Revenue Cycle Management

KPG Newsletter - CLIVE 2017
January 2017

Kathy Puziak PMP CMPE

  CLIVE 2017; Why YOU Should be There!
by Kathy Puziak CMPE PMP

Yes, you've barely finished ringing in the New Year, but now let's look ahead to a prosperous 2017! Does your future include a trip to Boston, MA for
CentricityTM  LIVE 2017, GE Healthcare's premier IT education conference? This year's conference will be held May 17-20th at the Hynes Convention Center in Boston, MA.  
Whether you seek continuing education, professional development, to glean best practices from GE Healthcare's
CentricityTM  Group Management leading users, or to broaden your resource base through active networking, consider CLIVE 2017.
The call for CLIVE 2017 speakers and presenters wrapped up on January 7th.  Over the next 60 days, topics will be reviewed, presenters selected and the detailed agenda published. Check the CLIVE 2017 web site often for updates. 
Each year, GE Healthcare system users gather to educate, inform and enhance their knowledge of system capabilities, through interaction with peers, professional colleagues, industry leaders and IT executives. This two- and- a- half- day event features an agenda chock full of in-depth training, as well as general healthcare industry information. You'll get updates on the latest trends in technology and healthcare policy. A CLIVE highlight is the opportunity to observe or participate in interactive software and hardware demonstrations, with a chance to get answers to your questions on systems you use.

Also, with the upcoming change in administration and new MACRA requirements for 2017, this year's conference is not one to miss. Dedicated educational tracks and pre-conference offerings allow you to capitalize on the knowledge and experience of industry leaders, targeted directly at the work you do.

This year's Keynote address "2013 Boston Marathon and Disaster Medicine", promises to be a riveting, first time together presentation by a panel who represent a victim, first responders, tending physicians and administrators on that fateful day. Hear firsthand their stories of heroism, compassion and perseverance.

Early-bird registration discounts are available through February 28th and discounts are also available for 3 or more registrants in a group.

In summary, 5 good reasons why you should attend CLIVE 2017:
  1. Dedicated Education Tracks
  2. Product Roadmap Sessions
  3. Earn Continuing Education (CE) Credits
  4. Exchange Best Practices with other Healthcare Leaders
  5. Meet GE Healthcare executives, product managers, developers and support service staff
Department of First Impressions
by Kathy Puziak CMPE PMP
January and the perfect opportunity to start the New Year with a checkup of your "Department of First Impressions", your front desk team.
Create an " Action Plan".  Ask the team for input-ideas and improvements that they would like to see addressed.

  Examples of "Action Items":
  • Are there current job descriptions in place and a clear reporting structure?
  • Has everyone had the training they need to be effective and successful.  Do you have a "New Hire" process in place that includes a "go to" mentor for the new hire?
  • Are workloads, and work schedules clearly defined?  Is there a plan for back up when busy, when someone is out sick or on a vacation?  Is the team cross trained to provide the back up?
  • Good time for a HIPAA review and the perfect opportunity to review password security.
  • Have some fun with a front desk greeting review-do you wear name badges, do you make eye contact, do you smile, do you acknowledge your customer's presence.
  • Is your sign-in counter clear and accessible?
  • Do you have clear, easy to read documents for your healthcare consumer to fill out-particularly new patient documents.  Documents that have been copied and copied and copied----and copied affect the perception of your office
  • Have a team meeting and have some fun with the "Action Items".


Notes in Group Management  
Part 4 in a Series on Notes
by Ellen Jakovich, 
Director of Training, KPG RCM  
Task Management Notes
Although not much formal documentation exists on Task Management notes, it is a vital function for users who work on charges and claim submission. For easy follow-up in the future, all comments pertaining to a certain task should be entered in Task Management notes (yellow folder) to attach the note to specific charge(s)/claim(s). Notes attached to charges/claims in Task Management include a date, time and user stamp. This helps identify who worked on the task while also making the note HIPAA compliant.

Before a charge is released as a claim and sent to a clearinghouse (EDI) it passes through a set of edits before being transmitted. If the claim contains an error, it will be routed to an Edit queue. Edit queues should be given high priority for issue resolution to minimize delays in claims processing. Once the required changes are identified a Task Management note is added, detailing the edits to be made to the charge. After the edits are made the charge will clear on the next edit run.

The next step in the process is claim review at the clearinghouse. If there is a problem with a single charge in the claim, the entire claim is rejected and returned to an EDI Task Management queue for resolution. Documenting changes is an important part of the audit trail. Knowing what has occurred and when is extremely important to making changes/corrections and rebilling the claim. Unlike rejections, denials are issued per charge, not per claim. This means that only part of the claim may be denied and must be corrected. The notes entered in Task Management become extremely important in cases where claim(s) needs to be appealed. All necessary information to produce a clean claim (e.g. edits and/or corrections made, the dates and times of changes, etc.) is right at your fingertips in Task Management.
If a charge has little or no documentation of non-payment it will "land" in the Ageing queues. Users who follow up at this point must research the entire charge history and EOBs to try and discern the reason for non-payment. If the charge traveled through the queues of the charge/claim cycle, and was documented in Task Management notes, precious user time is saved because the notes are still attached. You can find them in the blue bubble in the yellow folder under Inactive Tasks.
Using Templates
As with Coded Notes, if there is an area where specific information is crucial for follow-up, a template can be created and copied into the Task Management note, making it easy for the user to merely answer the questions in the template.
For example: a charge is denied for incorrect diagnosis and needs to be sent to a coder for the updated code. The following template could be used:    
              Original DX:
              New DX:            
              Coder updated:
Coders frequently do not work within Task Management or do not have security permissions to correct or edit charges. Others may not even have access to Task Management. This does not prevent them from using the "Added Note" function in Patient Manager / Transaction, storing the new codes for review or corrections by billers from within Task Management.  The note will be user, time, and date stamped and the biller will have the information required to correct and rebill the charge(s).
Other teams in the practice besides coders also have information required to correct a claim or charge but do not work within Task Management. A frequent item missing from a claim is the Authorization or Precertification number(s). Because the Pre-Authorization team may not have permissions to correct and edit charges, the following template could be used in a Task Management note to convey the information to the Billing Team:
              Auth/PreCert #:
              Dates active through:
Remember, If the charge or claim is ever tagged for an appeal, takeback, or refund, utilizing Task Management notes can save the staff multiple hours of follow-up review.


For more on Notes, check the Resource Library at