Thank You to Our Platinum and Presidential Sponsors

2006 Issue 3

2006/2007 ISSUE Three
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 M

President's Message

Dear fellow HFMA members:

As spring finally arrives in Northeast Ohio, we celebrate a new season and new beginnings. This is also a time to embark on a new season in our chapter. In January, we elected our officers and board members for the 2007/2008 chapter year and appointed new junior co-chairs to several of our key committees. Our newly elected leadership team traveled to San Diego, California, the week of April 22nd to attend the Leadership Training Conference where they networked with other chapters and obtained the skills they need to fulfill leadership responsibilities this year. Our officers will be formally installed at the Gerry Haggerty Leadership Conference at Quail Hallow Resort, May 21 - 23, 2007.

Although we are on the verge of a new beginning with our chapter, your current leadership remains committed to exceeding the aggressive goals that we set for this year. Several key areas on which we have been focusing include:

  • Continuing to meet with senior leadership of our local healthcare providers to make sure that our chapter continues to provide them with value.
  • Looking at ways to increase networking opportunities for our members while focusing on controlling our cost.
  • Working with National to continue the process of incorporating within the State of Illinois.
  • Implementing our succession planning process for leadership and committee chairs.

In This Issue…
click or scroll to see as article

In addition, Karen Mihalik, Chuck Josey and I submitted applications for our chapter to be considered for three Yerger Awards for the 2006/2007 chapter year. Yerger Awards are awarded to chapters that demonstrate innovative ideas that have been implemented and provide value to the membership. We have submitted applications based on our enhancements to the GHALI, our improved corporate sponsorship program and our succession planning process. Awards will be presented to the winning chapters at the Annual National Institute in San Diego, California, June 24 - 27, 2007.

Finally, I would like to extend personal thanks to all of you for the kind words and cards that you shared with me and my family over the past few months. I can not tell you how much it meant to me and my family to have the support of our HFMA family during this very difficult time.

I look forward to seeing you all at the GHALI as we start a new year full of promise and new opportunities.


Chris Milligan
President Northeast Ohio HFMA

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Membership Message

Thanks to all for participating in the most recent membership survey. The winner of the raffle was Mary Jane Reedy. Congratulations MJ!

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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 often for updates on events.

May 21-23, 2007Gerry Haggerty Annual Leadership InstituteQuail Hollow Country Club
June 21, 2007Professional EthicsCorporate College East
July 19, 2007Managed CareWindows on the River

ghali 2007 committee

The GHALI committee has worked hard for a successful program.

Some GHALI Highlights (and there are many!)…

Monday will have great keynote speakers. Seminars will be followed by a cocktail reception and dinner including filet mignon and Chilean Sea bass and Casino Night as entertainment…

Tuesday’s sessions will be followed by a choice of networking activity including golf, spa, wine tasting and shopping. The evening tops off with musical entertainment, and a themed dinner of “Food Across America” featuring the following:

  • New York – Coney Island chili hot dogs, French fries, buffalo wings,
    and long island iced teas
  • New England – shrimp cocktail, blue point oysters on the half shell, steamed clams
  • Texas – prime rib, smoked BBQ ribs, keg of beer
  • Lake Erie – fish fry of walleye and perch
  • New Orleans – jambalaya, sausage meatballs with red gravy and Hurricanes
  • Hershey, PA – Chocolate fountain

End the night at the Texas Hold’em tournament.

Be sure to be there!

If you have not registered, please do so:

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Past Event Recaps
A Presidential Affair

When I was given the honor of serving as president of our great chapter, the first thing I did was contact those past presidents who had come before me to learn from their experiences…and mistakes. In doing so, I began to realize that we could all benefit from their experiences, and we needed to make sure that we continued to honor them for all they have done for our chapter.

In an effort to both keep our past presidents engaged in our chapter and honor them for their commitment, the 1st Annual Past Presidents meeting was held on January 18, 2007, at Windows on the River. Over 18 of our past presidents attended as well as many current members and guests.

The evening began with an informative presentation, Revenue Cycle Management, by our friends at ARC Group Associates. Following that presentation, attendees enjoyed a wonderful dinner, drinks and networking. I'm sure you can imagine that, as the night went on, many of the past presidents began to share stories of their year as president and of the many memories and experiences that they had.

It was obvious as the night went on that embracing our past is one of the great ways to make sure that we succeed in our future. It is my hope that this meeting becomes an event to which we all look forward and that we continue to honor our past presidents.

PFS Review

Our chapter's annual Patient Financial Services program was held on February 22, 2007, at Corporate College East. The program featured four speakers on a range of PFS-related topics. Claudia Birkenshaw discussed issues with respect to the New UB-04 and the implementation of National Provider Idenfitiers.

Kevin Willis, Director of Medicare Operations at Claim Services, Inc. followed on the subject The New MSP National Recovery Contractor and Related Issues. Kevin's unique presentation style described the many issues associated with MSP billing and collecting and gave suggestions to help hospital's navigate this complex area.

Thomas Matthews, Business Development Manager for TransUnion Healthcare, talked about the increasing uninsured / underinsured population hospitals are serving. He gave an overview of technology and processes designed to identify and collect from those patients who could afford to pay their bill.

The last speaker of the morning was Diane M. Signoracci, Partner for Bricker & Eckler LLP. Diane's presentation focused on the legal issues of hospital charges and discounts.

Relationship Building Key for Creating Value in Physician Practices

The annual Medical Group Practice educational program was held on Thursday, March 29, 2007 at Corporate College East in Warrensville Heights. This program was divided into 2 sessions. The first session, Building Relationships with Patients, was presented by Michael J. Printy and Wally Ziegler of Source One, LLC.

Mike and Wally talked about how medical services advertising is now on radio, television, direct mail and billboards. To keep existing patients and attract new ones, practices will need to embrace “great customer service”. Consumer Driven Health Plans have begun turning patients into more informed consumers, providing even more incentive to provide great customer service.

Discussions then moved to the “cost” of poor customer services and the financial impact of losing customers as a result. Common areas of concern that practices should focus on include the reception window, the waiting room, telephone answering, discussions with the doctor and the billing process upon leaving the office.

The second session, Building Relationships Among Providers, Payors and Employers, was a panel discussion featuring Barbara Belovich from The Health Action Council of Northeast Ohio, John Fenner from Fenner Consulting and Joe Gregor from CIGNA.

From the payor perspective, one hypothesis was a radical change is coming, as the current healthcare situation is not sustainable in its current state. This “crisis” has both economic and patient care related implications. One proposed solution is to re-couple cost and consumption by creating financial ownership for members through Consumer Driven Health Plans.

From the consumer/purchaser perspective, there appears to be a huge lack of technology evidenced by the current use of paper forms and paper charts. As low cost international providers are now competing with U.S. providers, consolidation of practices has become a necessary consideration to leverage costs and increase quality and efficiency.

From the provider perspective, there is a lot of frustration and even anger in physicians’ minds. One perception is health plan executives are compensated millions of dollars while physician reimbursement sees little increases. On the topic of electronic health records, some practices may still question the usefulness and not have money available to implement them.

In this type of environment, the question still remains…how can relationships between providers, employers and insurance companies be improved?

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Kudos to You!

Our own Brian Quinn, Northeast Ohio Chapter Treasurer, completed the Boston Marathon on April 16th. Brian has been a runner all his life and qualified for the Boston by running a marathon in Columbus in 2005. The weather for this Marathon was some of the worst seen in many years. Heavy rain before the race caused flooding in many areas around the race. High winds with gusts up to 50 mph made running tougher than usual.

Of the 23,869 originally registered to race, only 20,614 actually started. Brian finished with a time of 3:53:46 - approximately 9 miles per hour overall. Brian brings home a long sleeved T-shirt and a commemorative medallion. Approximately 1 million people lined the streets of Boston to watch the race. Well done, Brian!

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Health Savings Accounts: Healthcare CFO’s Look for the Positive

Technology and systems will help hospitals embrace the HSA patient,
and improve patient satisfaction.

Health Savings Accounts (HSAs) are a boon to large corporations and consumers, but they also offer hospitals an opportunity to improve a patient’s entire experience with a healthcare organization, from the first point of inquiry to the final billing.

Recent studies indicate hospitals should jump at the opportunity: A 2006 national healthcare satisfaction report*1 from Press Ganey Associates concluded the healthcare industry in general "is not successfully responding to the opportunities for improvement presented by its customers."

Preparing for HSAs can help healthcare organizations alter negative consumer perception by:

  • Encouraging the development of a more comprehensive pre-service financial clearance process.
  • Pushing the adoption of on-line access to consolidated, consumer-focused billing
  • Requiring customer service and pricing transparency in hospitals, as patients with HSAs are empowered to be the “first payer” following treatment;
  • Forcing hospitals to put in place procedures and technology that facilitate information flow between the patient and the administrative staff;
  • Ensuring the correct patient information is up front and disseminated to all relevant administrative departments.

We know that patients are happier when they can simply show up for treatment and be quickly checked in, without having to provide demographic information again and again. Patients appreciate thinking that every person they encounter is thinking only of how to best care for them—not how the organization will be paid in the end.

Of course, most patients aren’t naive enough to believe hospitals exist purely for altruistic reasons. But their “patient experience” could be vastly improved if they were required to provide relevant billing information just once, and to have all of their records—from treatment to billing—accurate the first time, and accessible to all departments on demand.

HSA patients are savvy consumers, too, and want transparency in pricing and the opportunity to ask billing-related questions before turning their complete attention to their medical situation. For the healthcare organization, this means not only developing new policies for communicating pricing information, but creating new systems that facilitate upfront dissemination of pricing information, the review of the patients financial obligations and their ability to pay and completed the necessary follow up with the patient including approval for access to the HSA funds, and verification that funds are available for payment.

These systems must connect the front-end processes with the back end, procuring payment in a timely, accurate manner and with minimal impact to the hospital’s workflow—and minimal additional contact with the patient on billing matters.

But how? Hospitals must deploy end-to-end solutions that streamline cash flow and speed up reimbursement process. They must use an electronic system that allows direct access to federal health insurance program and be able to link all patient information to ensure true and complete financial picture.

In other words, the right technology and systems will help hospitals embrace the HSA patient, and improve patient satisfaction.

Each day, consumers are gaining power. Hospitals must find new methods of satisfying patient demands in unprecedented ways. Technology holds the key to meeting those demands.

Sheila Schweitzer is chairperson and CEO of CareMedic Systems Inc., a leader in proactive financial management. Schweitzer was elected to her current position in September 2004, after serving as the company’s president and chief operating officer since March 2003. She has an extensive background in the health IT realm and is a recognized industry visionary with almost 30 years in the healthcare field.

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Addressing Patients’ Financial Responsibilities in Pre-Access

By The Academy of Healthcare Revenue

With patients’ personal financial responsibilities on the rise, many hospitals have recognized the need to collect at point of service.

Requesting full or partial payment of patients’ financial responsibilities at point of service has become a practice vital to healthcare providers’ financial health. Specifically, insured patients’ out-of-pocket costs—which are significantly more difficult to collect after patients’ discharge—continue to rise. The second most-prominent strategy that most businesses employ to contain their health insurance costs is increasing cost sharing with employees, in the form of larger premiums and benefit amounts. Research has found that approximately two-thirds of surveyed businesses increased their insured employees’ co-pay or co-insurance responsibilities in 2006, while more than half of the businesses have increased individuals’ deductibles as well.

Academy research consistently shows that between 60 – 70 percent of surveyed providers do actively collect patient balances at point of service. However, some patients may be unprepared to pay when out-of-pocket costs are requested at POS, which may potentially cause surprise, reduce collections, and negatively impact patient satisfaction. In response to this concern, many best-performing hospitals are proactively addressing patients’ financial responsibilities prior to patients’ appointments. Following are several tips that these providers have found important.

  • Optimize Pre-Registration Rates and Activities. During pre-access, revenue cycle staff members can certainly advise patients that payment will be requested on the date of their appointments. However, in order to provide patients with their actual deductible or co-pay amounts, staff members will need to verify patients’ insurance coverage—often requiring an initial conversation with patients, followed by calling patients’ payers or verifying benefits through an online mechanism. Academy research shows that best performers currently pre-register 95 percent or more of scheduled patients—ensuring their benefits are verified and requests of deductibles and co-pays can take place at point of service.

    Some hospitals have begun to obtain patients’ insurance information during scheduling by asking referring physicians or patients to provide their insurer’s name and group number, as well as fax insurance cards to the hospital. Then insurance can be verified before patients are called by pre-registration staff—and at that time, pre-registration staff can inform patients of their actual benefit amounts, such as remaining deductibles.

  • Begin Financial Counseling Prior to Patients’ Appointments. During pre-registration phone calls, pre-registration staff members can also explain the payment options available to patients (e.g., credit cards and payment plans), while also informing patients that financial assistance is available for those who qualify. Pre-access also serves as an excellent opportunity for financial counselors to proactively call patients, set up meetings on patients’ appointment dates, and encourage patients to bring specific documentation (e.g., tax returns) that will help in determining their eligibility for aid.

    Based on patient volume and the size of hospitals’ financial counseling departments, patient access leaders can identify criteria for determining which patients will be contacted about financial assistance before service. The Academy’s research found one facility that pre-registers most patients 14 – 21 days in advance of their scheduled appointments, enabling financial counselors to identify which patients are registered as self-pay patients and begin the counseling process before the date of service. If a patient is registered for a visit as a self-pay patient, the hospital sends a welcome packet to them, which includes information in four languages about the resources available for individuals who are unable to afford the care they’re about to get. The packet also encourages the patients to bring certain documentation to their appointment, and to arrive early to see one of the hospital’s financial counselors.

    Alternatively, Academy research has found that financial counselors at another facility are responsible for collecting in pre-access. In this case, the hospital’s counselors receive a daily census of patients with high-dollar accounts over $200 whom they should contact to make financial arrangements before each patient’s date of service.

  • Utilize Multiple Means of Outreach. The informational packet sent to self-pay patients by the hospital cited earlier illustrates a very important point: informing patients of hospitals’ point of service collections and financial assistance policies does not solely need to be the responsibility of pre-registration staff. In fact, creating multiple outreach materials are vital in that they enable hospitals to convey their policies to patients who are not scheduled or pre-registered before service. For example, hospital brochures in local physician offices can explain why payments are requested at point of service, and how patients can apply for charity care. Communications such as advertisements or articles in local news media can also help to drive these points across, while firmly emphasizing hospitals’ commitment to serving all patients and helping them to afford the cost of medical care.

With patients’ personal financial responsibilities on the rise, many hospitals have recognized the need to collect at point of service. Furthermore, best-performing hospitals are adopting several strategies to ensure patients are aware that payments may be requested before care is provided, and that financial counselors are available to help those who may not be able to afford paying for services.

You can reach The Academy of Healthcare Revenue at 888.700.5223 or

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HFMA Member Benefits - Certification

One way to enhance your career potential is by becoming a Certified Healthcare Financial Professional (CHFP). HFMA's certification program provides you an opportunity to earn this designation when you meet the following requirements:

  • Be an HFMA member for a total of two years and be a current active member
  • Have two years of professional experience in the healthcare finance industry
  • Successfully complete the HFMA Core certification exam and one of the specialty exams - Accounting and Finance, Patient Financial Services, Financial Management of Physician Practices, or Managed Care
  • Obtain a reference from an elected HFMA chapter officer and your CEO or supervisor

The Certification Review Committee of the Northeast Ohio Chapter will hold an Overview Review Session for the Accounting and Finance Specialty Exam,(these topics are also in the CORE Exam) presented by Robert S. Matitia, CPA, CHFP MBA, MAFIS. The topics covered will be Capital Planning and Financing, Cost Analysis and Management, Strategic Financial Planning and Budgeting, Investments and Cash Management, Employee Benefits, Insurance and Risk Management, Internal Control, Financial Reporting, Accounting Principles and Auditing, and Corporate Compliance. If interested, please email

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Two boxers are in a boxing match (regular boxing, not kick boxing). The fight is scheduled for 12 rounds but ends after 6 rounds, after one boxer knocks out the other boxer. Yet no man throws a punch. How is this possible?

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:
Answer: mistaken
Winner: Ruth Homuth, Samaritan Regional Health System

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