March, 2007
Vol. 18, No. 3

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DID I HEAR YOU SAY WHAT I THINK YOU SAID?

If any of you have ever attended a PMI seminar, you know that communication is the key?the key to performing your duties assigned, and a key topic in many performance reviews. In this article I will discuss the most important aspect of communicating: LISTENING:

Have you ever been in a conversation with a co-worker, be it your physician or manager or even a co-worker, and walked away wondering what was just said? You are not alone. A lot to times we listen but don't comprehend or we comprehend but don't understand. This could be for several reasons; one being that we zone out?meaning our minds run to other thoughts of the day in progress or re-playing last nights events. Another reason we fail to understand a conversation might be that the person we are trying to listen to just won't get to the point, so therefore we begin to jump ahead with our own thoughts with questions and provide our own answers. Or perhaps the person talking just won't come out and say what he/she is really trying to say, which leaves us scratching our heads and wondering and hoping we are doing correctly what was "talked about".

Listening takes practice and it's an art in itself. Listening is supposed to provide information so that we give can give feedback. When this doesn't happen, we walk away thinking "is it me or him/her". Well, it's both. It takes two to communicate, one talking and one listening.

If you find yourself with these thoughts, stop, drop and roll:

Listening is hard work but with a little practice, you will find that it is the key that unlocks the door to true communication.

What Does the OIG Have In Store For You This Year?

The Office of the Inspector General (OIG) is the entity that watches over government programs for fraud and waste. Each year the OIG puts out a work plan that consists of a list of items they will pay close attention to for that year. Here is a bit of what the OIG will be watching for this year.

Billing services will be closely monitored this year. The OIG wants to pay attention to the relationship between the billing service and the physician and what the impact of that relationship has on the practice. The OIG will also be evaluating the -25 modifier to be sure it is billed correctly by the physicians and paid for correctly by the state carriers. The 'Welcome to Medicare' exam will also be reviewed to be sure all Medicare requirements are met.

Medicare spends a lot of money in some areas of healthcare benefits, in some cases more money than anticipated. The OIG pays close attention to these areas to be sure the services are being reported correctly and are medically necessary. This year the services under the OIG's watchful eye include:

The OIG will also take a good look at the Medicare Advantage plans to be sure the communication is what it should be between the plan and the beneficiary especially where the 'lock in' provision is concerned. Medicare as a Secondary Payer will also be closely scrutinized. The OIG is concerned that Medicare is paying primary when they are actually the secondary insurance. 'Incident to' services, occupational and physicial therapy, along with place of service are just a few of the other issues being monitored by the OIG this year. The monitoring of Evaluation and Management codes was removed from the OIG work plan several years ago but they are very clear to the fact that E/M codes are still being watched very closely. Remember that the physician's documentation must justify the E/M selected. The documentation must also be complete and legible according to the OIG's Compliance Plan Model for Individual and Small Group Physicians published in the October 5, 2000 Federal Register on page 59440.

PMI/Decision Health Networks Debuting Across the Country

Medical office professionals seeking a one-stop resource for networking, certification, advanced training in coding, compliance and management, and access to industry news and publications, can now look to Practice Management Institute® (PMI) and DecisionHealth®.

The award-winning publisher of Part B News, Medicare Compliance Alert, and the Coder's Specialty Pink Sheets recently joined with PMI as its 2007 national sponsor. Together, they are launching a nationwide network dedicated to helping medical office staff advance in their profession with access to specialized training and tools to improve their knowledge. The grassroots network will include professionals from across the country, focused on coding, billing, and other practice management issues. "PMI and DecisionHealth are on track to provide a one-stop coding, reimbursement, compliance and practice management network, which we believe will both inspire and motivate medical office professionals to further excel in their careers," said Doreen Bieryla, President of DecisionHealth. Earlier this year, PMI announced a merger with the CMC Group, LLC®, which grew their product offerings by more than 100 in-house coding, billing and compliance book titles, and brought new life to its consulting division, PMI Resources, LLC. "We've come full circle in our commitment to bring a complete range of services to physicians and their staff," said Douglas O'Dell, CEO of PMI. "Never before has an organization offered this level of support and services focused on helping physicians run a more efficient and compliant practice."

My PMI/DecisionHealth Network Experience

Being a part of the PMI / Decision Health Network has been one of the greatest experiences for me. I currently work for a busy family practice office and I believe it's crucial to know people who work in the same type of practice to be able to share ideas. A couple of years ago I became involved with an office manager's group sponsored by a medical society in my area. It was a wonderful organization, where we were able to network together, share ideas, and listen to guest speakers. At the same time I also became involved with a local chapter of certified coders, whose members shared coding situations, sponsored guest speakers and provided continuing education units. Both organizations provided unique opportunities to network and share ideas, but they operated independently. It was tough trying to attend meetings for both groups as well as keep up with membership fees. My peers and I all seemed to agree: starting a group in our community that would accommodate everyone that is employed in some capacity within the medical practice, would make the most sense. With confirmation of a wide interest in my area, and with the help of the PMI home office, I was able to launch the first ever PMI / Decision Health Network in El Paso, TX.

These meetings are open to everyone, and well attended! It's now the biggest of its kind in our region. There are no membership fees, and an open invitation exists to all regardless of holding a certification or not, and regardless of which organization a credential is obtained. CEUs are earned by attendees and of course, the networking is the best! The guest speakers provide essential information that can be incorporated into member's daily activities. I also invite members to a round table discussion where they can bring their issues, and together we provide solutions. Also, we welcome students from various colleges in our area to attend our meetings. This gives them an opportunity to meet people in the medical field who can mentor them. Getting students involved is important.

Networking has been a key component in my overall professional success, plus it has opened many doors for me. I want members to feel the true PMI Network experience. It's a great one! I'm writing this to thank you for allowing us the opportunity to make this new networking opportunity possible. It's 80 members strong as of this writing, and is the best networking group in this area!

If you are interested in starting a PMI/Decision Health Network in your area, please contact Michael Moore, Director of Outreach and Business Development at 1-800-259-5562, ext. 270.

National Conference for Medical Office Professionals

This year's conference will serve up 24 topics with three customizable learning tracks to choose from. Network with your peers and earn all 12 of the required PMI CEUs for certification renewal in one two-day event.

This year's featured guest presenters were selected based on their detailed knowledge of some of the hottest topics plaguing the industry right now. Annette Grady, Greg Milliger, Robert Liles, Stan Luke and PMI Faculty will be on hand to address your questions and provide real-world examples you can implement in your practice.

Improve your communication and leadership skills. Improve the practice's revenue stream by adding ancillary services to the service mix. Improve collections while reducing denials. Advance your understanding of E&M services. Learn to accurately audit your medical charts. Take away these skills and many more at this year's conference.

Enjoy the charm and culture of San Antonio while staying at the AAA 4-diamond Crowne Plaza Hotel. The Crowne Plaza combines luxurious comfort with all the amenities of today's business hotels. It is located a mile or less from most of downtown San Antonio's famous spots such as the Alamo, the Tower of the Americas, El Mercado Marketplace, Rivercenter Mall, and many other attractions.

This year's conference has limited space and registrations are already underway. If you would like further information on sessions, faculty, pricing and availability, please visit our Conference Page. There is a downloadable/printer-friendly brochure on the site, or call 800-259-5562 to have a color brochure mailed to you.