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HBS Update
March 3, 2016

A Newsletter for Rural Health Clinics 
by Healthcare Business Specialists

Specializing in RHC Reimbursement 

CMS Open Door Session today 
(March 3rd) at 3:30 Eastern Time 

The next CMS Rural Health Open Door Forum is scheduled for:
Date: Thursday, March 3, 2016;
Start Time: 3:30pm-4:30pm Eastern Time (ET);
Please dial in at least 15 minutes prior to call start time.
Conference Leaders: Carol Blackford, John Hammarlund and Jill Darling.
**This Agenda is Subject to Change**
Opening Remarks
Chair- Carol Blackford, (CM)
Co-Chair - John Hammarlund, Regional Administrator, Seattle Regional Office
Moderator - Jill Darling, Office of Communications
Announcements & Updates
· RHC HCPCS Coding Update-Corinne Axelrod
· Critical Access Hospital Necessary Provider Designation Documentation- Kianna Banks
Open Q&A
Next ODF: April 14, 2016
Open Door Forum Participation Instructions:
This call will be Conference Call Only.
1. To participate by phone:
Dial: 1-800-837-1935 & Reference Conference ID: 38296329
Persons participating by phone are not required to RSVP. TTY Communications Relay Services are available for the Hearing Impaired. For TTY services dial 7-1-1 or 1-800-855-2880. A Relay Communications Assistant will help.
Encore: 1-855-859-2056; Conference ID: 38296329
Encore is an audio recording of this call that can be accessed by dialing 1-855-859-2056 and entering the Conference ID. Encores for ODFs held on Thursdays can be accessed the following Monday. The recording is available for 3 business days.
CMS Mission: As an effective steward of public funds, CMS is committed to strengthening and modernizing the nation's health care system to provide access to high quality care and improved health at lower cost.
HCPCS Webinar moved to March 4, 2016
Please register for Repeat Session: HCPCS Coding Changes effective April 1, 2016. A Brief Overview. on Mar 4, 2016 12:00 PM EST at: 

Due to the large number of people wanting to hear this webinar, we are going to repeat the session after the Rural Health Open Door Session next week. This webinar will focus on the recent revised guidance that CMS provided RHCs for billing effective April 1st, 2016. There are some issues that will take some time to code correctly and may cause billing issues in the future. Also procedures are going to be handled differently as well as the use of modifier 59.

Carolyn Duncan, BS, CPC, CPC-H of 
Health Care Consulting Services, Inc. has been added as a panelist and will help me conduct the webinar. Carolyn is an expert in CPT coding and has worked with Rural Health Clinics for a number of years.

After registering, you will receive a confirmation email containing information about joining the webinar.

Brought to you by GoToWebinar®
Webinars Made Easy®

NOTE: This webinar is already overbooked. If you want to get in to the webinar, sign on early. I will open the room at 11:45. You can still listen by calling in and following on the handouts that I will email at approximately 11:00 that morning. Do not call me or email me if you get in to late. There is nothing I can do. If you do not get the 11:00 AM email it is because your server has blocked it (most hospitals do not allow us to send dropbox or large attachments), I will post the slides on the Rural Health Clinic Information Exchange group Facebook page.

"A place to share and find information on RHCs."

Remember to ask to join the group today or before 11:00 AM tomorrow or you will not be able to use the group to get the slides as well. We will have the slides in the webinar for download as well. We try to make this as available as possible, but this is a free service and we have budgetary limits on webinar seats (our license only has 100 seats and to add seats basically costs $11,000 per year in additional expense)
Here is a link to the YouTube recording of our webinar on HCPCS Coding

CMS released another revised MLN-9269 on the tranistion to HCPCS coding on RHC claims effective April 1, 2016. Here is a link to the recording.
This release updated the examples which really was a step backward in my opinion. The examples are even more confusing now. CMS did clarify that HCPCS coding is only required for dates of service on or after April 1, 2016, but did not rectify the procedures only issue. We are still waiting on that.

RHC Billing and HCPCS Seminar in Jackson, Tennessee on March 17, 2016

This Seminar will focus on RHC billing for those just starting RHC Billing and those who want to know about the changes to the billing system due to the HCPCS changes effective April 1, 2016.  We will cover Tenncare Quarterly Wrap Payments for 30 minutes as well. Those wanting to stay as we conduct the Webinar on changes to HCPCS at 1:00 Central are welcome stay until 2:00 as well and hear that information again or listen if they missed that session earlier in the morning.
The seminar will start promptly at 8:30 and will be over at 12:30. The webinar will start at 1:00 and go until 2:00 if you want to stay for that.
The professional fee is $200.00 for the entire session. (For Cost Report,  Annual Evaluation, and Certication clients use discount code Client34 and for the 4th person or more from the same organization use the discount code Quanity for a $100 discount per person) Coffee and Orange Juice will be provided in the morning, soft drinks available during the day. Lunch is own your own.
Other Information
We do not block or discount rooms, so the hotel may not know we are there. We are. Catering handles our contracts and sometimes they do not talk to reservations. There are no special rates that the hotel offers due to the small number in our group. We offer a 100% refund if you can not attend as long as we know within 7 days of the seminar. Emergencies will be refunded if you call us. If you do not call or show up, there is no refund.
This link will get you registered and provide additional information.

Radiology Reimbursement Reduced 20%

In December 2015 President Obama signed the  Consolidated Appropriations Act of 2016 . Included in the 2000-page document is a special rule for diagnostic radiology that pushes imaging providers to adopt more advanced x-ray technology by cutting reimbursement to older technology beginning in 2017 including a 20% cut for analog radiology equipment.

RHC Cost Reporting Webinar Recording and other Documents

Please find some links to documents, webinar recordings, and other information that will help you pull information for the accurate and complete preparation of your RHC Cost Report for 12/31/2015.


Liquidate Accruals for Owners within 75 Days
Remember if you are an owner of a RHC and the RHC is a corporation, you only have 75 days after your fiscal year end to liquidate any accrual of bonus payable to you if you want to include it on the previous year's cost report as an allowable expense. Get those bonus checks written and cashed at the very latest on March 15, 2016 if you are December 31, 2015 fiscal year end.
Other types of vendors and employees can receive bonuses or accrued expenses within one year.

Help in getting your P S and R

To assist your cost report preparation, the Provider Statistical and Reimbursement (PS&R) summary report can be obtained from the CMS website: 

It is your responsibility to obtain the reports directly from the PS&R system. In an effort to ensure all providers have signed up for the PS&R system successfully, we are requiring an EIDM helpdesk ticket in order to process PS&R requests for FYEs 2009 and after.
If you have not signed up for an EIDM account, please visit the following link for information on obtaining access:

You must complete the registration process in order to pull your own PS&R going forward. Also, please ensure you log into the PS&R system every 60 days so you can change your password and keep the account active.
  RHC Information Exchange Group is Growing
Thanks to everyone for joining the RHC Information Exchange Group this past week.  We have 30 new members and encourage everyone to join and exchange information about RHCs. Here is the link.
"A place to share and find information on RHCs."

CCM Billing Webinar with Care 24/7

Chronic Care Management Billing for RHCs on Apr 13, 2016 2:00 AM EDT at: 
FAQ on Chronic Care Management Released in February, 2016

Improve your Quality with The Compliance Team

The Compliance Team - You do not have to be accredited through them to participate in this (there is a nominal fee through)

"The most successful clinics are those that break their quality control "chores" into small tasks throughout the year. They find opportunities to assess compliance and educate staff in manageable segments, which makes everyone's job a bit less stressful.

It is a great idea to put time into your schedule, monthly or at the minimum quarterly, to persona lly assess that the most common deficiencies are not becoming habits in the place where cleanliness and quality matter most. Remember it's all about the patient.

Walk into the waiting room and sit down for 5 or 10 minutes during the course of the day and look from the patient's perspective with a critical eye.

Is it warm and inviting? 
Is the area clean and orderly?

These elements are essential; they even get their own standard in CFR 491.6 (b)(3).
Are staff members following the guidelines set for general disinfection in between patients and at the end of every day?
Are they using the right products and following manufacturer's instructions?
Actually take 5 minutes to ask questions and watch your staff because your surveyor sure will.
Does your clinic utilize a tabletop sterilizer for instrument processing? 

Take a look at the cleaning log and determine the last time the chamber and the reservoir have been cleaned. A hint, it should be done monthly, as recommended by most manufacturers.
Are all of the pouches sealed properly and labeled to identify the load?
Are the hinged instruments in open positions?
Are they stored correctly to avoid punctures in the pouches?

The Compliance Team's Patient Quality Measurement™ (PQM) database service is a value-added feature of our industry leading accreditation; helping you achieve healthcare delivery excellence through process simplification.

To learn more contact Kate Hill at or 215-654-9110."

What RHCs need to know about National Health

 Service Corp Loan Repayment and Shortage 

Designations Webinar on April 19, 2016

Please register for What RHCs need to know about National Health Service Corp Loan Repayment and Shortage Designations on Apr 19, 2016 2:00 PM EDT at: 

Joseph N Lampard of HPSA Acumen will be our panelist and presenter for a webinar on what RHCs need to know about National Health Service Corp loans, HPSA designations, shortage areas and incentive payments based upon location for rural health providers. 

For information about HPSAs email at HPSA Acumen.

After registering, you will receive a confirmation email containing information about joining the webinar.

Brought to you by GoToWebinar®
Webinars Made Easy®

Youtube Channel with RHC Webinars

HBS has started a YouTube Channel and it has all the recordings of previous webinars on it. Here is the link:

  Recorded Webinars on RHC Billing, Cost Reporting, Certification, and Annual Evaluations  


Also visit our partners who are experts in various services related to RHCs and rural healthcare.
HPSA Acumen
National Health Service Corp Loan, HPSAs, and MUAs
Joseph Lampard
  (716) 483 - 0888
Rural Behavioral Health, LLC
Mental Health Services
Dave Jolly
(423) 243-6185
Heart Watch Wellness
Preventive,  Diagnostics,  & Weight Loss
Dan Hayes  
(615) 732-0768
AMS Software
RHC Software  and Services
Matt Kannan
(800) 440-6949
Care 24 / 7
Chronic Care Management
Huy Nguyen, MD
1 (800) 218-3780

Thank you for reading this newsletter and working with our partners in providing healthcare to rural underserved America. If you need any help with RHC cost reporting, annual evaluations, certifications, or seminars or webinars for RHCs, please let us know.

Mark R. Lynn, CPA (Inactive)
RHC Consultant
Healthcare Business Specialists
Suite 214, 502 Shadow Parkway
Chattanooga, Tennessee 37421
Cell Phone: 423-243-6185
Fax: (800) 268-5055