Welcome to spring and goodbye to winter.  It is better that the white on the ground be a golf ball rather than a couple feet of snow (even if the ball is in the other fairway!).

It appears that the economy is showing some consistent signs of improvement, which is welcome news to all of us.  The question now is how will healthcare reform impact our industry?  While there seems to be some potential positives in the gargantuan bill, the proof will really be in the implementing regulations.  How will the terms in the bill be defined and interpreted?  Certainly more people will be covered by insurance, but what will be the impact on other reimbursement such as the remaining level of uncompensated care and Medicare Disproportionate Share Hospital (DSH) payments?  What will the President’s commitment to fund much of the reform on the backs of providers in the form of ever-expanding efforts to reduce billing errors, fraud and abuse bring?  Will it become such a burden on providers whereby you are in the position of constantly having to respond to inquiries and defend yourselves while attempting to comply with some of the most complex billing and coding requirements of any industry?  How will providers have to reposition themselves in terms of the delivery of care to address declining reimbursement and increased demand?  These are huge questions and we must all be diligent in staying on top of reform developments and planning strategically to ensure the best possible outcome. 

As you have come to expect, the BESLER team is monitoring all of these areas and more.  As always, we will be prepared to help our clients in assessing the impact of reform on their operations and we will be able to advise our clients on how to cope with the impending changes.  If you are looking for strategic assistance with anything from evaluating FQHC opportunities under the reform bill to optimizing participation in existing government programs such as 340B, we can be of assistance. 

Our Coding, Accreditation & Clinical Services team is available to support your internal efforts to measure compliance and improve coding and documentation so as to minimize potential exposure related to hospital and professional billing down the line.  The RACs are just the tip of the iceberg – a solid operation that is able to effectively manage, respond to and track requests from a growing number of government agencies and incentivized contractors will be critical to future success.  BESLER’s expertise coupled with a strong, active internal compliance program can do wonders to reduce the uncertainty of the future.

There has been no time that is more critical than now to take a hard look at all aspects of provider reimbursement.  This includes a review of Medicare cost reports, assessment of data reporting impacting the wage index and ensuring that you capture every eligible DSH day.  Looking to assess specific service areas and wondering about the implications of expanding or contracting the service? BESLER’s reimbursement team can guide you all along the way.

At the same time, we will continue to offer our expansive revenue integrity and recovery services to ensure that no cash goes uncollected.  We pride ourselves on our no-risk approach to recovering missed dollars in areas such as transfer DRGs, Medicare Advantage IME, Section 1011, the 72 Hour Rule and aged receivables.  Of course, our professional staff can also lend assistance in process improvement across the revenue cycle. 

Now is the time to ensure that you are operating at full efficiency: reducing exposure and capturing every dollar to which you are entitled.  We can help and will tailor our approach to your specific needs.  If we do not have the expertise in your area of need, we pride ourselves on maintaining excellent strategic partnerships so that at the very least we can guide you to the right resources.  So, feel free to reach out to us no matter what your need and we will do all we can to help you or point you in the best direction.

We look forward to hearing from you and continuing the BESLER tradition of going the extra mile for our clients.  As we move toward years of reform measure implementations, BESLER is striving to keep you on the right path through uncertain times.

Very truly yours,

Brian P. Sherin, FHFMA

President

BESLER Consulting