Thank You to Our Platinum and Presidential Sponsors

2007 Issue 3

2007/2008 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
Fenner Consulting
Joseph R. Harrison Company, LPA
HRSI/FirstCredit International Corp.
IC Systems
JP Recovery Services, Inc.
MedCom Solutions
NatCity Investments, Inc.
Revenue Group/HRS
Total Practice Management, LLC

Gold Club
CareMedic Systems
RelayHealth (Formerly Per-Se Technologies)
Squire, Sanders & Dempsey LLP

Silver Club
Cirius Group, Inc.
Kreg Information Systems

Bronze Club
ARC Group Associates
Bruner-Cox, LLP
Calfee, Halter & Griswold LLP
CDR Associates, LLC
DMI Transitions
Engelhardt & Emrhein
HMC Group
JP Morgan Chase
KeyBanc Capital Markets
Masters Assocs Receivables Mgmt, Inc.
NCO Financial Systems Inc.
OSI Healthcare Services
Quadax, Inc.
Receivables Outsourcing Group
Resources Global Professionals
Sanford Rose Associates - Executive Search
Senex Services
Vorys, Sater, Seymour & Pease LLP
Wise Management Services, Inc.
Wolfskill & Associates

HFMA Northeast Ohio
Chapter Officers 2007-2008

Karen J. Mihalik

Charles S. Josey

Vice President
Anna Sulewski

Susan R. Flaherty

Suzanne M. Tschetter

Christopher Milligan

Chapter Coordinator
Kathleen A. Much

Board of Directors

Jack L. Bailey
Cynthia A. Dormo
Joyce Gusman
Michael J. Manfull
Robert S. Matitia
Mary Jayne Reedy

Visit HFMA National at:

Visit HFMA Northeast Ohio at:

Click here for Past Newsletters

HFMA Northeast Ohio

Joyce Gusman

Jack Bailey

Steve Rybka

Email the Committee


President's Message

Dear fellow HFMA members:

Happy New Year! I hope that all of you enjoyed the holiday season. Many thanks to our Networking committee, chaired by Steve Rybka, for the wonderful evening at our annual Holiday Party and Awards Dinner. The tradition of top-notch networking in a festive, elegant setting continues. Our chapter's annual 50/50 raffle raised $900 for Harvest Home; many thanks to our raffle winner for donating their contribution. We demonstrate HFMA National's theme of Making a Difference and appreciate your involvement.

What's your New Years Resolution? When it comes to my professional development, I believe that becoming a certified member of HFMA is a great investment. I recently ordered my study materials and plan to make my HFMA certification a personal goal for 2008. We do have study resources available to help you. Please contact me or Bob Matitia if you would like additional information. Congratulations to Grace Jen of the Cleveland Clinic who has recently completed her certification!

We are in the heart of our program calendar. The offerings this year have been outstanding, and the upcoming events will continue to provide quality speakers on timely topics. We look forward to seeing you at an upcoming event!

In This Issue
click or scroll to see as article


Karen Mihalik
Northeast Ohio HFMA Chapter President, 2007-2008

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A Great Way To Start The Holidays!

We tried to warn you in previous newsletters and emails. We announced our expectations at the start of our fall meetings. We moved the event near I-71 so everyone could get there. And almost 100 members and guests were treated to one of our best party and award banquets yet.

Blue Heron Golf Club welcomed us with candles up the walkway, a beautiful Christmas tree in the lobby along with a quartet of carolers singing and playing holiday classics. We had the "magic of JR Grieco" mixed with a large table of appetizers as we walked into the ballroom decorated for the holidays. With background music by TKO Entertainment our focus switched to dinner that was topped off by a huge chocolate fountain with fresh fruit.

How could it get any better? President Karen Mihalik (joined by her lovely assistant Jim Hutchinson) passed out the awards for the year topped off by Chris Milligan receiving the very prestigious Muncie Gold award. A very special moment was taken to thank and acknowledge Kathy Much for her years of service and commitment to the chapter. First time for a standing ovation in chapter history (just a guess).

To close out the evening, we had our annual 50-50 drawing for Harvest Home, our designated charity. Although Mary Jane Reedy from Human Arc won the raffle, she very graciously kept with recent tradition and donated her winnings back to the charity. The following day, I had the pleasure of delivering a $900 check to harvest Home in Akron.

The evening ended with dancing until they closed the doors on a wonderful memory. The annual Dancing with the Stars Award went to Suzanne Tschetter from the Cleveland Clinic. She promises to give us all lessons before next year's event.

Congrats to the Networking Committee on a job well done. They are Michael Vydra, Steve Rybka, Evelyn Dobbins, Bill Emrhein, Joyce Gusman, Dan Hardwick, Lisa Hilling, Mary Jane Reedy, Ellen Zizis, Tammy Zografos, Rene Maira and Coletta Victor.

View Photos From The Event

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Award Winners


Robert S. Matitia
Mary Jayne Reedy
Joyce Gusman
Peter Ryerson


Carl S. Ebner
Brian Quinn


Chris Milligan

Dale Reed Award

Chris Milligan

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Member Experience:In My Own Words

My first experience at HFMA's national conference (ANI) was a very enlightening experience for me-personally and professionally. I first started in healthcare in October of 1997. Not long afterwards, I decided healthcare is the industry I wanted to pursue. However, at that time, I did not know what I wanted to do or where I wanted to go with my career. I had a great boss at the time so there was no consideration of the career path. He was always challenging me with new duties every six months or so.

I had requested to attend ANI in 2006 but was not approved. How perfect that was in retrospect. I was excited to be able to attend 2007's ANI. I could not wait to hear the keynotes-General Colin Powell, James Gilmore, and Quint Studer-speak. I had signed up for some interesting breakout sessions, too. I even signed up for a whole day seminar on the Medicare Cost Report.

I learned quite a bit from the breakouts as well as the keynote speakers. However, what most impacted me were two things: One, Mary Beth Briscoe's speech she gave as the new HFMA chairman; and two, Quint Studer's keynote speech.

Mary Beth Briscoe's main theme in her speech was "to make a difference." She related an experience she had that helped her to realize healthcare is more than just the numbers. It is about the customers we service-our patients and their families and friends. Quint Studer's keynote about evidence based leadership hit a chord with me. It made sense.

Needless to say, both of these people energized me. They cleared the path before me as far as where my career is to go. I had a purpose and a drive. I know where I want to be and what I want to be doing in the next three to five years. Most importantly, I believe I will get there.

As I mentioned earlier, not attending in 2006 was by "divine intervention." I do not believe I would have garnered as much from that experience as I did from attending in 2007. It was, as I stated before, a very enlightening experience.

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HFMA Certication


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, 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 . A mutually convenient date and time will be set for the Review Session for interested parties.

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Medical Group Practice Session: Jan. 17th, 2008

The Medical Group Practice session kicked off with a presentation by A. Gus Kious, MD entitled "Beyond Physician Recruitment: Building, Maintaining, and Driving to Top Tier Performance." Dr. Kious is the 2007 recipient of the Physician Executive of the Year Award from Medical Group Management Association. As President of Huron Hospital - Cleveland Clinic, he created a high-performance environment that revolves around quality, safety, improved health outcomes, creativity, and has given his hospital a "green" makeover to an environmentally friendly place. Dr. Kious highlighted his methodology for improving recruitment and retention and shortening his hospital's length of stay through a hospitalist program. Analyses of the physician market and supply, financial benchmarks, strategies for physician recruitment, and a new model of care were shared.
View Presentation (powerpoint)

Jeff Smith, Esq., Director of Government Relations at OSMA, represents members before the state legislature, executive agencies, Ohio Congressional delegation, and the Ohio Lobbying Association. His presentation, "Managed Care Reform - a Legislative Update", addressed OSMA priorities re: our healthcare system, managed care and administrative simplification, and medical liability. The physicians' framework for health care reform includes access, wellness & prevention, personal responsibility, quality & transparency, and financing priorities. He explained the background and initiatives within the House Bill 125, "the Healthcare Simplification Act - patient care, not paperwork" and detailed the components of transparency and fairness in contracting, standardized credentialing, and web-based insurance eligibility verification. Jeff closed with a summary of the positive impacts of medical malpractice reform within Ohio.
View Presentation (powerpoint)

Chris Kalkhof, Director of the Provider Revenue Cycle and Managed Care Lead at Deloitte Consulting LLP, presented "Medicare Advantage Plans: A One Way Street - the Physician's Perspective." Chris explained the changing economic landscape for physicians under managed care delivery/ financing models then detailed the Medicare Advantage Program and the various impacts that MA Plans (HMO, PPO, PFFS, MSA, SNP) each have on patients/ enrollees. He compared and contrasted the Medicare program and the Medicare Advantage Plan physician and hospital reimbursement, outlined the key drivers of revenue, and emphasized the importance of business intelligence and getting the right information to the right people for effective contracting to maximize revenue. Jeff shared guidelines for contracting and tactical questions for practices to evaluate MA contracts and closed with key implications for physicians and group practices.
View Presentation (pdf)

View Photos From The Event

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Post-Acute Session January 17, 2008

The Post-Acute session kicked off with a presentation by Carol Rolf, Esq. Carol is the President and Senior Partner of the law firm of Rolf & Goffman. She has extensive experience in the representation of diverse health care providers in a variety of matters involving Medicare & Medicaid audits and appeals, licensure, certification, survey and enforcement, risk management, employment, fraud and abuse compliance and defense. She has been recognized by Law & Politics Magazine as one of the top 100 attorneys in Ohio and is a nationally recognized speaker. Carol discussed current issues and problems impacting long-term care operations. Topics included Corporate Compliance, Tort Liability, Audit and Reimbursement, Ancillary Contracting, Survey, and CON and offered practical solutions to many of the issues discussed, as well as suggested best practices.
View Presentation (powerpoint)

The second session, entitled "Current Trends in the Capital Markets, Including Impact of Recent Sub-Prime Meltdown" was presented by Amy Hayman. Amy is Senior Vice President of Cain Brothers. Amy brings 18 years of corporate and investment banking experience to her clients. During her tenure as an investment banker in the senior living industry, Amy has completed transactions totaling over $2.5 billion in par value. Amy has experience in management, structuring, and financial analysis of a variety of senior living transactions, including letter of credit backed variable-rate demand bond issues, insured variable rate demand bonds and variable rate auction bond issues, multi-facility system obligated group financings, fixed rate insured bond issues, bond tenders, advanced refunding, as well as various swap transactions. Amy's presentation focused on current capital markets and trends, including the impact on capital markets as a result of the recent sub-prime loan debacle. Her presentation provided attendees the opportunity to compare their organizations' current borrowing scenarios with market trends.
View Presentation (powerpoint)

J. William Kutschbach presented a post acute reimbursement update during the final presentation. Bill is a Principal of Howard, Wershbale & Co. and the Director of its HW Health Care Advisors. Bill represents numerous long-term care facilities and post acute providers in all facets of Medicaid and Medicare reimbursement and operational consulting. Bill has been involved in the industry for more than 25 years and was formerly the Chief of the Bureau of Medicaid Reimbursement for the State of Ohio. Bill is a frequent lecturer on various health care reimbursement topics, for national and local organizations including various national and local long-term care provider groups, the OSCPA and HFMA. Bill's presentation covered current Medicaid and Medicare payment systems' issues relative to funding for post-acute care providers and related trends, issues and opportunities on the horizon.
View Presentation (powerpoint)

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Guiding Principles for Healthcare Providers

Debt collectors longstanding commitment to respectful practices

How do you know what your healthcare collection agency (or ARM agency), stands for? Can you be assured that your patients will be handled respectfully while payment for their outstanding debts is being pursued? A new document recently adopted by ACA International, the Association of Credit and Collection Professionals (ACA), can be a valuable new tool as you analyze your facility's relationships with all ARM agencies.

The first document is the Code of Ethics and Code of Operations. (For the full text, visit The second document is the Healthcare Collection, Servicing and Debt Purchasing Practices-Statement of Principles and Guidelines. These documents represent voluntary practices that will help ACA members continue to align their services with the unique mission of each of their healthcare clients. (For the full text, visit

An ACA task force of collection agencies, debt buyers and healthcare providers developed these important principles to serve as a roadmap to positive patient relations at every point along the collection timeline.

ACA members may choose to sign the optional Confirmation of Commitment included in the document, to outline key areas of patient communications, business relationships and quality assurance that their company will strive to achieve. A good business agreement carefully spells out when and how services are to be delivered. But by signing the commitment and sharing it with a healthcare client, an ACA member signifies they've taken your core values and internalized them in order to best meet your needs.

So, what does this document mean to you as a healthcare provider?

Due to the increased focus on healthcare collection and payment processes by the media, regulatory agencies and state and federal legislators, providers are looking for assurances that their relationships with patients will be managed appropriately. By encouraging your collection agencies and debt buyers to sign the commitment, you can help educate stakeholders about the values you and your business associates espouse.

If you want further assurances, you may even ask for it to be included as an addendum to your business associate agreement, your collection servicing agreement or the healthcare debt purchase agreement.

The document may also serve as a checklist of items to consider before entering into a debt sale, collection or servicing agreement. ACA's Statement of Principles is a means by which members and clients can open a dialogue about engaging in the type of collection practices that will maximize revenue while at the same time preserving and protecting the patient relationships on which both parties depend.

The role that the documents play are simply to put in writing what was an unspoken fact in the past - that healthcare collectors and debt servicers are a professional and ethical group intent on helping providers maximize receivables while treating patients respectfully and within the bounds of all applicable laws and regulations.

Dan is the Business Development Director at RBC, Inc.

Much of this information has been made courtesy of ACA International. ACA International, founded in 1939, brings together more than 5,500 members worldwide. For more information about ACA International, visit

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ORHS's Efforts to Improve Patient Access Work Quality and Accuracy

Since implementing web-based Registration Quality Improvement (RQi) in June of 2005, Orlando Regional Healthcare System (ORHS) has measured 99% billing accuracy for all registrations. ORHS records 50,000 registrations per month and one day AR of $2.6 million annualized.

"With RQi we are able to look at the account in two ways: Discharged (D) and Billed (B). With our manual process that was showing us 10% of accounts registered, we were usually in the 83-85% range," said ORHS Director of Patient Business Craig Pergrem.

"As a corporation, we stand at 99% and have not been lower than that since May 2005. Several of our facilities maintain a score of 100% at 'B' status, as well as, many of our representatives maintain 100% in both 'D' and 'B' accounts."

ORHS has been working to improve patient
access professionalism, accuracy and accountability.

Upon implementation, management was able to learn about the system in a live environment for one month. Following that, RQi was rolled out to staff with a 30-day grace period to learn the system without having it impact their coaching plan score.

"RQi is a continuous education tool that each staff member receives daily." Pergrem said. "They are able to look at their errors on a daily basis and not only see what they did wrong, but get a chance to correct it themselves and know why the error was made."

"The reporting capabilities in RQi allow us to pull reports on individuals for that period and break it down by error and the total account dollars that could be or were impacted with those errors."

ORHS has been working to improve patient access professionalism, accuracy and accountability for years. By implementing RQi, ORHS has implemented the newest most cutting edge and cost effective way to review and account for 100% registration and information accuracy while achieving a level of employee training and accountability never accomplished before.

For more information on Registration Quality Improvement, contact Chuck Kramer at 407.872.7969, or visit

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Save The Date

You do not want to miss these two upcoming educational sessions!

Revenue Cycle and You and Registrations Link to the UB-04
February 19 & 26, 2008
AM Sessions (both days)
Guest Presenter: Lorraine Schnelle, CPA - Bridgefront
Learning Objectives: These "one of a kind" sessions are designed specifically with the front line patient access team member in mind. The participants will gain an in depth understanding of the revenue cycle process, its key players and ultimately the impact it has on the financial success of the hospital. They will also have the opportunity to dissect the UB-04 and gain an understanding of how to avoid a variety of processing delays and denials as it relates to the data gathering at patient intake. If you or your patient access team members have been looking for a workshop to clearly explain the revenue cycle and make it meaningful and applicable to your facility ... you will not want to miss these sessions.

Cost Reporting 201
February 28, 2008 - All Day
February 29, 2008 - AM Session
Guest Presenter: Walt Theado, CPA - Plant Moran
Guest Presenter: Pete Harmon - Health Financial Systems
Learning Objectives: For the first time, the Northwest Ohio Chapter of HFMA will be presenting a multi-day session. These sessions are specifically targeted toward expanding your knowledge of the Medicare Cost Report. There will be in depth sessions on various key issues like Medicare Bad Debt, Wage Index, and Physician Time Studies. For those of you at Critical Access Hospitals, we have not forgotten about you, as focus will be given to issues that directly affect your facilities. Each participant will also learn how to maximize the use of their cost reporting software from one of the leading providers in the industry today - HFS. If you or your reimbursement staff have been looking for a workshop to "brush up" or expand upon your knowledge of the cost report ... you will not want to miss these sessions.

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Help Wanted

We are seeking members who have technical/graphics or website experience that can help us enhance our communication to members. If interested, please contact Karen Mihalik at

Also, the newsletter committee is always in need of some additional help. No experience required! If you can help out please contact Joyce Gusman at


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Kudos to You!

Mary Jayne Reedy has been nominated and approved to serve the American Red Cross Blood Services Northern Ohio Region as a member of the Executive Committee in addition to her role as a member of the Board of Advisors and the Chair of the Donor Recruitment Committee

University Hospitals Finance structure changes include:

  • Maria Jayoussi has been promoted to Finance Director for Cancer Services.
  • Ken Lakota has been promoted to Finance Director for Women's and Children's Services.
  • Brian Nestor has been promoted to Finance Director, Decision Support and Managed Care Finance.

Mike Fiorilli has been named Director of Billing for Cleveland Clinic Health System.

Anthea Daniels had twin girls last June - Alexandra and Madeleine.

Congrats to Sameer Alramahi of University Hospitals' Internal Controls Evaluation and Audit Department on successfully completing the fourth and final part of the CPA examination.

Matt Rish started a new job as the Finance Director at Hillcrest Hospital. Matt was formerly the Director of Finance at St. Vincent Charity Hospital.

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Puzzle - Be My Valentine

By Jack Bailey

Freddie was in love - with three girls from his school! He couldn't decide which one he wanted to give his heart to so he sent all three a Valentine's card. But poor Freddie was out of luck - each girl thought the card came from someone else and Freddie was left on the sideline.
From the clues below, can you work out the name of each potential sweetheart, the colour of each card Freddie sent and the name of the boy each girl believed the card was sent by?

    Unluckily for Freddie, when Miss Jetson received her card, she thought it was from Adam.

    When Molly received her blue coloured card, she told Miss Hanson and together they worked out whom the card was from. It didn't occur to either of them that it was from Freddie!

    The girl who received the red card was convinced it came from Ethan.

    Neither Millie nor Miss Motson received a pink card.

First Names: Lily, Millie, Molly
Surnames: Hanson, Jetson, Motson
Colours: Blue, Pink, Red
Boys: Adam, Dylan, Ethan

E-mail your answer to Jack Bailey at All correct entries will be included in a drawing and one lucky entrant will receive a $25 gift certificate.

Previous puzzle: Shriekville's Ghosts


NameGhost's NamePlaceNameType of Dwelling
ArchibaldBloodcurdling BrianSt George'sHotel
BillyChilling CharlieRosedalePub
CharlieTerrifying TonyHigh LodgeBungalow
GaryCreepy CraigBriar HillBed and Breakfast
LucasMacabre MalcolmAvalonCastle

Winner: Bob Kaliszewski of UHHS/CSA won a $25 gift certificate to The Cheesecake Factory.

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