Program Information - the Illinois Chapter of AAHAM

Illinois Chapter
Spring Meeting
Thursday, March 12, 2015
8:00 a.m. to 8:45 a.m.
Registration opens & continental breakfast
8:45 a.m. to 9:00 a.m.
General membership meeting
9:00 a.m. – 10:30 a.m.
Today’s Business Office Model: Streamlined
Staffing and Productivity
Presented by: Lori Zindl, President
OS inc.
With ICD-10 and the many upcoming changes
in healthcare reimbursement, revenue cycle
management has never been more closely
tied to a provider’s financial viability. A weak
RCM strategy today will be nothing short of a
disaster next year at this time. This session will
focus on identifying opportunities to improve
RCM performance and productivity now,
allowing for reallocation of FTE to meet the
ICD-10 challenges head on. Topics will include:
FTE calculators for business office personnel,
productivity standards, performance matrixes
and deciding which investments in technology
are necessary in RCM to achieve long term
success.
SPEAKER BIO: An entrepreneur and industry
leader, Lori Zindl built OS inc. on the principles
of valuing both clients and employees equally. Under her direction, OS inc. has
become a foremost authority in revenue cycle
management for hospitals, clinics and
healthcare institutions. Lori has more than 20
years of experience in the revenue cycle
management field and is a nationally
recognized
speaker,
seminar
leader,
consultant and trainer. She is currently serving
on the Wisconsin Hospital Association ICD-10
task force helping providers manage the
upcoming changes and associated effects.
Lori and her team spearheaded the
development of efficientC®, OS inc.'s state-ofthe-art proprietary claim processing software.
Building on the success of efficientC, strong
client partnerships, a talented staff and proven
business philosophies, OS inc. effectively
manages more than $3 billion in client
receivables.
10:30 a.m. to 10:45 a.m.
Break
10:45 a.m. – 12:00 p.m.
Illinois Medicaid changes to EAPGs and
Medicare changes to APCs for 2015:
Understand the Impact on Your
Organization
Presented by: David Fee, Content
Manager, Applied Research Group
3M Health Information Systems
Payment reform is a major theme for
healthcare. We see clear examples of that in
Illinois with IL Medicaid transitioning to 3M
Enhanced Ambulatory Patient Groupings
(EAPGs) and in the changes Medicare is
making to APCs. This session will provide
background on 3M EAPGs, and how they work
to calculate payment.
The session will describe the methodology used
to build the system, and will also address
bundling and payment, and the impact of
modifiers and the Illinois ambulatory procedure
list (APL).
Attendees will also learn about major changes
to the Medicare Outpatient Prospective
Payment System (OPPS), including the new
comprehensive APCs (C-APCs), the dramatic
increase in packaging of services for Medicare
payment, and impact on processes that need
to be reviewed. The session will also describe
new modifiers introduced by CMS and
changes to medically unlikely edits (MUEs).
SPEAKER BIO: As a content manager with the
Applied Research Group for 3M Health
Information Systems, Dave Fee is responsible
for:
 Understanding agency regulations

Providing industry and internal education
on outpatient payment methodologies,
including Medicare’s OPPS with APCs
and 3M™ Enhanced Ambulatory Patient
Grouping System™ (EAPGs)

Identifying customer needs for product
development

Helping agencies understand and
implement 3M EAPG-based payment
systems

Working with product development to
translate needs to enhancing existing
products and developing new products
Dave works with technical development teams
to create 3M software for ambulatory care
products that assist hospital efforts to generate
compliant and complete claims, and to
validate accuracy of payment for outpatient
claims. These products include APC and 3M
Enhanced APG (EAPG) classification systems,
including related reimbursement and editing
modules. Dave has been involved with
outpatient prospective payment (OPPS) since
Iowa Medicaid implemented Ambulatory
Patient Groups in 1994. He has been a speaker
at national conferences, including AHIMA,
HFMA, and the American College of
Healthcare Executives, and has published
articles on the topics of APCs, outpatient
prospective payment, and related subjects in
a number of industry publications.
He received his M.B.A. from Brigham Young
University in Utah.
12:00 p.m. to 12:45 p.m.
Lunch
12:45 p.m. – 1:15 p.m.
AAHAM Certification Trivia
Presented by: John Currier, CRCE
Revenue Cycle Director
Gibson Area Hospital
SPEAKER BIO: John is the Executive Director of
Revenue Cycle Management for Gibson Area
Hospital & Health Services in Gibson City, IL.
John has been in healthcare management for
25+ years, dealing in Revenue Cycle
Management (for hospital & physicians).
Besides his current duties, John spends a great
deal of time doing presentations on customer
service, motivation and team building
throughout the county. John holds a BS in
Education from IL State University and a MS in
administration from the University of IL at
Springfield. A father of 4 and a grandfather of
9, his number one priority is family. John is
currently the National AAHAM First VicePresident.
1:15 p.m. – 2:30 p.m.
5 Things Government Payors Don’t Want
You to Know
Presented by: Ed Norwood, President
ERN/The National Council of
Reimbursement Advocacy (NCRA)
We are in a war. A war to preserve patient
access to care. A war to advocate for
medically appropriate healthcare for patients.
So if you are having difficulty getting
government claims paid, more than likely you
are fighting with the wrong weapons. As
advocates, we have a right to demand
substantiation of payer action or inaction. In
this powerful half day session, you will learn:
1. How to request internal VA and CMS
prompt payment policies, directives and
Standard Operating Procedures under the
Freedom of Information Act.
2. Federal laws that statutorily deem poststabilization services authorized when VA
and Medicare Advantage Plans (MAO) fail
to respond to authorization request timely.
3. Federal timeframes for VA and MAO
emergency reimbursement and appeals.
4. How to challenge Medicare untimely
payment and date of death errors that
result in improper denials.
5. How to overcome Observation vs Inpatient
Denials AND MORE!
SPEAKER BIO: President of ERN/The National
Council of Reimbursement Advocacy. He has
been recognized as a unique and distinctive
authority in transitional leadership and
administrative laws that govern the healthcare
delivery process.
Few have blazed the trail of success in the
same inimitable style as Ed. With an
entrepreneurial story which is both entertaining
and inspiring, Ed has a seasoned, realistic
perspective that inspires people: “It’s never too
late to become what they might have been”
(Eliot.)
Multi-faceted, with a creative ability to inspire
his audience, Ed combines his healthcare
influence and expertise with his passion to help
providers advocate for medically appropriate
healthcare pursuant to Wickline v. State of
California (1986) 192 Cal. App. 3d 1630 [239
Cal. Rptr. 810.]
2:30 p.m. to 2:45 p.m.
Break
2:45 p.m. – 4:15 p.m.
5 Things Government Payors Don’t Want
You to Know (continued)
Presented by: Ed Norwood, President
ERN/The National Council of
Reimbursement Advocacy (NCRA)
4:15 p.m. to 4:30 p.m.
Q & A and Adjourn
Illinois Chapter
SPRING MEETING
LOCATION INFO
When:
Where:
Hotel Phone #:
Room Cost:
Rooms blocked until:
Wednesday, March 12, 2015
Hawthorn Suites by Wyndham
101 Trade Centre Drive
Champaign, IL 61820
(217) 398-3400
$99.00 + tax (king) or $104.99 + tax (2 double beds)
February 19, 2015
Room Block ID: CG11IL
Meeting Cost:
$50.00 (AAHAM members)
$75.00 (non-members)
Meeting attire:
Business casual
Click to register on-line at www.illinoisaaham.com
Illinois Chapter
SPRING MEETING
REGISTRATION
Please provide us with your registration information:
Name:
Title:
Company Name:
Company Address:
Phone:
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E-mail:
Certified:
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If certified please indicate which:
Are you a member of AAHAM?
Is this your first IL AAHAM meeting?
Did you register on-line?
 CRCE
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 CRCP
 CRCS
 CCT
Membership # _____________
Cancellation policy is 72 hours from date of event for full refund.
Registration deadline is Monday, March 9, 2015. Please send your payment by Monday, March 9,
2015.
Please make checks payable to IL AAHAM and mail your registration form and payment to:
Maria Orwig
26285 Oak Leaf Lane
Canton, IL 61520
e-mail: illinoisaaham@yahoo.com
Illinois Chapter
MEETING AGENDA
Wednesday, March 11, 2015
6:00
p.m.
Board Meeting
Thursday, March 12, 2015
8:00
-
8:45
a.m.
Registration & continental breakfast
8:45
-
9:00
a.m.
General membership meeting
9:00
-
10:30
a.m.
Today’s Business Office Model: Streamlined Staffing & Productivity
presented by Lori Zindl, President, Os inc.
10:30
-
10:45
a.m.
Break
10:45
-
12:00
p.m.
Illinois Medicaid changes to EAPGs and Medicare changes to APCs for 2015:
Understand the Impact on your Organization
presented by David Fee, Content Manager, Applied Research, 3M Health Information Systems
12:00
-
12:45
p.m.
Lunch
12:45
-
1:15
p.m.
AAHAM Certification Trivia
presented by John Currier, Revenue Cycle Director, Gibson Area Hospital
1:15
-
2:30
p.m.
5 Things Government Payors Don’t Want You To Know
presented by Ed Norwood, President, ERN/The National Council of Reimbursement Advocacy
2:30
-
2:45
p.m.
Break
2:45
-
4:15
p.m.
5 Things Government Payors Don’t Want You To Know (continued)
presented by Ed Norwood, President, ERN/The National Council of Reimbursement Advocacy
4:15
-
4:30
p.m.
Q & A – Adjourn