Thank You to Our Platinum and Presidential Sponsors

2006 Issue 2

2006/2007 ISSUE Two
Corporate Sponsor Program
We gratefully acknowledge the commitment of our Corporate Sponsors who assist in the funding of the Chapter's programs and activities

Presidential Level
Ernst & Young, LLP
Human Arc
Long-O'Shea & Co. LLC

Platinum Club
CPS Statement & Paper Management System, Inc. Fenner Consulting
HRSI/FirstCredit International Corp.
Joseph R. Harrison Company, LPA
JP Recovery Services, Inc.
MedQuist, Inc.
Meridan Leasing
NatCity Investments, Inc.
Revenue Group/HRS
Total Practice Management

Gold Club
Kreg Information Systems
Squire, Sanders & Dempsey LLP

Silver Club
Healthcare Funding Solutions
Robert Half International
Masters Associates Receivables Management, Inc.
Quadax, Inc.

Bronze Club
Bruner-Cox, LLP
Calfee, Halter & Griswold LLP
CDR Associates, LLC
Engelhardt & Emrhein
HMC Group
Howard, Wershbale & Co.
ImaCS, Ltd.
KeyBanc Capital Markets
Mutual Hospital Services
NCO Financial Systems Inc.
OSI Support Services, Inc.
Per-Se Technologies
Professional Receivables Control, Inc.
Receivables Outsourcing Group
Resources Global Professionals
Ryerson Management Associates
UCB-A Receivables Management Company
Vorys, Sater, Seymour & Pease LLP
Wise Management Services, Inc.
Wolfskill & Associates

HFMA Northeast Ohio
Chapter Officers 2006-2007

Christopher Milligan

Karen J. Mihalik

Vice President
Charles S. Josey

Suzanne M. Tschetter

Brian K. Quinn

Chapter Coordinator
Kathleen A. Much

Board of Directors

Maureen A. Wood
Cynthia A. Dormo Robert S. Matitia Brian C. Nestor Laurie A. Rauser Mary Jayne Reedy Anna Sulewski

Visit HFMA National at:

Visit HFMA Northeast Ohio at:

Click here for Past Newsletters

HFMA Northeast Ohio

Joyce Gusman

Human Arc

Jorie Novacek

Parma Community General Hospital

Maureen Campbell
The MetroHealth System

Laurie A. Rauser
The MetroHealth System

Mary Jayne Reedy
Human Arc

Steve Rybka
United Collections Bureau

Email the Committee

Chris Milligan

President's Message

Dear fellow HFMA members:

Although we are starting a new calendar year, we are already well into our chapter year. In my initial presidential address, I referenced the national theme, "Courage in Leadership," and how my fellow officers and board members could embrace that theme to make our great chapter even better.

Over the past months we have surpassed many of the goals established in our strategic plan, and we are well on our way to accomplish our remaining goals. With the hard work of our president elect, Karen Mihalik, we have exceeded our corporate sponsorship goal. Our membership committee, headed by co-chairs Mary Jayne Reedy and Suzanne Tschetter, has done a fantastic job of increasing and retaining our membership and helping us to exceed the national matrix in this area. Robert Matitia has overseen the fine efforts of the certification committee to increase the number of our chapter's certified members.

In This Issue…
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Overall, with the hard work and dedication of many talented individuals, we are on our way to exceeding the expectations established by national. But let's not forget that this chapter is not just about hitting a certification or membership goal established by national. Our chapter is about providing great educational and networking events to our members …and, most of all, having fun!

Over the past months, we have held two very successful networking events - our annual holiday party and the 1st annual past presidents' dinner. Additional networking activities are planned for the remainder of the year, including a March Madness poker tournament and some new and exciting events at this year's GHALI. In the next few weeks, nominations will be held for new officers, board members and committee chairs to continue in the tradition of succession planning to allow new members to become more involved in leadership within the chapter. Those members who are nominated and elected will travel to San Diego in April for the annual Leadership Training Council. If you are interested in being considered for a position or know of a member who you feel would represent our chapter well, please let me know. After all, the success of our chapter is a direct result of our volunteers who serve as our chapter leaders.

Next month, chapter leaders will be submitting applications to national to be considered for Yeager Awards in the areas of membership, sponsorship, networking and education. The Yeager Awards will be awarded at this year's Annual National Institute (ANI), also to be held in San Diego in June. If you have never attended an ANI, I would encourage you to do so this year.

As you can see, we are on our way to completing a very successful chapter year. However, I know we can do even better. If you have a suggestion on how we can further improve on our chapter, I encourage you to speak up.


Chris Milligan
President Northeast Ohio HFMA

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NEO HFMA Sponsorship Update

Attention sponsors! If you were not able to attend the second sponsorship committee meeting of the year, please watch your mail for information about our premier event that is taking place on May 21-23 at Quail Hollow. The GHALI is a great opportunity to network with our members. We look forward to working with you to support this event. Please contact Chuck Josey, Dave Lang, or Bill Watson for further information.

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Committee Corner

Patient Financial Services

Historically, the PFS educational meeting has been one of the best attended seminars put on by our Chapter. The February 22'nd meeting looks like another "must attend" event. Last year over 110 people registered for this meeting and our advice is to register early this year. Speakers for this year's event include:

Suzanne Lestina - Technical Manager, HFMA Westchester Ill.
Tom Mathews - Bus Development Mgr, TransUnion Healthcare
Diane Signoracci - Partner, Bricker & Eckler LLP
Kevin Willis - Director of Medicare Operations, Claim Services Inc.

Watch for more details and registration forms soon.

Congratulations and Thanks from the Membership Committee

The HFMA membership committee recently conducted their annual survey and promised a raffle of all early returns. The winner of a gift card is Rick Jorz of Metro Health Medical Center. The second raffle of all participants will be on February 1st.

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Upcoming Events

Listed below are the remaining events planned for the 2006/2007 program year. Details and dates are announced as soon as they are available. Check the events calendar section of for updates on events.

February 22, 2007Patient Financial ServicesCorporate College East
March 29, 2007Medical Group PracticeCorporate College East
April 26, 2007Post Acute CareCorporate College East
May 21-23, 2007Gerry Haggerty Annual Leadership InstituteQuail Hollow Country Club

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Past Event Recaps

Annual Reimbursement Program, November 10, 2006

Our chapter's annual Reimbursement program was held on November 10, 2006 at Corporate College East. The program featured three speakers on a range of reimbursement-related topics. Tom Voytko, Quality, Appeals and Training Coordinator for AdminaStar Federal, discussed "hot button" Medicare cost reporting issues including Medicare fee schedule bad debts and required Medicare bad debt collection efforts; the SSI% calculation and Medicaid eligible days; requirements for counting and appropriate documentation of FTE residents for medical education; and wage index and occupational mix.

Joe Becht, a partner in the Health Sciences Advisory Services practice of Ernst & Young followed, presenting on the subject What Every Healthcare Finance Management Should Know About the Medicare Cost Report. Mr. Becht's presentation focused on the aspects of the cost report that had a direct impact on reimbursement by discussing the various inputs and calculations involved in each component of the Medicare cost report settlement.

The last speaker of the morning was Chris Mahler, Consulting Manager for Plante & Moran. After giving an overview of HCAP, the state's disproportionate share matching program, Mr. Mahler discussed compliance issues and recent changes to the Medicaid cost report schedule E/F.

This was our chapter's first experience with Corporate College East. Members in attendance gave overwhelmingly positive feedback on the facility. The meeting room was comfortable and bright with natural light, and the food served at lunch was definitely worth staying for.

10-26-06 HFMA / HIMSS : Collaboration of Information Technology and Finance in Healthcare

The need for cooperation between IT and Finance personnel is inevitable as up-and-coming technology and changes in how healthcare is marketed become reality. This was the theme of keynote speaker J.B. Silvers at the first convergence between the Northeast Ohio chapters of HIMSS and HFMA. Silvers, a legend in the healthcare environment Northeast Ohio, provided an engaging and provocative look into the future of healthcare, emphasizing how information systems are at the core of the changes to come in healthcare due to the emergence of consumer directed health plans (i.e. high deductible plans). These are the fastest growing new benefit, nearly doubling every year. Consequently, consumers of health care will be more cautious on how they spend their money. The market will be driven by outcome measures, as individuals "google" where they should have their MRI or colonoscopy. Even if only 15-20% of consumers shop around for their healthcare, providers of care will lose out if they are not attracting those patients. While there are key challenges to this outlook, like how the government impacts these changes, Silvers' perspective provided an intriguing looking into the future. Silvers can be reached a, or for information on Weatherhead, go to

Next up was Richard DeSoto from Perot who spoke about leveraging EDI to improve revenue cycles. By using transaction code, providers can better assess eligibility and out of pocket expenses more quickly. EDI opportunities provide the ability to measure, report, retrieve and support financial operations.

Jim Bransfield, from Hewlett-Packard discussed making a business caser for IT projects. One has to translate technological solutions to business value. By using a template for projects, all the bases are covered, and are likely to make them more palatable, because "being right is not good enough to sell it".

Charlie Robinson from Medquist discussed computer assisted coding. CAC is the "use of computer software that automatically generates a set of medical codes for review validation and use based upon clinical documentation provided by healthcare practitioners." Emphasizing that technology is great, but always should be reviewed, CAC provides efficiency and a tool to address the shortage of coders and can positively impact turnaround time from service to billing.

The afternoon panel discussion "Information Security Issues in Patient Financial Transactions and EDI", included Kevin Cash, (Ernst and Young), Anthea Daniels (Calfee, Halter and Griswold), Alan Ogilbee (University Hospital) and Ashoke Talukdar (Metrohealth Systems). They offered engaging conversation and often levity while they answered questions about how to ensure PHI and EPHI remain secure. When addressing the question "what keeps you up at night?" all the panelists stressed a common sense approach and limiting when PHI is taken from the office is key to compliance. They also agreed that the issues lie more WITHIN the institution versus the fear of outsiders actually hacking into IT systems.

A wine and cheese reception topped off the day. As a long time HFMA member, I found this a very beneficial meeting, as there is such a need for collaboration and communication between IT and Operations. I would recommend more sessions and encourage HFMA attendance.

2006 Holiday Banquet and Awards Dinner

With the evening in downtown Cleveland, food and service provided by the Ritz, a magician amazing every table, Christmas trees lighting up the room, the Fairview High Scarlet Singers filling the air with carols and all of this at the Silver Grille, how could it get any better? The answer is that it couldn't!

What a delightful evening our chapter had at this year's event. For one evening, there was no hustle or bustle of the holidays, just friends, food and fun. Chapter President Chris Milligan passed out awards after dinner and the night ended just as it started, with friends spending time with friends.

Many thanks to the Network Committee headed by Joyce Gusman for all their hard work. It should be noted that those beautiful invitations you received were donated by HumanArc and the Magic of J.R. Grieco was provided by UCB.

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Community Benefit: What Counts?

Does a health fair count as a community benefit? What about the time our hospital employees spend volunteering in the community? And what's the answer on whether or not to include Medicare shortfalls and bad debt as community benefits?

It is imperative to explain that your not-for-profit hospital is fulfilling its mission as a charitable organization to justify the tax exemptions received from the federal, state, and local governments. For reporting, you want to capture all of your community-benefit dollars to show the true extent of investment. At the same time, what is reported as a community benefit must be creditable and distinguishable from simply the costs of doing business.

CHA/VHA Guidelines
In June 2006, the Catholic Health Association (CHA), in cooperation with VHA Inc. (VHA), released guidelines on what to count as a community benefit in A Guide for Planning and Reporting Community Benefit. Based on years of work in the field, the Guide provides value to health care organizations in planning and developing an overall community benefit program, as well as providing recommendations on what and how to count community benefits. Chairman Grassley of the Senate Finance Committee, PricewaterhouseCoopers, and The American Hospital Association, among others, have encouraged health care organizations to adopt the CHA/VHA guidelines.

Community Benefit includes:

º Charity care at cost

º Government-sponsored indigent health care - unpaid costs of public programs

  • Medicaid
  • State Children's Health Insurance Program
  • Medically indigent programs

º Community benefit programs and activities that provide treatment and/or promote health and healing as a response to identified community needs; they are not provided for marketing purposes. The Guide details seven categories (A-G):

  1. Community Health Improvement Services
  2. Health Professions Education
  3. Subsidized Health Services
  4. Research
  5. Financial and In-Kind Contributions
  6. Community Building Activities
  7. Community Benefit Operations

Answers to the Opening Questions
In the absence of federal or state law, the ultimate decision on what to include in your community benefit reporting rests on you. However, using the CHA/VHA guidelines will give you firm ground for your decisions based on the tried-and-true experience from varied hospitals and health systems. It should also position you to report with creditability to internal and external groups, including the Ohio Hospital Association.

Should you count a health fair as a community benefit? The recommendation is to count health fairs that are held in locations accessible to the broad community, including underserved populations. They are designed to improve health status through linkage to needed care. A health fair that's purpose is to bring market share into the health care organization should be recognized as a marketing activity and not as a community benefit.

Can you count the time that hospital employees spend volunteering in the community? If the employee is acting on behalf of the hospital, on paid time, and participating in a hospital-identified community benefit activity, the recommendation is to count the value of the staff person's time as a community benefit expense.

Should either Medicare shortfalls or bad debt be included as community benefits? The CHA/VHA guidelines recommend that neither Medicare shortfalls nor bad debt be included in the total community benefit dollar value. The Ohio Hospital Association is asking Ohio hospitals to report community benefits using the categories in the Guide, and then list both Medicare shortfalls and bad debt at cost below the community benefit total dollar value line.

Patsy Matheny consults on community benefits with individual hospitals/health systems, regional and national organizations; RR 1 Box 554, Sugar Grove, Ohio 43155; phone 740-746-0286; fax 740-746-0295;

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Ghali - May 2007

Need something to look forward to? . . . Mark your calendar for the 2007 Gerry Haggerty Annual Leadership Institute (GHALI)! The annual event will be held from Sunday, May 20 until noon on Wednesday, May 23. By popular demand, the conference will once again be held at the Renaissance Quail Hollow Resort in Painesville, Ohio.


The conference educational sessions will begin on Monday morning with networking events held each evening. Additionally, Sunday may be used to play a full 18 holes of golf at Quail Hollow Country Club's Delvin-Von Hagge championship golf course, host site to the PGA Ben Hogan, NIKE,, and Nationwide Tours for 12 straight years. There will also be a Welcome Reception at Quail Hollow on Sunday evening.

The 2 and-a-half day conference will also feature a vendor fair and educational sessions with separate tracks designed for urban and rural facilities. Many exciting speakers have already been confirmed. Watch for more information over the next few weeks!

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Puzzle - Numeric Jumble

I am eight letters long - "12345678"

My 1234 is an atmospheric condition.
My 34567 supports a plant.
My 4567 is to appropriate.
My 45 is a friendly thank-you.
My 678 is a name.

E-mail or fax your answer to Joyce Gusman at All correct answers will be included in a drawing and one lucky entrant will receive a $25 gift certificate to Giant Eagle.

Previous puzzle: Semantics
Answer: women
Winner: Barbara French, from UH Hospitals, who won a $25 gift certificate to Giant Eagle.

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