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Welcome to the MiraMed Focus

Welcome to our first issue of MiraMed’s new healthcare journal, The Focus. I am very excited to launch this journal which I hope you will find timely, educational and illuminating. We will deliver The Focus on a quarterly basis, so look out for our next edition.

We are at the halfway point in 2015. The rest of the year comes with the promise of great growth and change. As part of our own expansion and growth, we’re excited to launch our inaugural edition of The Focus and share it with our loyal subscribers.

At MiraMed we have some of the best and brightest subject matter experts in the business processing outsourcing (BPO) industry. We are pleased to have two of our team members share their knowledge in our first edition of The Focus. Jonathan Landsman, our Director of Big Data and Strategy explains in his article, The Power of Big Data and Analytics, how big data and analytics can provide breakthrough possibilities for new scientific research, clinical discoveries and the improvement in financial performance.

Joette Derricks, Vice President of Regulatory Affairs & Research for MiraMed shares her knowledge about how prevalent gray areas are when coding for Evaluation and Management services (E/M). In her article, Shades of Gray in Evaluation and Management Services, she explains how the Office of Inspector General (OIG) is working closely with Centers for Medicare and Medicaid Services (CMS) to help providers eliminate improper coding of E/M encounters.

Lyman Sornberger, the CEO of LG Associates headquartered in Cleveland Ohio brings 28 years of experience leading revenue cycle operations for Cleveland Clinic Health Systems and University of Pittsburgh Medical Center. He shares his experience and insights about how and why the responsibility of payment for healthcare services has shifted from government and commercial payers to the patient being responsible for much of the payment for their services. In his article, The Self Pay Tipping Point, he explores how the shift to patient responsibility has affected the industry and where the greatest risks are that will require new strategies and tactics needed to protect the revenue generation in the future.

We are pleased to have Nathaniel Lacktman, Esq., from Foley & Lardner LLP, explore the topic of his article, Telemedicine Business Opportunities and the “Doc Fix” Bill. Mr. Lacktman discusses how clinical and operational reform has helped the healthcare industry to achieve greater delivery system efficiencies, cost stabilization and quality improvement.

Also featured in this issue is Gerry Baker, MBA, with McGraw Baker Consulting, LLC. In his article, Protecting Revenue with Accurate and Complete Hierarchical Condition Coding, he explains how specific tactics can help hospitals eliminate the potential revenue leakage caused by inaccurate Complete Hierarchical Condition Coding (HCC). His article reviews strategies and steps that can be taken to ensure providers receive appropriate reimbursement.

David W. Johnson, CEO and Founder, 4sight Health, has provided us an interesting perspective with his article, When Healthcare is a “Lemon”: Asymmetric Information and Market Failure. He explains why asymmetric information can cause problems in healthcare delivery because it contains imperfect knowledge. Mr. Johnson suggests that health companies should make it a priority to use the same consumer-friendly strategies to engage patients to provide the right care at the right price at the right time in the right place.

Patient interaction and communication has recently become a major focus of healthcare leaders. Bird Blitch, CEO of Patientco, makes a strong case for developing new strategies for patient interaction clinically and financially. In his article, The Case for a Patient-Centric Revenue Cycle, he suggests how a patient centric environment can improve care, communication and clarity of information for the patient, improving the entire healthcare experience.

We are proud of the group of authors we have assembled and appreciate their perspectives. Your feedback is important to us, so please give us your thoughts and suggestions. I hope you enjoy reading this edition.We are pleased to introduce Mitch Mitchell, a consultant, from T.T. Mitchell Consulting Inc., to our list of authors. Mr. Mitchell shares his experience and tactics about how to better manage a hospital’s charge master in 5 Tips Towards Finding Missing Revenue. Improper management of the charge description master (CDM) can cost a provider millions of dollars in revenue. Mr. Mitchell details five reimbursement strategies that focus on the areas that providers typically miss when interpreting the guidelines set up in a CDM.

I wanted to let you know that we will be exhibiting at the upcoming Healthcare Financial Management Association Annual Institute (ANI) in Orlando Florida from June 22-25, 2015. Please stop by our booth #1309 and say hello.

With best wishes,

Tony Mira
President and CEO

 


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