National Conference Set for May 2008 in San Antonio

Three years ago PMI debuted our National Conference for Medical Office Professionals. In this short period, it has grown to the point that for 2008, it must be held at the convention center in downtown San Antonio.

At last year's conference the PMI Advisory Board met for many hours evaluating that conference, and planning for the next. Attendees submitted evaluations and additional meetings were held throughout the past year. In short, you told us what you wanted, and we listened. As a result, the 2008 conference is sure to be something very special indeed.

Here are some quick highlights of what's in store:

• A special pre-conference workshop will allow you to choose advanced level training in chart auditing or practice leadership.
• An expanded lineup of topics, additional general sessions and three learning tracks: coding, reimbursement, and office management.
• Nancy Maguire, a nationally renowned coding lecturer, author and motivating force in the coding industry will give share her insight on the past, present, and future of medical records.
• A new perspective for our coding and reimbursement attendees - Dr. Adam I. Harris will team up with Linda D'Spain to present both the provider and coder approach to chart notes.
  
• Motivational speaker, Jerry Bridge, will present his exclusive approach, developed over two decades, to better customer service and collections.
• Our interactive fraud and abuse compliance panel will feature an Assistant U.S. Attorney, an FBI Special Agent, a leading health care attorney from Washington DC, and a compliance officer specializing in OSHA and Corporate Integrity Agreements.
• Our wrap-up general session will feature open microphones enabling our panel of PMI instructors to address your toughest coding, reimbursement and management questions.
• A bonus toolkit will be provided to all conference attendees containing forms, resources and practice tools to implement in the office.

Plus, we have a lot more in store for you. Our popular networking luncheons will be back this year. Exhibitors will greet you at a special reception and registration held the evening prior to the conference. And, as always, this conference provides all of the CEUs to satisfy annual certification renewal requirements for PMI certified professionals.

The brochure is in the works, and should be mailed to you very soon. Click here to view the 2008 Conference details on our web site now.

This is an industry event you truly do not want to miss! I look forward to seeing many familiar faces and welcoming our first-timers this year in historic San Antonio, Texas.

Sincerely,

Jimmie Hebert, CMC, CMIS, CMOM
2008 Conference Chair

Regulations that Affect Billing Compliance

Stark I & II

Summary: Stark Law prohibits referring a Medicare patient for any health service to an entity which the provider (or an immediate family member) has a financial interest unless an exception applies. The entity that receives a prohibited referral may not bill Medicare for services performed. The original Stark Law (Stark I) was enacted in 1989 and basically referred to clinical laboratory services. In 1993, Congress broadened the Stark law (Stark II) to include referrals of a broad array of health services.

False Claims Act

Summary: The False Claims Act 31 U.S.C. sec. 3729-3733, protects the federal government against fraud and abuse. Under the False Claims Act (FCA), anyone who knowingly submit, or causes another person or entity to submit, or knowingly makes, uses, or causes to be made or used, a false record or statement to get a false or fraudulent claim paid or approval of government funds are liable for three times the government's damages plus civil penalties of $5,500 to $11,000 per false claim.

The term "knowingly" means that a person:

1. has actual knowledge of the information;

2. acts in deliberate ignorance of the truth or falsity of the information; or

3. acts in reckless disregard of the truth or falsity of the information, and no proof of specific intent to defraud is required.

The FCA contains qui tam, or whistleblower, provisions which allow anyone with evidence of fraud to sue on behalf of the government, in order to recover overpayments of federally funded health care programs. The Department of Justice can investigate and decide whether to join the action. If the government elects not to intervene, the qui tam relator may proceed with the action. The whistleblower may be awarded a percentage of the recovered funds.

Anti-Kickback Statute

Summary: The federal anti-kickback law's main purpose is to protect patients and federal health care programs from fraud and abuse. The law states that anyone who knowingly and willfully receives or pays anything of value to influence the referral of federal healthcare business, including Medicare and Medicaid, can be held accountable for a felony.

Interviewing Applicants for Office Staff

In Part 1 of this article, I gave you some tips for pre-screening your job applicants. This month, I'll give you some more detail now that they've made the cut to the face-to-face interview.

Now that you have chosen your candidate for a face to face interview, let's look at some open ended questions:

1) Tell me about yourself - this is when they start talking and talking and talking. Telling you hopefully all the things you cannot ask (i.e., Are you married, how many children do you have, what language do you speak at home? Need I remind you these are considered illegal questions!)

2) What are your strengths/weaknesses? You may be surprised how perfect people are with no weaknesses at all!

3) How can I tell if you are having a bad day? I have gotten some responses - Oh you'll know!

4) Are you willing to be bonded? Or have you ever been convicted of a felony? A person is not guilty of a crime because of an arrest!

5) What additional information about yourself do you want me to know? Oh I don't know, my husband and I have been trying to get pregnant for some time now but we just decided to let nature take its course. Or I am diabetic. This is important to know!

Don't Overlook the Basics

Develop a standardized list of questions in advance and follow a pattern of questions and conversations that will provide the needed information.

You should only ask questions that can be judged to be job related. If there is interest in a candidate, it is suggested that the following guidelines be followed:

• set up a second interview to obtain more information about the candidate
• conduct a brief tour of the facility
introduce the candidate to the other staff members
• thank the candidate for their time
• make final notes on the initial interview

The two most common errors a manager can make in the hiring process are:

a) not taking or allowing enough time for the interview and

b) talking too much about themselves instead of using the interview to learn as much as possible about the candidate.

If out of all your interviews you find the best "fit", act on it immediately. If there is procrastination, be best candidate will take another position with someone else. Having made the decision to hire, set a date for a commitment interview. This meeting will help to eliminate any misunderstandings about the job or expectations. The manager should review personnel and practices policies, general review of working conditions, confirms salary and starting date, and the candidate should also be given the opportunity to ask any questions.

The First Day at Work

An employee first day is always a blur. Do not expect a full day's work in the position on the first day on the job. Go slow, and introduce the employee to ALL other employees. Time should be spent on housekeeping items such as where you keep the extra tissue stored, where's the CLEAN kitchen, location and function of equipment. At the end of the first day it's a good idea to invest some time to meet with the new hire and see if there are any additional questions which might have arisen during the day and ask for an explanation of procedures, if necessary. You do not want any misunderstandings or bad habits, so invest the time the first week. Do not give a new employee too many new tasks during the first few days. This can create unnecessary stress during a learning timeframe. Allow time for the employee to see the whole operation in action so that it is then easier for them to tackle the job with fresh ideas.

Remember, a successful employee receives adequate orientation and training prior to assuming duties. Therefore it's the responsibility of the manager in ensure the new employee is ready to sit and stay a while.

Ione Broussard is a veteran of the healthcare industry with more than 25 years of experience in medical practice management. Her broad spectrum of experience includes business development, purchasing, and governmental guidelines. Prior to joining PMI, she served as a practice management consultant specializing in practice coordination and assessment for healthcare providers. She has comprehensive knowledge of relations, equipment, physical plant, compliance, coding, and governmental regulations.

Meet Audrey Coaxum, CHI, CMC, CMOM

Audrey Coaxum has more than 15 years of health care experience with documented success in planning, training, research analysis, management, sales and marketing. As one of the newest additions to the PMI Faculty team, Audrey is a hands-on specialist who takes pride in her ability to prioritize and multi-task. She has worked as a Houston-based associate instructor and recently came on full time with PMI.

She is a soft-spoken professional with extensive knowledge and experience in medical billing and coding, utilization review and practice management. A Certified Healthcare Instructor, Audrey has trained many healthcare personnel, including physicians on medical documentation and compliance issues relating to the coding, billing and reimbursement for services.

Her passion and area of focus has been compliance and risk management. She has served on Quality Assurance, Medical Management, Risk Management, Network Development, Utilization Review, Health Disparities Collaborative and Compliance Boards.

She has overseen the development and implementation of policy and procedures relating to practice management, risk management and compliance based on federal, state, NCQA, HIPAA and OSHA standards. She also has experience conducting in-services, training programs and assessments on practice management and compliance.

In January, Audrey will be teaching Reimbursement Strategies 2008, Accounts Receivable/Patient Collections, and CPT/E&M/ICD-9-CM Coding classes in Texas, Alabama and Louisiana.