Price transparency, charge reconciliation, and association updates take center stage on January quarterly call

Wednesday, February 5, 2020

Members of NAHRI’s Professional Advocacy Committee offered insight on changes to price transparency and strategies for charge reconciliation following association updates on NAHRI’s January 28 Quarterly Call.

NAHRI Director Jaclyn Fitzgerald, CHRI, led off the call with a handful of important announcements, including information about the new online application for the Certification in Healthcare Revenue Integrity. Revenue integrity professionals preparing to sit for exam should check out the new 80-question practice exam, which is delivered in an electronic format and includes remediation to help the test-taker understand why an answer was correct or incorrect.

Fitzgerald also previewed the 2020 Revenue Integrity Symposium (RIS), which will take place October 6‒7 at the Westin Westminster Hotel in Westminster (Denver), Colorado. In addition to excellent networking opportunities, RIS offers presentations on a range of topics critical to the revenue integrity profession. Early-bird RIS registration comes with a $150 discount, and NAHRI members can save an additional $100. Register today and save..

The Revenue Integrity Leadership Exchange precedes RIS on October 4‒5. The exchange is an invitation-only event where 25 of the most forward-thinking revenue integrity leaders from across the country gather and engage in peer-to-peer roundtable discussions. Recruiting for the event will begin soon. If you would like to be considered for the event, please email Fitzgerald at jfitzgerald@hcpro.com. Additional information about both events is available on the NAHRI website.

Fitzgerald also took time to highlight the NAHRI Local and Regional Chapters, which continue to expand. To join or launch a local chapter in your area, visit the NAHRI Local Chapter website.

Finally, Fitzgerald discussed NAHRI Workgroups, which give members the opportunity to connect digitally and further explore topics of interest. Currently, the NAHRI Revenue Integrity Collaboration Workgroup is accepting new members. The group holds a monthly one-hour meetings through GoToWebinar. To join this NAHRI Workgroup or launch a new one based on your preferred schedule and topic, email Associate Editor Kevin Duffy at kduffy@hcpro.com.

Following the announcements, two members of the NAHRI Professional Advocacy Committee delivered presentations on pertinent topics. The Professional Advocacy Committee released several position papers and stories on regulatory updates since launching in 2019, the most recent of which offered guidance on tackling price transparency requirements.

Terri Rinker, MT (ASCP), MHA, revenue cycle director at Community Hospital Anderson in Anderson, Indiana, expanded on the topic of price transparency during her presentation, explaining how laws, rules, and executive orders all tie together when healthcare organizations implement policies.

Using price transparency as an example, Rinker outlined a decade of modifications, beginning with the 2010 Affordable Care Act and ending with 2020 outpatient prospective payment system final rule.

It can be difficult to understand how these frequent updates work in conjunction with one another, but there are many ways to keep up with the ever-evolving regulations, Rinker said. CMS offers Open Door Forum Calls, giving revenue integrity professionals the chance to ask questions. CMS records each call and posts a transcript on its website. Additionally, CMS posts FAQs and publishes podcasts. Revenue integrity professionals can also take advantage of NAHRI Local Chapters to better understand how state laws fit into the equation, Rinker said.

Rinker’s presentation was followed by a demonstration from Debra Seyfried, MBA, CMPE, CPC-I, CPC, director of revenue integrity at Truman Medical Centers in Kansas City, Missouri. Healthcare organizations are often searching for efficient and effective charge reconciliation programs, and Seyfried took time to explain how Truman Medical Centers has excelled in this area.

Seyfried provided a detailed overview of the homegrown ChargeRecon program that helped Truman recoup more than $2.4 million of revenue in FY 2019, adding more than $760,000 to the bottom line.

The ChargeRecon system shows who is reconciling and who isn’t. It can also track late charges and analyze charges across the organization.

Seyfried took us through the system step-by-step, showing examples of pages for charge audit, error audit, suspended charges, analysis, and revenue. Seyfried called the ChargeRecon system the “first line of defense” for healthcare organizations.

A recording of the January quarterly call is available on the NAHRI website for members, who can now earn CHRI CEUs for listening to or presenting on quarterly calls. Register now for our upcoming quarterly members-only calls. If you would like to present during an upcoming quarterly call, please contact NAHRI Associate Editor Kevin Duffy at kduffy@hcpro.com.

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