Financial Compliance Check-Up

Financial Compliance Check-Up

 

LUTZ BUSINESS INSIGHTS

 

financial compliance check-up

Now that winter is here, what better way to spend some additional time indoors than doing a winter healthcare financial compliance checkup. In this webinar, we take a step back and look at the overarching financial infrastructure vital to a facility’s long-term success and stability. Reviewing each major section of healthcare finance, we discuss key policies, internal controls, contracts, and other best practices to help organize the financial compliance aspects for healthcare providers.

 

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What is a Family Office?

Modern family offices have been in existence since the late 19th century when John D. Rockefeller decided he needed a professional team to manage his wealth. The complexity of the financial landscape, coupled with…

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OMAHA

13616 California Street, Suite 300

Omaha, NE 68154

P: 402.496.8800

HASTINGS

747 N Burlington Avenue, Suite 401

Hastings, NE 68901

P: 402.462.4154

LINCOLN 

601 P Street, Suite 103

Lincoln, NE 68508

P: 531.500.2000

GRAND ISLAND

3320 James Road, Suite 100

Grand Island, NE 68803

P: 308.382.7850

Revenue Cycle

Revenue Cycle

 

LUTZ BUSINESS INSIGHTS

 

revenue cycle

As Healthcare institutions, we hear a lot of talk surrounding the Revenue Cycle. This presentation, led by Amy Evanich and Claire Thelen, will discuss helpful hints to help ensure your revenue cycle is operating efficiently and effectively.
 
Every employee plays a role in the impact of the revenue cycle, and this webinar is tailored to cover each area. If there are inadequacies or an opportunity for improvement in the revenue cycle process in a certain department, please consider having the direct staff in this area listen in.

 

RECENT POSTS

What is a Family Office?

Modern family offices have been in existence since the late 19th century when John D. Rockefeller decided he needed a professional team to manage his wealth. The complexity of the financial landscape, coupled with…

read more

SIGN UP FOR OUR NEWSLETTERS!

We tap into the vast knowledge and experience within our organization to provide you with monthly content on topics and ideas that drive and challenge your company every day.

Toll-Free: 866.577.0780  |  Privacy Policy

All content © Lutz & Company, PC

OMAHA

13616 California Street, Suite 300

Omaha, NE 68154

P: 402.496.8800

HASTINGS

747 N Burlington Avenue, Suite 401

Hastings, NE 68901

P: 402.462.4154

LINCOLN 

601 P Street, Suite 103

Lincoln, NE 68508

P: 531.500.2000

GRAND ISLAND

3320 James Road, Suite 100

Grand Island, NE 68803

P: 308.382.7850

Medicare Cost Report

Medicare Cost Report

 

LUTZ BUSINESS INSIGHTS

 

medicare cost report

This presentation, led by Kirk Delperdang and Julianne Kipple, discusses helpful tips to keep in mind as hospitals prepare and review their Medicare cost report. Kirk and Julianne specialize in accounting and reimbursement consulting for CAHs. This presentation also covers the cost report preparation process and review topics that can have a significant impact on Medicare reimbursement for the facility.

 

RECENT POSTS

What is a Family Office?

Modern family offices have been in existence since the late 19th century when John D. Rockefeller decided he needed a professional team to manage his wealth. The complexity of the financial landscape, coupled with…

read more

SIGN UP FOR OUR NEWSLETTERS!

We tap into the vast knowledge and experience within our organization to provide you with monthly content on topics and ideas that drive and challenge your company every day.

Toll-Free: 866.577.0780  |  Privacy Policy

All content © Lutz & Company, PC

OMAHA

13616 California Street, Suite 300

Omaha, NE 68154

P: 402.496.8800

HASTINGS

747 N Burlington Avenue, Suite 401

Hastings, NE 68901

P: 402.462.4154

LINCOLN 

601 P Street, Suite 103

Lincoln, NE 68508

P: 531.500.2000

GRAND ISLAND

3320 James Road, Suite 100

Grand Island, NE 68803

P: 308.382.7850

CMS Finalizes Changes to Help Improve Patient Care Including Price Transparency

CMS Finalizes Changes to Help Improve Patient Care Including Price Transparency

 

LUTZ BUSINESS INSIGHTS

 

CMS Finalizes Changes to Help Improve Patient Care Including Price Transparency

PAUL BAUMERT, HEALTHCARE CONSULTING SHAREHOLDER
CATHY BOJANSKI, HEALTHCARE MANAGER

 

Of high interest to many hospitals is the requirement for increased price transparency. Previously, the Centers for Medicare & Medicaid Services (CMS) required the posting of standard charges or policies for the public to view upon request. Effective January 1, 2019, CMS has made the requirements more specific. The updated guidelines now require hospitals to post this information in a machine-readable format on a publicly available domain.

Although keeping information up to date on a hospital website may pose an increased burden for hospitals, CMS reports that the goal is for the focus to return to quality patient care with transparency being one of the measures.

To help comply with the new requirements Lutz is providing the following information:

  • All hospitals are required to comply
  • The published list must include every service and item provided by the hospital based upon the charge description master file in XML, CSV or Excel format
  • Website links to pricing comparison data will not fulfill the requirement
  • Hospital to determine the definition of standard charges, but gross charges in the charge description master file will comply with the requirements
  • Include the item and service description and standard charge, but not the CPT/HCPCs codes, unless receiving permission from the American Medical Association has been received
  • APC or DRG amounts will not satisfy the requirement

These charges should be updated at least annually, or more frequently as needed. Below are recommended disclosures on the hospital website for improved patient understanding of the data presented.

  • The standard charges are not the patient’s financial responsibility
  • Uninsured or underinsured patients may qualify for charity care or financial assistance
  • Physician services may or may not be included in the standard charges

Disclaimer language should be added so that patients understand that charges listed are not necessarily their final bill. Below is an example of basic disclaimer language for your consideration:

“This list of charges reflects the standard charges for inpatient and outpatient services provided at _________ (hospital). The hospital’s charges are the same for all patients, but the patient’s financial responsibility for services provided may vary, depending upon payment plans negotiated with individual health insurers as well as reimbursement schedules set forth by public payers such as Medicare and Medicaid. Patients should contact our staff (list name, email, phone number, etc.) for assistance. These charges do not include items or services that may be billed separately for physician services, lab, diagnostic services, etc.”

In order for both patients and hospitals to fully benefit from the requirements of the rule, it is important that hospitals follow through with keeping chargemasters up-to-date and educating staff on pricing and how to have patient financial responsibility discussions.

 

 

References

CMS Finalizes Changes to Empower Patients and Reduce Administrative Burden. August 2, 2018. Retrieved on November 27, 2018 from https://www.cms.gov/newsroom/press-releases/cms-finalizes-changes-empower-patients-and-reduce-administrative-burden
Frequently asked questions regarding requirements for Hospitals to make public a list of their standard charges via the internet. Retrieved on November 27, 2018 from https://www.cms.gov/Medicare/Medicare-Fee-for-Service-Payment/AcuteInpatientPPS/Downloads/FAQs-Req-Hospital-Public-List-Standard-Charges.pdf

ABOUT THE AUTHOR

Paul Baumert

402.827.2315

pbaumert@lutz.us

LINKEDIN

PAUL BAUMERT + HEALTHCARE CONSULTING SHAREHOLDER 

Paul Baumert is a Consulting Shareholder at Lutz with over 20 years of experience in accounting and consulting for healthcare and nonprofit industries. He specializes in the areas of financial management support services and reimbursement analysis.

AFFILIATIONS AND CREDENTIALS
  • Nebraska Society of Certified Public Accountants, Member
  • American Institute of Certified Public Accountants, Member
  • Healthcare Financial Management Association, Member
  • Certified Public Accountant
  • Fellow of the Healthcare Financial Management Association
EDUCATIONAL BACKGROUND
  • BSBA, Creighton University, Omaha, NE
COMMUNITY SERVICE
  • Elkhorn Public School Foundation, President
  • Iowa Healthcare Financial Management Association, Past President
  • Nebraska Society of Certified Public Accountants Legislation Committee, Chairman

402.827.2366

cbojanski@lutz.us

CATHY BOJANSKI + HEALTHCARE MANAGER

Cathy Bojanski is a Healthcare Manager at Lutz with over 25 years of experience. Her primary responsibilities include preparation and review of Hospital and Clinic Chargemaster (CDM) reviews for healthcare clients, as well as assisting with coding and billing services.

AREAS OF FOCUS
AFFILIATIONS AND CREDENTIALS
  • Association for Rural Health Professional Coding, Member
  • Certified Billing Specialist

SIGN UP FOR OUR NEWSLETTERS!

We tap into the vast knowledge and experience within our organization to provide you with monthly content on topics and ideas that drive and challenge your company every day.

Toll-Free: 866.577.0780  |  Privacy Policy

All content © Lutz & Company, PC

OMAHA

13616 California Street, Suite 300

Omaha, NE 68154

P: 402.496.8800

HASTINGS

747 N Burlington Avenue, Suite 401

Hastings, NE 68901

P: 402.462.4154

LINCOLN 

601 P Street, Suite 103

Lincoln, NE 68508

P: 531.500.2000

GRAND ISLAND

3320 James Road, Suite 100

Grand Island, NE 68803

P: 308.382.7850

Updated Current Procedural Terminology Codes for 2019

Updated Current Procedural Terminology Codes for 2019

 

LUTZ BUSINESS INSIGHTS

 

Updated Current Procedural Terminology Codes for 2019

The Current Procedural Terminology (CPT) code changes for 2019 are here! The American Medical Association (AMA) has announced the release of the 2019 CPT Code Set. The changes include 335 codes in the new CPT edition in an effort to capture the latest scientific trends and advances. The code changes include new remote patient monitoring codes and new internet consultation codes. These New CPT category I codes are effective for reporting as of Jan. 1, 2019.

Below are three tabs that include the new, deleted and revised CPT codes. Please remember to inactivate any 2018 codes that have been deleted. Included with the deleted codes are possible replacement codes for use if applicable.

AMA Releases 2019 CPT Code Set. September 5, 2018. Retrieved November 27, 2018 from https://www.ama-assn.org/ama-releases-2019-cpt-code-set 

RECENT POSTS

What is a Family Office?

Modern family offices have been in existence since the late 19th century when John D. Rockefeller decided he needed a professional team to manage his wealth. The complexity of the financial landscape, coupled with…

read more

SIGN UP FOR OUR NEWSLETTERS!

We tap into the vast knowledge and experience within our organization to provide you with monthly content on topics and ideas that drive and challenge your company every day.

Toll-Free: 866.577.0780  |  Privacy Policy

All content © Lutz & Company, PC

OMAHA

13616 California Street, Suite 300

Omaha, NE 68154

P: 402.496.8800

HASTINGS

747 N Burlington Avenue, Suite 401

Hastings, NE 68901

P: 402.462.4154

LINCOLN 

601 P Street, Suite 103

Lincoln, NE 68508

P: 531.500.2000

GRAND ISLAND

3320 James Road, Suite 100

Grand Island, NE 68803

P: 308.382.7850

Cost Report Corner

Cost Report Corner

 

LUTZ BUSINESS INSIGHTS

 

Cost Report Corner

Certified Registered Nurse Anesthetist (CRNA)

Have you ever heard the saying “The devil is in the details”? Well, in the case of CRNA services provided by a critical access hospital (CAH), you’d be correct.

Annually, CAHs must ensure that they meet the CMS criteria for cost-based reimbursement, submitting the appropriate data to their Medicare Administrative Contractor (MAC) in a timely fashion. This yearly exercise of submitting annualized procedure data to the MAC and attesting to the various CRNA qualification criteria may seem mundane to do every year – and that may be the case. However, if you ever miss a year of filing the appropriate paperwork AND/OR receiving the MAC approval letter, you will never forget this mundane task again. The reimbursement differential of having to bill all CRNA services on a CMS-1500 with fee schedule reimbursement versus UB billing with cost reimbursement for an entire calendar year will sharpen your memory and focus.

Do not procrastinate

When you receive the CRNA letter from your MAC, analyze, complete, review and submit the information in a timely fashion and ensure you receive the approval letter from the MAC. File this letter appropriately in your facility and provide a copy to your cost report preparer, so that you have the documentation should the need arise.

Questions you should ask yourself

If your CAH contracts for CRNA services, have you reviewed the contract lately with your cost report preparer? Are there provisions in your negotiated CRNA contract that unknowingly impact reimbursement? Have you received multiple bids for your CRNA contract to demonstrate you comply with the CMS prudent buyer principle? One of CMS’ current focus areas is to ensure the prudent buyer principle is being followed and can be verified.

At the time (and that time is now), all of these activities may seem mundane and unnecessary, but you will be glad you did when you get that “star” on your cost report during the MAC audit and ensure your facility receives correct reimbursement for CRNA services.

 

RECENT POSTS

What is a Family Office?

Modern family offices have been in existence since the late 19th century when John D. Rockefeller decided he needed a professional team to manage his wealth. The complexity of the financial landscape, coupled with…

read more

SIGN UP FOR OUR NEWSLETTERS!

We tap into the vast knowledge and experience within our organization to provide you with monthly content on topics and ideas that drive and challenge your company every day.

Toll-Free: 866.577.0780  |  Privacy Policy

All content © Lutz & Company, PC

OMAHA

13616 California Street, Suite 300

Omaha, NE 68154

P: 402.496.8800

HASTINGS

747 N Burlington Avenue, Suite 401

Hastings, NE 68901

P: 402.462.4154

LINCOLN 

601 P Street, Suite 103

Lincoln, NE 68508

P: 531.500.2000

GRAND ISLAND

3320 James Road, Suite 100

Grand Island, NE 68803

P: 308.382.7850