The 2002 Radiology Business Management Association (RBMA) radiology summit in Naples, FL from June 2-5 offered a range of topics from regulatory changes to practice marketing to professional development in management and operations. In addition, more than 50 vendors displayed products and services to the 400-strong RBMA members attending the 34th annual conference.
The RBMA conference stressed the importance of a proactive approach to management issues such as coding, reimbursement, business growth, and legislative compliance. With the first implementation of the U.S. Health Insurance Portability and Accountability Act (HIPAA) coming in October 2002, the potential impact of the regulations was of concern to many of the attendees.
The Centers for Medicare and Medicaid Services (CMS) issued the final privacy rule of HIPAA before it released the final rule on security. Unfortunately for radiology administrators, privacy cannot be assured without security, and the final security rule is slated for later in 2002.
Cynthia Smith, senior manager of HIPAA security services for PricewaterhouseCoopers in Pittsburgh, presented options for radiology managers to put a plan in place before the April 2003 deadline for security arrives. While the security rule isn’t final, there is enough substance in the proposed rule to build a HIPAA security backbone.
"The commonalities of the privacy and security rules are what an administrator should look at to define their implementation policy. For example, security boundaries are established by who and what is covered in the privacy rule," she said.
Also on the compliance front, current trends in fraud and abuse regulatory investigations captured administrator’s attention at the RBMA summit.
Business managers have the greatest stake in complying with U.S. fraud and abuse regulations, because they’re the ones at whom all fingers will point if there’s ever an investigation. And, as radiology gets a greater percentage of the U.S. federal healthcare dollar, the specialty's billing and coding practices are coming under greater scrutiny.
Alice Gosfield, a healthcare attorney with Alice Gosfield & Associates in Philadelphia, presented her take on some of the hottest issues in fraud, abuse, and reimbursement. As no proof of specific intent is required for a successful prosecution on the fraud and abuse regulations, radiology administrators must exercise careful diligence when coding procedures at their facilities.
Gosfield recommended that if there are ever any questions about the appropriateness of a billing code, radiology administrators should contact their facility’s healthcare attorney for guidance.
"Don’t ever call the carrier with ‘how-to’ billing questions. One, they don’t know what they’re doing, and two, if you call three times, you’ll get three different answers," Gosfield said.
Consulting an attorney about a billing problem provides a practice with attorney-client privilege, a safety factor that should not be underestimated given the zealousness of U.S. government attorneys.
Coding compliance is not just a prudent strategy for the savvy business manager; it also provides an opportunity for revenue optimization, according to Dr. Gary Dorfman, president and chief medical officer of Health Care Value Systems in North Kingstown, RI.
Timely and accurate revenue capture is the lifeblood of the U.S. radiology practice. Timely revenue is crucial because many practices are faced with bare-bones costs and a delayed cash flow, both of which threaten viability. Accurate revenue capture is critical because the penalties for inaccurate coding are catastrophic enough to shutter the doors of any facility.
"All aspects of billing and collections have optimization and compliance implications, and altering processes to improve either aspect will affect both," he noted.
Another hot-button topic for RBMA attendees was the consolidation of competing radiology practices to better accommodate a region’s economics.
"Radiologists are looking for increased negotiating clout with hospitals and managed care programs," said Will Latham, president of Charlotte, NC-based Latham Consulting Group. "In fact, the single force driving the majority of radiology group consolidations is managed care."
Latham and Joseph Serio, CEO of Nashville-based Radiology Alliance PC, discussed successful merger strategies at the RBMA. Although market forces may dictate that the best course of business is to merge practices, a business manager must be the driver in keeping the process on track. "The key thing in conducting a merger is to keep highly structured and organized, otherwise you’re going to waste years trying to get anywhere," Serio observed.
Getting a practice going, or revitalizing a stalled practice, requires strategic marketing, In a special session, RBMA past president, Patricia Kroken outlined a roadmap to successful marketing.
Kroken, president of Albuquerque, NM-based Healthcare Resource Providers, shared her experiences -- both good and bad -- in building marketshare for radiology practices.
"Marketing isn’t something that is done solely by a representative of the group. It’s everybody in the practice’s job -- the radiologist, the technologist, the front desk, and billing and collections -- to support the goals of the marketing plan," she noted.
The RBMA will holding its fall educational conference October 20-23 in Las Vegas. Its 2003 radiology summit will be held May 18-21 in San Antonio, TX.
By Jonathan S. BatchelorAuntMinnie.com staff writer
July 22, 2002
Related Reading
Prudence, attention to detail help managers steer clear of fraud and abuse, July 17, 2002
Revenue optimization, compliance assurance provide practice Rx, July 15, 2002
HIPAA final privacy rule drives security implementation, June 7, 2002
Surviving and thriving in a radiology group merger, June 6, 2002
Marketing plan charts course to success for radiology group, June 5, 2002
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