"I have had the privilege of working with HMI for twenty plus years and have always found their representatives to be professional and knowledgeable in all aspects of acute hospital and professional service charge master management. Additionally ongoing coding related reviews and billing reviews and associated report backs are timely and positively impact appropriate revenue capture - billing - and compliance." "I recommend HMI to be considered when choosing a partner to assist with the...
Greg Yost, PFS Director Princeton Community Hospital, Princeton WV
We have utilized HMI Corp. since 2002 for consultation services related to chargemaster review and updates and have always found their services to be professional of nature and valuable to our organization.
David Alley, CFO Athens Regional Medical Center, Athens TN
We recently transitioned to HMI from another Physician Documentation & Coding Compliance Review vendor, and the entire experience has been positive. HMI has been extremely accommodating throughout the process and has demonstrated a willingness to adapt to our workflows, leading to a seamless transition. We’ve received positive feedback from our providers about their experiences with HMI, and the Coding Hotline has been an invaluable resource. For anyone looking for a new consulting partner,...
Dawn Chrismer, RHIT, CHC, CCS-P Director of Business Services/Compliance Officer Heritage Medical Associates, Nashville, TN
HMI has been a very reliable resource for Princeton Community Hospital for many, many years. I have had the opportunity to work with many staff members and have found all to be reliable and courteous in every aspect. The staff is very flexible and provides Princeton Community with the support and coding stability needed. Thank you for the sometime short notices for coding coverage when unexpected situations arise with our staff. We thank you for your coding expertise as well as your...
Denise Moore, CCS Coding Manager Princeton Community Hospital
I’ve worked with HMI employing them to conduct audits of physician documentation and coding. They have consistently produced quality work in a very timely fashion with reports that were well written and easy to understand. Communication has always been prompt and effective. I have such confidence in their work that, over the years, I brought them from my prior location to my current location. I would recommend HMI to anyone in need of accurate and timely coding or auditing.
Robert C. Kay, RRT, MBA, MJ, CHC, CPC-A Chief Compliance Officer St. Christopher\'s Hospital for Children
“I have had the privilege of working with HMI over the past 10+ years with two different health systems. I have used HMI for hospital CDM and compliance reviews as well as physician coding reviews and education. I always receive top-notch service from the HMI team and I appreciate working with a partner that is always honest and responsive to my questions and needs. I have worked with Mary Quimby and Vickie Faler and both have proven to be very knowledgeable, accessible, and...
Rodney Adams, MMCH, Associate Administrator of Finance Williamson Medical Center
HMI has been a great partner with MedStar Washington Hospital Center now for many years. We can always count on them to provide us with support on small to very large projects. HMI delivers consistent and honest results and additionally provides very thoughtful & targeted education to our physicians.
Purvi Jani AVP Reporting and Revenue Cycle MedStar Washington Hospital Center
Having worked in healthcare revenue cycle for more than three decades, I have partnered with many vendors. My vendor of choice for CDM Review, E/M Coding Compliance and Physician Education is without a doubt HMI, LLC. Mary Quimby and Vickie Faler are not only subject matter experts, they are true partners providing that extra level of service that sets them far above others in the industry. I have worked with them for 15+ years in 5 different acute facilities, and multi-specialty physician...
MaryAnn Hastings, CPMA, Director Revenue Cycle Operations, Galen Medical Group
We have been working with HMI since 2010 and have expanded the use of their services to include CDM and ED Coding. The HMI coding staff is extremely knowledgeable and has become an integral part of our coding team. Our consultant Beth never shies away from any CDM project that comes her way. We appreciate the professionalism and teamwork we have with HMI.
Janet Willis, Director of Revenue Management, Monadnock Community Hospital
We have utilized HMI’s for chargemaster compliance and billing reviews for nearly 10-years. We have always found that their staff to be knowledgeable, resourceful and professional in all services provided to our organization.
Jessica Mayfield, Manager Revenue Management University of Missouri Health Care
Healthcare Revenue Cycle Management and COVID-19: Coronavirus Impact & Management Strategies
Healthcare Revenue Cycle Management during COVID-19: Coronavirus Pandemic
97% of America’s healthcare organizations have experienced some disruption due to COVID-19.
As states re-open, healthcare organizations continue to navigate healthcare revenue cycle management. Some organizations are managing more effectively than others.
COVID-19 has introduced billing and coding challenges, patient financial responsibility issues, and other problems for healthcare organizations.
Today, we’re explaining strategies firms are using to manage revenue cycles during the COVID-19 pandemic – including how your organization can stay ahead.
Medical Coding Challenges
Many organizations have faced billing and coding challenges during the COVID-19 pandemic.
To navigate the pandemic, your organization needs to know what is covered by health plans for both inpatient and outpatient care.
Rules are changing constantly. That means staff require frequent training and regular updates to avoid billing and coding problems.
Many outpatient facilities are scheduling telehealth appointments, for example. Some insurance companies treat telehealth appointments the same way as in-person appointments. Others treat them differently. Check if the insurance company pays the same full rate for telehealth appointments. Check if the insurer needs further documentation or approvals.
Many healthcare organizations have shifted their billing office to work remotely. With some preparation, organizations can handle billing responsibilities from home.
To setup remote billing, an organization may need to give employees remote access. Employees may need to access certain systems and equipment to remain productive.
Employees also need to adhere to regulations – including privacy and data security. Working from home introduces new challenges with HIPAA, and your organization needs to address these challenges before compliance issues occur.
Business Continuity Issues
COVID-19 has made some healthcare organizations starkly aware of business continuity issues. Some organizations have strong emergency preparedness plans. Others do not.
Every healthcare organization has some type of emergency plan – but few healthcare organizations were prepared for a multi-month pandemic-related shutdown.
You may think it’s too late to address emergency preparedness for the coronavirus pandemic. However, nobody knows what happens next: a second wave later this year could be worse than the first wave. There’s no such thing as too much preparation.
Changes to Medicare
Several Medicare changes were introduced in recent weeks. Healthcare organizations need to review these changes and stay up-to-date on other upcoming changes.
Some of the biggest changes involve billable services, including services that can and cannot be billed under Medicare. Medicare allows billing for the treatment of uninsured patients with COVID-19, for example, or providing telehealth care.
Another big change is with Medicare cash flow: organizations can receive accelerated or advance payments from Medicare in certain situations, increasing cash flow at a time when needed most. By taking advantage of these cash flow changes, organizations can minimize COVID-19 disruptions.
Collecting from Patients
Patients are facing higher financial responsibilities during the coronavirus pandemic. Some patients are facing financial difficulties because their health plan lacks coverage for coronavirus-related bills.
Today is a great time to evaluate your organization’s collection and credit system. Each organization should evaluate its credit and collection policies. Pay close attention to changes in:
Copays and Deductibles: Some of America’s largest insurers have changed copay and deductible policies, including out-of-pocket responsibilities for patients.
Standard Referral Requirements: Consider standard referral requirements, as this can move payment obligations from the patient to the insurer.
By keeping staff trained and up-to-date on patient financial responsibility changes, healthcare organizations can optimize revenue cycles during the pandemic.
Other Things to Consider
Healthcare organizations are dealing with countless challenges during the coronavirus pandemic. Other things to consider with revenue cycle management include:
Capacity Assessment: Hospitals in many states are facing a surge in patients, including surges that overwhelm capacity. Your healthcare organization needs to develop proactive revenue cycle strategies to ensure you continue to meet patient needs when nearing capacity.
Staff Management: Your staff are on the front line of patient care. Has your organization created proactive plans for hours of operation, staffing and documentation requirements, telehealth accommodations, and other unique situations created by the coronavirus?
Hire a Consultant
There’s never been a better time to hire a revenue cycle management consultant. A good revenue cycle management consultant spots inefficiencies that impact revenue.
By implementing a consultant’s recommendations, your organization can thrive during the pandemic, surpassing revenue management cycle obligations and goals.
Revenue cycle management consulting is an investment. A good consultant firm provides a return on that investment, providing actionable recommendations that impact your firm’s revenue immediately.
At HMI Corp, we have offered revenue cycle management services since 1989. As a diversified healthcare company, we provide a spectrum of revenue cycle management services, including charge capture, chargemaster reviews, medical bill audits, and claims reviews.
Our clients include physician groups, large teaching hospitals, and organizations of all sizes in between. Contact us today to discover how we can help optimize revenue cycles for your organization. Our goal is to help you meet revenue goals while maintaining quality and compliance standards.
The COVID-19 pandemic has introduced many challenges for healthcare organizations.
The situation is fluid, and it’s uncertain what happens next. However, organizations must continue to meet obligations and missions throughout the pandemic.
Using the strategies above, healthcare organizations can manage and thrive during the coronavirus pandemic, ensuring they meet revenue cycle goals.