Tracey Tomak, PMP, RHIA, the director of project management and client engagement at Intersect Healthcare, was quoted in this article. For the full journal and original article, see the source information below.

Source: NAHRI Journal October 2018 Vol. 2 No. 4

by: Jaclyn Fitzgerald Associate Director, NAHRI

It’s been just over one year since the National Association of Healthcare Revenue Integrity  (NAHRI) welcomed its first member and we are now more than 700 members strong. That’s more than 700 driven, dedicated individuals from across the country who have joined forces to ensure the revenue integrity profession is recognized for its unique contributions to the healthcare field.

I can’t think of a better way to celebrate your individual contributions and the impact we will continue to make as a united front than to come together for NAHRI’s 2018 Revenue Integrity Symposium (RIS) to be held October 16–17 at the Wigwam Resort in Litchfield Park (Phoenix), Arizona. RIS is NAHRI’s premier event for revenue integrity and revenue cycle networking and education, offering you the opportunity to:

  • Engage with NAHRI Advisory Board members
  • Share operational strategies with peers
  • Learn cutting-edge regulatory information that will arm you with the tools you need to take 2019 by storm

If you don’t believe me, just wait until you hear what our NAHRI Advisory Board members and RIS speakers have to say about the event.

“RIS is such an important event because the field is becoming more and more technical between the regulations/rules from CMS, the technology innovations, and the patient/clinician demands,” says Angela Lynne Simmons, CPA, vice president of revenue and reimbursement at Vanderbilt University Medical Center in Nashville, and a NAHRI Advisory Board member. “Folks working in the revenue integrity space need support, collegial contacts, and training. This group and this conference fill an important gap.”

Networking

Networking is the cornerstone of every professional association, and RIS is the perfect venue for NAHRI members looking to connect with one another while learning about the latest changes in regulatory information and gaining insight into revenue integrity work plan practices. In addition to networking opportunities at breakfast, lunch, and during breaks, attendees can enjoy downtime with one another at our networking reception on day one, October 16, at 4:45 p.m.

One of my favorite aspects of last year’s event was getting to know NAHRI members. I’m looking- ing forward to it this year as well—and I know I’m not alone. “I have attended RIS before, and I always look forward to seeing long-time friends and colleagues there. Often, we only run into each other once a year at the symposium,” says Sarah L. Goodman, MBA, CHCAF, COC, CCP, FCS, president and CEO of SLG, Inc., in Raleigh, North Carolina, and a NAHRI Advisory Board member. “If there are any new attendees, they should know that the general sessions are a must, and depend- ing upon your specialty or interests, there are a number of excellent breakout sessions from which to choose.”

Hearing stories about your revenue integrity triumphs and tribulations helps me better understand the direction the profession is moving in so we can best align NAHRI to meet the needs of today’s ever-changing healthcare landscape. If you see me at the NAHRI booth, in a session, or during a networking block, please be sure to introduce yourself and let me know how NAHRI and RIS can better help you meet your professional goals.

Chatting with NAHRI Advisory Board members about ways the association can best serve you and how regulatory changes impact your day-to-day is also a great way to elevate the profession and ensure we are all on the same page when it comes to implementing sweeping changes.

“In addition to the great speaker lineup, I’m most looking forward to the networking opportunities. Talking to attendees about the daily operational challenges they face implementing CMS’ initiatives/rules that impact coding, billing, the charge description master, finance, compliance, and the entire revenue cycle is incredibly valuable,” says Jugna Shah, MPH, the president and founder of Nimitt Consulting, Inc., in Spicer, Minnesota, and a NAHRI Advisory Board member. “It helps me put into context the real-world challenges you face that I’m always striving to get CMS to understand. By attending the conference, my hope is that every attendee will hear something of value, such as a best practice from a fellow attendee or something new from a presenter, that can be taken home and immediately acted upon to make your daily lives easier.”

Regulations

One of the greatest things about RIS is the timing of it. Each year, we gather in the fall just after major annual rules are released to break down changes and their impact on the year ahead. The 2019 IPPS final rule is focused on the overhaul

of the newly coined Promoting Interoperability Programs, significant reductions to reporting requirements for quality initiatives, and updates to payment rates. Meanwhile, the 2019 OPPS proposed rule continues CMS’ efforts to enforce site-neutral payments and reduce drug payments by introducing policies to reduce reimbursement for hospital outpatient clinic visits at off-campus, provider-based departments (PBD) and expanding last year’s payment reductions for drugs purchased under the 340B discount pricing program by non- excepted PBDs.

“I am looking forward to hearing about CMS’ proposed regulation changes. In particular, I am interested in hearing more about what is happening in regard to admission status and how providers can mitigate their audits and denials for inpatient medical necessity,” says Tracey A. Tomak, PMP, RHIA, the director of project management and client engagement at Intersect Healthcare in Towson, Maryland, and a RIS speaker.

In addition to the regulatory guidance you expect from RIS, we’ve refocused our agenda this year to ensure we are offering best-practice guidance for revenue integrity professionals. Marilyn Hart Niedzwiecki, MBA, CPA, RN, CPC, COC, CIRCC, will provide an overview of how an annual work plan has been developed and implemented at Ann & Robert H. Lurie Children’s Hospital of Chicago. This session will demonstrate what is included in the work plan, complexities encountered, and the importance of collaboration, communication, and EMR comprehension. “An annual work plan is essential to ensure that all areas of charge capture are reviewed on a regular basis, keeping us on track. As we are all aware, there is often more to do than is possible, and it allows us to prioritize and focus. It also allows the revenue integrity department to be more transparent in an organization,” says Hart Niedzwiecki.

Another session added to this year’s agenda to help ensure attendees are on the right track with their revenue integrity departments focus- es on program design options. Caroline Rader Znaniec, the owner and consulting lead of Luna Healthcare Advisors LLC in Denton, Maryland, will discuss nationwide approaches to revenue integrity program designs as well as strategies for getting buy-in from leadership. “There is not one single best practice model out there for revenue integrity, but there are many things that must be considered when looking at program design,” says Rader Znaniec. “My presentation will highlight key considerations, pros and cons of program designs, and allow for active sharing and discussion. It’s a great atmosphere for me to share my professional experience from working with organizations across the country, but also to hear firsthand from peers.”

Enjoying the Area

RIS speakers can’t say enough about the location of the event. October is a fantastic time

to enjoy everything about Phoenix’s unique climate—and for those of us in the Northeast, the symposium is a welcome retreat just before winter rains down upon us. For me, one of the most interesting things about traveling for a national conference—outside of the exciting people you meet—is exploring a new landscape.

Judith L. Kares, JD, an instructor for HCPro’s Medicare Boot Camp—Hospital Version® and a RIS speaker, lives in the Phoenix area and filled me in on all the exciting things it has to offer. Scotts- dale, Arizona, is not far from the Wigwam Resort and has a wealth of shopping malls to offer for those who are interested in retail therapy following a busy day of networking and education. If history and culture are more your style, the Phoenix area is ripe with museums ranging from art to Native American history.

“I am in love with Phoenix. It is such a great place, and the conference is being held at the perfect time of year to enjoy all that the Phoenix area has to offer,” says Kares. “The middle of October in Phoenix is as close to heaven as you’ll get. The weather is perfect, and it’s a superb environment that is completely different from what most people are accustomed to.”

Alicia Kutzer, Esq., LLM, MHA, adjunct instructor for HCPro’s Medicare Boot Camp®— Audits, Appeals, and Denials Version and Medicare Boot Camp®—Hospital Version, and a RIS speaker, is also a fan of the Phoenix area and is looking to reminisce a bit while at the event. “I grew up visiting Phoenix roughly once or twice each year, but I have not visited in nearly 20 years, so it is going to be nice to get back there,” says Kutzer. “I am hoping to visit Old Town Scottsdale and maybe get dinner at one of the many restaurants on or near the Arizona State University campus, which is in downtown Tempe. I remember really enjoy- ing these two places, and luckily both of them are close to Phoenix.”

In Closing

I hope you will join your fellow NAHRI members as well as other healthcare professionals from across the country at RIS and its associated pre- and post-conferences this fall. As a valued NAHRI member, you will save an additional $100 off the cost of admission. Use your exclusive member code NAHRIVIP100 at registration.

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