kinnear at jeff.kinnear@campbellwilson.com or 214-373-7077

document administrative and patient care

cost. Secondly, physicians and staff that

are involved in an organ transplant pro-

gram can complete a modified time study

that further divide their activities into pre

and post- transplant. The pre-transplant

time may be allocated into the reimbursa-

ble organ acquisition cost.

Basic Tenets

CMS regulations mandate that execution

of a time study adhere to a few basic prin-

ciples:

(A) The time study must be conducted for

at least 14 consecutive days per quar-

ter. The time study cannot occur in the

same part of a quarter as any other

quarter of the year (i.e. if you use the

last two weeks of the first month of

the quarter, you cannot use the last

two weeks of the first month in any

other quarter). Recording of the daily

activities can take one of two forms:

manual or digital.

(B) At the conclusion of each time study,

all participants are required to provide

a certified recordation of their time for

the 14-day period. This certification is

necessary for inclusion in the report.

In addition to the provider requirements,

administrators are charged with the re-

sponsibility of reviewing the data to ensure

compliance with CMS standards.

Current Environment

As mentioned, there are two methodolo-

gies for capturing the necessary documen-

tation.

(1) Traditional Paper Methodology. As the

term implies, provider’s capture their daily

activities utilizing some form of paper

template. This process is often cumber-

some and at times confusing for the partic-

ipants. While CMS has outlined the infor-

mation to be captured, they have not pro-

vided a uniform template, thus providers

are left to their own resources to create a

template. In some instances the templates

will meet the CMS documentation require-

ments, however, this is not always the

case. If the documentation does not meet

10

NEW MEMBERS as of 01/01/2014 Mark Miller

Chief Finance Officer

Lhp Hospital Group, Inc.

Eunice Moore

Managing Consultant

Pharmacy Healthcare Solutions

Mary Alexander

Director of Supply Chain

Financial Resource Group

Kade Rutherford

Executive Director Revenue Cycle

JPS Health

Briana Torres

Client Representative

IBM

Heather Schneider

Market Assistant Chief Financial Officer

Sierra Providence Health Network—Tenet

Healthcare

Melissa Bailey

BSA Health System

Terry Orr

Principal

Ryan

Jan Kenoyer

Vice President, Sales

CareFusion

Ralph Pettingell

Network Executive

BlueCross BlueShield of Texas

Ben Glisan

Chief Finance Officer

Legacy Community Health Services

Jeffrey Siegel

Financial Analyst

Tenet

Hunter Foreman

Deloitte

Dustin Anthamatten

Sharon Clark

VP Finance

Covenant Health

Shawna Shacklett

Regional Director of Financial Services

East Texas Medical Center

George Terrazas

Texas Care Alliance

Andrea Overman

Director, Marketing

Availity, LLC

Hunter Hawkns

Senior Financial Analyst

Children’s Medical Center

Matthew Borne

Reg. VP of Sales

NCO Group

Emiel Hill

Vice President

Bank of Texas

Leandra McHellon

Financial Analyst III

Baylor Scott & White Healthcare

Judith Gulihur

Chief Financial Officer

McCamey County Hospital District

Michelle Kundrat

President

Healthcare Operations Team

Sharon Hunt

Texas Tech University Health Sciences

Center

Ruth Harmon

Chief Finance Officer

Golden Living

Scott Wauhob

Vendor Cost and Control Manager

Conifer Health Solutions

Jennifer Cox

Senior Accountant

Coon Memorial Hospital

Chris Delaney

Director of Revenue Analysis

Lake Pointe Health Network

Alexandra Froebe

MD Buyline

Kyle Hemminger

Vice President

Lancaster Pollard

Aaron Stewart

Director of Finance

LHP Hospital Group

Will Kappauf

Regional Director

Recondo

Amy O’Meara

Sr. Internal Auditor

UMC Health System

Dev Batra

Interventional Radiologist

Robert Smith

Revenue Cycle Manager

Tim Morgan

Corporate VP of Finance

Cornerstone Healthcare Group

Cheryl Sharp

Director

MedSynergies

Julie Vordenbaum

Financial Analyst

North Central Surgical Center

Tracy Betts

Chief Financial Officer

Hardemann County Memorial Hospital

David Potenza

VP Healthcare Economics

I-Flow, LLC

Brad Sullivan

Associate

Margin Recovery International, LLC

Kelly Love

Texas Care Alliance

Raigen Padayachee

Assistant Treasurer-Debt

Baylor Scott & White Healthcare

Larisa Sadovsky

Director—Finance & Operations

TTPC, LLC

11

NEW MEMBERS as of 01/01/2014 Justin Mourning

MD Buyline

Matt Kelso

Robert Hamilton

Chief Operating Officer

Med-Trans Corporation

Bridget Triepke

Manager

VMG Health

David Hollis

Assurance Staff

EY

Matthew Hurtado

Consultant

Cymetrix

Todd Nordeen

Vice President

JPMorgan Chase

Ryan Rowe

Senior Decision Support Analyst

Texas Health Resources

Teresa Thomas

Faculty

Ashford University

Joe Bohling

Director (Member/Owner)

Berkeley Research Group, LLC

Jonathan Bailey

Chief Executive Officer

Hansford County Hospital District

Jill Connor

Director of Patient Access

Conifer Health Solutions

Aaron Hood

Director of Product Management

RemitDATA

Matt Wetrich

Co-Founder

Vevanto

Jennifer Hartzler

Sales Executive

RevSpring, Inc.

Brad Fowler

Executive Vice President

Elevate Recoveries

Chris Gauvin

Director, Finance and Corporate Develop-

ment

Conifer Health Solutions

Wyatt Roldan

Senior Associate

BKD LLP

David Dawson

VP Enterprise Client Management

Conifer Health Solutions

Brian Gadek

Director, Operations Implementation

MedSynergies

Monique Lambring

Strategic Account Manager, Oncology

Jazz Pharmaceuticals Inc

Kayla Marsh

Associate

BKD, LLP

Andrea Sartin

Senior Associate

BKD, LLP

Stacie Anderson

Javier Canetti

Manager

Campbell Wilson

Sera Grenier

Senior Manager

BKD, LLP

Megan Christopher

Senior Financial Analyst

UNT Health Science Center

Cynthia Potter

Connsultant

Campbell Wilson

Stephen Callahan

Senior Vice President

Wells Fargo Bank

Stuart Haskin

Sales & Marketing Head

Access Healthcare

Matt Bertucci

Practice Administrator

Baylor Health Care System

Michael Webber

Process Consultant

Protiviti

James Williams

Managing Director

Texas Tech University Health Sciences

Center

Natalie Person

Director, Cash Application

Schumacher Group

Rose Johnson

Managing Director

TTUHSC SOM

Ronald Bradshaw

Director of Finance

Texas Health Resources

Leslie Pierce

VP Revenue Cycle

Methodist Health System

Sarah Roth

Partner

The Riverside Company

David Hernandez

Audit Associate

BKD, LLP

Susan Angvall

Project Manager

Healthcare Reimbursement Services, Inc.

Shannon Compton

CFO/Controller

Hometown Homecare

Stephen Youngs

Regional Vice President

Stericycle Communication Solutions

Jeanette Verrelli

Tax Manager

BKD, LLP

12

NEW MEMBERS as of 01/01/2014 Steve Cambere

VP Sales

Aperia Solutions, Inc.

Larry Crowder

Director of Business Development and

Sales

PSG

Karen Crowder

Director, Client Services

MCAnaalyTXs

Brooke Lynch

Senior Financial Analyst

Christus Physician Group

Kristi Morris

Director of Revenue Integrity

Medical Center Arlington

Holly Golden

Oracle

Mary McCarthy

Executive Director

BBVA

Rob Shaum

Director, Master Black Belt

Conifer Health Solutions

Justine Burns

Lead Contractor Managed Care

Methodist Health System

Danny Casey

National Sales Manager Business Allianc-

es

ProfitStars

Darrick Yezak

Senior Consultant

United Health Group

Murray Sanderson

Decision Support Analyst

Texas Health Resources

Karen Cockrell

Nurse Auditor Billing

Texas Health Resources

Nicholas Marshall

Administrative Resident

Baylor Scott & White Healthcare

Alisa Bertrand

Corporate Recruiting Manager

Senior Care Centers

Sung Hwang

RTKL Associates

John Fabrizio

Executive VP, Sales & Marketing

Maxor National Pharmacy Services Corp

Jim Griffith

EVP & Chief Operating Officer

Phoenix Health Systems

Tina Hairston

VP, Group Product Manager

BBVA Compass

Chit Chan

Financial Systems Support Analyst

Methodist Health System

Jackson Linscott

Director of Accounting

Texas Health Resources

Kelene Hayes

Chief Financial Officer

Dan Karnuta

Chief Finance Officer

Conifer Health Solutions

Brandon Klein

Maxor National Pharmacy Services, LLC

Keith Luker

Director of Ancillary Services

Titus Regional Medical Center

Amie Gratch

North Texas Director of Finance

LifeCare Hospitals of North Texas

Melissa Nichols

Danielle Zimmerman

Senior Manager

BKD, LLP

Lewis New

Senior Director

Conifer Health Solutions

Kristen Small

Nurse Auditor Billing

Texas Health Resources

Wendy Aleman-Gonzales

Senior Accountant

Ricky Arredondo

Healthcare Solutions Architect

CedarCrestone, Inc.

Spencer Naegle

Healthcare Practice Lead

MAC Executive Recruiters

Jace Henderson

Chief Finance Officer

Parkview Hospital

Linda McIntosh

Director Administrative Operations

American Heart Association

Adell Brown

Director of Training and Quality Assur-

ance

HCFS, Inc.

Melissa Brunch

Practice Administrator

Pediatric Associates of Dallas

Prudence Budemer

Director, Clinical Reimbursement

CHRISTUS Health

Antonio Vargas

Financial Analyst

Ryan Eskridge

Credit Management, LP

J.Weldon

Manager

CliftonLarsonAllen

Jason Dean

UnitedRegional

Kathy Burns

Sr. Financial Consultant

Baylor Scott & White Healthcare

David Brown

Applications Analyst–Revenue Cycle

LHP Hospital Group

13

NEW MEMBERS as of 01/01/2014 Stacey Stone

Vice President, Treasury Relationship

Manager

MUFG/BTMU/Union Bank

Tammy Stone

Sr. Director, Patient Access Operation

Conifer Health Solutions

Jeffrey Tennant

Revenue Cycle Practice Leader

Dell Services

Melissa Lish

Director of Hospital Accounting

Methodist Health Systems

Eric Blear

RemitDATA

C. Koon

Sr. Consulting Mgr

Htms

Travis Singleton

Senior Vice President

Meritt Hawkins

Kezia Goodwin

Government Programs and Accountability

Representative

HCFS, Inc.

Karen Holden

Financial Analyst

Baylor Scott & White Health

Jen Johnson

CFA, Partner

VMG Health

Sarah Chambless

Consultant

Protiviti

Amanda Andis

Director Collections & Reimbursement

Texas Health Partners

Myron Albert

Accounting Manager

Lhp Hospital Group, Inc.

Jill Ligon

Chief Finance Officer

Integrative Emergency Services

Sean Shahkarami

Analyst

J. Taylor & Associates

Gisele McGuire

Director Operations—Billing Support

Texas Health Partners

Christopher Lloyd

Financial Analyst

Baylor Medical System

Karen Cruz

Controller/Exec Director Financial Report-

ing

UNT Health

Leslie Heatherington

Director, Sales Operations

VHA Inc.

Sandeep Misra

Vitreos Health

Laura Hale

Senior Director, Client Management

Carolgyn Rubin

Senior Director Revenue Cycle Innova-

tions

Anthelio

Katrina Lazare

Business Office Director

East Texas Medical Center EMS

Melanie Boyd

Wise Regional Health System

Will Scott

Account Executive

Centrak, Inc.

Carolyn Brown

Manager, Logistics/Cost Optimization

Cardinal Health

Lynn Giddens-Branscum

Director, Revenue Cycle

Wise Regional Health System

Neal Brennen

Process Manager Black Belt

Conifer Health Solutions

Rob Powers

Enterprise Executive

Availity, LLC

Jody Hodges

SVP, Healthcare Banking Manager

Bank of Texas

Joseph Osborne

Commercial Banking Officer

Comerica Bank

Andii LwJeune

Corporate Accounting Manager

Christus Health

Kimberly Brown

Senior Accountant

Trey Malone

Decision Support Analyst

BSA Health System

Judy Meitler

Administrator

El Paso Heart Center

Cheryll Myrick

Availity

Gary Bull

Accountant

BRMC—Community Health Systems

Michael McLaurin

Controller//Accounting Manager

Texas Health Partners

Amy Hill

Revenue Cycle Coordinator

Val Verde Regional Medical Center

Mallory Dauenhauer

Client Service Coordinator

Healthcare Payment Specialists

Cameron Hess

Director Client Services

Healthcare Payment Specialists

Kelly Nelson

Senior Consultant

MedAssets

Lola Ham

Senior Director, Revenue Cycle Services

Usmd

14

Meaningful Use Final Rule in Pictures

CMS and the Office of the National Coordinator (ONC) recently announced modi-

fications to the meaningful use attestation requirements for 2014. Following sig-

nificant lobbying from EHR vendors, eligible professionals (EPs), and hospitals,

CMS issued a brief reprieve to meeting Stage 2 meaningful use in 2014 – for some

lucky participants. Recognizing that EPs and hospitals may still be using 2011 cer-

tified EHR technology (CEHRT) or a mixture of 2011 and 2014 CEHRT, CMS

created a chart of decision points meant to enable flexibility for EPs and hospitals

alike. These options also accommodate EPs and hospitals that have upgraded to

the 2014 CEHRT but are still unable to meet the Stage 2 requirements within the

mandatory timetables.

However, this flexibility comes with a caveat: EPs and hospitals must explain that

their failure to meet Stage 2 in 2014 as scheduled is because they could not “fully

implement 2014 Edition CEHRT for the EHR reporting period in 2014 due to de-

lays in 2014 Edition CEHRT availability.” So who is allowed to claim this excep-

tion? Though CMS does not provide an exhaustive list of examples, its published

comments in the final rule provide some insights and helpful explanations.

Below is a map of decision points and examples of acceptable and unacceptable

justifications for not meeting an EP’s scheduled meaningful use stage in 2014,

whether it be the 2014 Stage 1 or Stage 2 objectives and measures. Any EPs or

hospitals that attest for a different stage than what they were scheduled for must be

prepared to defend this decision in an audit, understanding that each case will be

evaluated individually; this defense should therefore be very well documented.

Michelle Holmes

Michelle is a leading industry expert on the application of IT strategies in physician practices

and ambulatory care settings. As a leader of ECG’s Healthcare IT practice, she directs the

development of IT plans and other key services. Michelle’s deep background with imple-

mentation and management allows her to craft strategies that prioritize actions with the

greatest short- and long-term impact on patients, staff, physicians, and leadership, rather than

tasks that may be the quickest and easiest. She is known for leading focused engagements

that create value for her clients, apply innovation to complex tasks, and ensure clarity at the

task level so that action plans are successfully executed. With expertise in many major IT

platforms, including NextGen, eClinicalWorks, Epic, and MEDITECH, Michelle frequently

shares her insights in articles and educational presentations for national audiences.

Healthcare executives, IT vendors, professional associations, and industry publications, such

as The Wall Street Journal’s MarketWatch, rely upon her insights for using IT to enhance

and streamline patient care delivery and ensure that IT investments deliver their expected

returns and benefits. Michelle has master’s degrees in business administration and health

services administration from the University of Washington, a bachelor of arts degree in

health services administration from Eastern Washington University, and a bachelor of sci-

ence degree in business management from The University of Utah.

15

Meaningful Use Final Rule in Pictures

16

Meaningful Use Final Rule in Pictures

17

Above: Bill Galinsky accepting Chap-

ter awards at ANI from the outgoing

and incoming Chairman’s Steven Rose

and Kari Cornicelli.

Left: 2014-2015 Board Members in

MAD CAT III

Above: Elizabeth and Jonathan leading

MAD CAT III

Left: Elizabeth and Jonathan attend the

Presidents Fall Meeting in Chicago.

18

Announcing the 2014

HFMA Region 9 Annual Conference

November 16-18, 2014 Sheraton Hotel | 500 Canal St. | New Orleans, Louisiana

20.5 CPE Credits Available

HFMA Region 9 Website

Register Online

Sheraton Hotel Information

Topics Include: Louisiana, Texas & Federal Medicaid Updates

Medicare & Uncompensated Update Documenting to Support Billable Services

Co-Management The Financial Side of Patient Engagement Transparency Industry Impact on Providers Healthcare Policy and Technology Overview

The Economics of Healthcare The Virtual Central Business Office

Best Practices in Revenue Preservation & Documentation Integrity The Impact of Information Exchange & Data Analytics on Patient Care

The Arkansas Private Market Option - State Medicaid Innovation Exploring an Integrated CDI Program

Beyond Budgeting: Why Some Are Going All-In on Rolling Forecasts Novitas Update

Evidence Based Medicine and Financial Symbiosis Fraud Prevention Strategies for Health Care

Accounting & Audit Update 340b Audits ...and more!

19

HFMA Lone Star Chapter HealthCare Executive Happy Hour

Flying Saucer

Thursday, October 2, 2014

5:30 PM-7:30 PM

Come network with fellow Lone Star Chapter Members while enjoying a

few laughs and a few drinks. Appetizers provided with Alcoholic or Non-Alcoholic Drinks.

14999 Montfort Drive, Addison, TX 75254 http://www.beerknurd.com/stores/addison/

20

Come smell the roses while enhancing your management skills on October 24th; Tyler Texas!

The HFMA Lone Star—TAFHA Conference will help each of us engage in LEADING the

CHANGE. We think that this is the best way to enhance our skills; both individually and with

our teams!

The day will make a difference for you with:

● An update on the State healthcare landscape

● A step-by-step process on how to access and use public data

● Insights on how the 1115 Waiver impacts your work and hospital

● A reimbursement update with tips on compliance and what’s new with CMS

● The latest in the selection process for new hires…..achieving the ‘right hire’

● Best practices and how you impact the supply chain (and how it impacts you.)

When: Friday, October 24, 2014

Where: Rose Garden Center - Camellia Room | 420 Rose Park Drive | Tyler, Texas 75702

Please Mark Your Calendar and Join Us in LEADING the CHANGE by Starting Here!

21

i n teg ra ted h ea l th c a re

liability risk specialistsProAssurance.com

22

LONE STAR SPONSORS

GOLD

SILVER

BRONZE

Avadyne Health

BESLER Consulting

Cirus Group, Inc.

Enable Comp, LLC

HCFS, Inc.

MASH, Inc.

MED A/RX

Parallon Business Solutions

Parrish Shaw

Protiviti

The SSI Group

Triage Consulting Group

Adreima

Availity, LLC

BKD, LLP

Cardon Outreach

Citi-Money2 for Health

Cleverley + Associates

Emdeon

Managed Resources, Inc.

ProAssurance

Resonant

Resource Corporation of America

TransUnion LLC

H O L L A W A Y & G U M B E R T

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