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HSMN (Health Systems Management Network Inc), a leading consulting firm to hospitals and clinical practices, is being featured in the most recent edition of Modern Healthcare Magazine published on Sept. 2nd.

HSMN, a leading ICD-10-CM/PCS consulting firm, is advising their clients of new revenue cycle opportunities. They are predicting hospital and physician reimbursement will decline due to the PPACA but there are opportunities in reimbursement to regain the loss that may be missed if medical staff clinical documentation, coding and critical thinking coders don’t interact in a seamless and symbiotic process.

For almost 30 years HSMN has worked with providers of healthcare in every setting from academic medical centers to Individual physician practices. The firm was founded by Cathy Idema, BSN, MPH in 1987 and has built a practice that encompasses seasoned healthcare financial, operational, clinical professionals and who represent every function within the revenue cycle. HSMN is pleased to announce that it tops the list of revenue cycle consulting firms in the current issue of Modern Healthcare Magazine.

HSMN announces a program called “Start Ten Plus ICD-10-CM/PCS Systems Analytics”. Previous program announcements focused on preparing the medical/practice staff and the entire revenue cycle management team for the transition. HSMN has stated that unless the transition starts at the front end and at the source where the patient encounters and procedures are ordered, documented, and done, the most important aspect of the transition to ICD-10CM will be missed.

Many of HSMN clients have asked for help in solving the coding work queues that are accumulating in many organizations that have implemented enterprise wide systems such as Epic. Epic is a fine system and provides something clinicians have long sought but it can be a source of problems especially in coding and clinical documentation. Many clients have complained about claims sitting in queues for so long that they are missing filing deadlines or close to it.

HSMN announces that The White House’s delay in implementing certain provisions of the Affordable Care Act does not change the need for hospitals and private practice to get prepared when it comes to making sure they really understand the need to be ready for ICD-10-CM/PCS requirements.

Health Systems Management Network, Inc. announces the availability of web based training for ICD-10 transition programs. These programs are part of its “Start Ten Plus” programs which encompass the following elements: reviews of current clinical documentation and coding accuracy of the revenue cycle management team through its “Deconstruction Methodology”, reconstruction of such cases by clinical discipline and roles in ICD-10-CM/PCS, and the presentation of such cases by key medical staff and revenue cycle team members to their peers.

HSMN’s “Start Ten Plus” program has focused on clinical and revenue cycle management staff creating a clinical documentation, coding and claims continuum for hospital billing. In a recent article they announced HSMN’s acquired technology to personalize an assessment of the current clinical documentation through HSMN’s Deconstruction Methodology of ICD-9-CM and reconstruction into ICD-10-CM using active cases.

The Wall Street Journal recently published an article that expressed two distinct points of view regarding financial incentives for physicians. The first opinion was that some companies believe that it would be suitable to pay physicians based upon outcome because there are sufficient quality benchmarks in place to do this. The second opinion is supported by the Cochrane Collaboration’s review which did not find any evidence that patient outcomes are improved by financial incentives.

Hospitals that received a federal bonus in 2011 and 2012 were sent surveys to confirm compliance with “meaningful use” but some of the survey pertained to how clinicians document and code their services. There is no free lunch when it comes to CMS and the almost 18 billion dollars in additional reimbursement paid to hospitals and their medical staffs as a result of meeting “meaningful use” requirements. The implementation of electronic medical records makes it much easier to cut and paste documentation from one visit to another, resulting in a higher E&M level contributing to the increase in physician reimbursement. CMS and HHS have warned that “High Tech” fraud will be prosecuted. HSMN’s coding and ICD-10-CM implementation team of consultants assist hospitals and physician practices with these new coding challenges.