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I’m sorry, I can’t tell you.
Submitted by Cindi Moore from Health Care Connect in Canton, MI.
What does one experience once they’ve grown cold to
HIPAA compliance threats?
What do you call someone who complains incessantly
What do you call urgent HIPAA issues?
What do you call someone who thinks HIPAA is sweet?
What is the disease you get from too much HIPAA?
What do you call someone who is delighted with HIPAA?
Out of the mouths of Babes (kids answered these
What is the fibula?
A: A small lie.
Q: What does 'varicose' mean? (I do love this one...)
Q: Give the meaning of the term 'Caesarian Section.'
A: The Caesarian Section is a district in Rome.
Q: What does the word 'benign' mean?'
A: Benign is what you will be after you be eight
Have a good, clean medical joke? Send it to
AMBA 2009 National
Conference - Mission Accomplished
2009 Conference Success
We had a phenomenal conference this year, thanks to all the
attendees, speakers and exhibitors. For the past several years, we've
been hovering at around 100-115 attendees. This year, we had more than
175, counting exhibitors. We had double
the number of exhibitors that we normally have
and we had a lot more attendees this year. In
today's economy, we believe a real statement was
made - that AMBA members are committed to their
educational growth and development.
Our National Advisory Board Members and Local Chapter Officers met on
Wednesday, October 14th, for our
annual working dinner. This was the largest gathering we've had for this
event and we want to thank everyone for coming to Vegas a day early to
Playing "hot-potato" before adjourning the meeting. No one knew the box
actually contained a $50 gift card from Staples. Janet Woolsey, ("JW"),
happily accepted the prize. Thanks to Lisa Bugsalewicz, AMBA Chapter
Coordinator for providing that gift.
AMBA members, Jennifer Brisse, presents her breakout on
marketing and billing for EMS.
Lunch on Day 1 - Are you in this picture?
Members Cheri Freeman, Rey Stafford (left 2), Ann
Brunk and Sheila Hokes (right 2) assist Elvis (Brice Duffie, middle)
in presenting Cyndee & Larry Weston with gift cards, flowers and a
plaque all paid for by AMBA Members. (A pleasant surprise!)
Cheri Freeman and Elvis (thank you! THANK YOU VERY MUCH!)
AMBA's Social event was a big hit!
Jake Harper and Harrison Peery with Liles Parker take time
out to get their picture taken
Conference SynchVue DVD ROM
We had some really great presentations during the conference. If you
were unable to attend, you can still benefit by purchasing the SynchVue DVD
ROM of the conference. It is full audio along with the presentations - just
as if you were there - earn 6 CEUs.
Click here to learn more
I wanted to
make sure that
all of you know
how much Larry
gift cards, the
plaque and the
flowers. It was
such a wonderful
your gifts and
simply over the
Thank you so
2009 Award Recipients
Member of the Year - Ann Marie Brunk,
5 Star Award - Mori West
Director's Award - Karla Webster,
Einstein Award - Cheryl Freeman, CMRS
I Can Do It! Award - Susan Garrett, CPC, CPC-H, CHP
Team AMBA Award Recipients:
Lisa Paoli, CMRS, Cheri Freeman, CMRS, Rey Calvin,
CMRS, CPC, Brice Duffie, CMRS, Anita Wells, CMRS, Mori West, Sheila Hokes,
CMRS, Ann Marie Brunk, CMRS, CPC, Jackie Zube, CMRS and Barbara Cobuzzi,
MBA, CPC, CENTC, CPC-H, CPC-P, CPC-I, CHCC
The following members are being recognized by their
Chapters for your outstanding leadership. We are sorry that we were unable
to present your awards in person during the conference. Award certificates
will be mailed to you directly.
Local Chapter Award Recipients:
Ohio Chapter - JoAnne Hadler, CMRS
Southern California - Ann Grinnell
Central Texas - Barbara Wells
IL AMBA - Victoria Thomas, CMRS
Rocky Mountain AMBA - Martina Lang
Congratulations to all award recipients - you all are well deserving of
the recognition for your leadership and the fine example you set for others.
If you haven't taken time to visit all of our conference exhibitors,
please do. Each of them had a great service to offer members.
Computer Systems, a 27 year old national software development company with
installations in 43 states offers HIPAA compliant medical billing and
practice management software along with a CCHIT certified EMR. Our
software has been specifically designed for billing companies. We
offer an ASP or turnkey solution. View our exciting new GUI product!
Call 1-800-831-9419 Ext. 202
EDI is one of the nation's fastest growing healthcare clearinghouses.
Services include electronic claims, claim status, eligibility,
paper claims, patient statements, and remits.
is a medical billing and patient scheduling package. It is
workstation-based, supports one to multiple users on any number of systems,
handles all patient statements and insurance claims (paper and electronic),
and runs on Windows XP and VISTA. MedLook is easy to learn and easy to use.
The patient scheduler/appointment manager is extremely easy to learn and
use. For the front desk the scheduler greatly facilitates managing patients
once they arrive at the office. Learn more by
printing technology offers a combination of speed, economy, durability, and
flexibility that can brighten up your work life -- or the life of your
organization -- literally overnight. We invite you to explore our product
line, learn what RISO technology can do in your workplace, and see our
machines at the AMBA conference.
The Connect IQ® Online Bill Pay is an
online patient billing solution that includes eStatements and Web-based
online bill pay. These two solutions work in concert to allow sending of
electronic and paper statements and enable patients to pay their balance or
set up a payment plan online.
Synergy's integrated PRO Solutions includes Practice Management, EMR,
Document Management, Transcription, ePrescription and a Patient Portal,
which brings revenue efficiency to your physician practice.
Management Solutions offers a private labeled, comprehensive ASP remittance
management processing solutions that enables billing companies to minimize
keying, maximize revenues and more. Must be seen!
MedEnEx provides the
highest quality of enrollment credentialing services, with
an exceptional personalized touch. We are the leader in
enrollment services, providing specialized enrollment
services for physician groups, medical management
organizations, billing companies and private practices from
across the United States.
to providing the best results for over 88 years. We offer
competitive rates, fast results and custom services tailored
with your specific needs in mind. We provide a range of
services including accounts receivable management
Added Reseller for PRO Practice Management, a totally
integrated product that streamlines efficiency and allows
practices to achieve peak performance and maximize
Payment Systems delivers credit/debit/prepaid card
processing, payroll, check management and payments
solutions, to more than 300,000 business locations
nationwide. Representing the Check Management – Remote
Deposit Capture (RDC) product at the AMBA conference: “Our
systems offer a cost-cutting single source for bank neutral
remote deposit, returns, recovery and collections processing
solutions to eliminate excess fees and redundant labor. The
simplistic design is the only system on the market that is
built to scan and allows to automated reconciliation and
II Software Solutions offers the most revenue-enhancing
features of any medical coding software. Our suite of
applications and developer toolkits supports coding,
compliance, claims editing and revenue analysis for tens of
thousands of healthcare professionals. Built on the strength
of decades of healthcare experience and dedication, Alpha II
software is the first and foremost solution to revenue cycle
have served in a variety of significant positions with the
U.S. Department of Justice, as Assistant District Attorney,
and as General Counsel for a publicly-traded company.
Our attorneys apply decades of focused experience and
expertise in the representation of our clients. A
number of our attorneys have established national
reputations in the areas of regulatory compliance, corporate
transactions and health law. We will aggressively work
to safeguard your financial interests, and in some cases
your personal liberty. We strive to provide quality,
innovative representation in a cost-effective fashion.
offers a fast, state-of-the-art communications network that
will deliver your insurance claims in the most expeditious
manner. If your claim can be delivered electronically, LTC
can do it. LTC has connections with nearly all insurance
carriers who accept electronically transmitted claims with
one of the industry's most extensive supported
payor/carrier list. We also offer printing services to
process claims destined for insurance carriers who do not
accept claims electronically.
CardChoice Merchant Services is a fast
growing purveyor of credit card transaction terminals and
merchant processing services. We carry a complete line of
point-of-sale (POS) equipment that allows merchants to
accept credit, debit, gift/loyalty, and EBT cards. In
addition, we offer other electronically driven financial
products and services, including ATM machines and all
AdvancedMD offers comprehensive medical billing solutions designed to grow with your business. With compelling ROI, unsurpassed client satisfaction and guaranteed results; AdvancedMD makes you indispensable to your clients. Visit our website or call 1-800-825-0224
Personal Laptop with Data on 850,000 Physicians Stolen
The un-encrypted data identifying contracted physicians across the
country were on a laptop computer stolen from an employee recently. The laptop
was stolen from a vehicle on August 27, 2009 although notification of doctors
didn't start until October. As of a couple of weeks ago, many physicians still
have not been notified about the breach. The BCBS Association estimates that
only about 187,000 of the physicians whose data was stolen actually included
Social Security numbers.
The rest of the providers may not be notified at all since their stolen data
only included name, address, tax ID and NPI. BCBS is giving free credit
monitoring services to those doctors whose Social Security numbers were stolen
but said other doctors, upon request to their home-state plans could receive
credit monitoring as well.
Because no health information was contained in the breached data, HIPAA
privacy breach disclosure rules that recently took effect requiring notification
within a specified time would not apply.
OIG 2010 Work
The OIG released its
2010 OIG Work Plan, giving healthcare billing and compliance
professionals an idea of what types of audits and reviews to expect in
the coming year.
Key Initiatives for Physicians and Other Health Care Practitioners:
Trends in Medicare Hospice
– review of Part A hospice claims in order to identify trends in hospice
utilization, including the characteristics of hospice beneficiaries,
geographical variations in utilization, and differences between for-profit
and not-for-profit providers.
Payments for E-Prescribing
– review of Medicare incentive payments made in 2010 to eligible health care
professionals for their 2009 e-prescribing activities to determine whether
incentive payments were made in error, and if so, to assess CMS's actions to
remedy erroneous payments.
Medicare Payments for Part
B imaging Services
– review of payments for certain Part B imaging services with a focus on the
practice expense component included in the payment for such services,
including equipment utilization rate, in order to determine whether the
Medicare payment for such services reflects actual expenses incurred and
whether the utilization rate reflects current industry practices.
Services Performed by
Clinical Social Workers
– to determine whether services performed by clinical social workers in
inpatient facilities were separately billed to Medicare Part B (listed in
2009 OIG Work Plan but apparently the start date was delayed to 2010).
Therapy Performed by Independent Therapists – to determine whether the services
billed to Medicare by independent physical therapists complied with Medicare
requirements (listed in 2009 OIG Work Plan but apparently the start date was
delayed to 2010).
Use of the Modifier GY on
– to examine patterns and trends for physicians' and suppliers' use of
modifier GY (used to code services that are statutorily excluded or do not
meet the definition of a covered service) (listed in 2009 OIG Work Plan but
apparently the start date was delayed to 2010).
Medicare Payments for Polysomnography (Sleep Studies) – to examine the
appropriateness of Medicare payments for sleep studies and the factors
contributing to the rise in Medicare payments for sleep studies as well as
provider compliance with Federal program requirements (listed in 2009 OIG
Work Plan but apparently the start date was delayed to 2010).
Geographic Areas with a
High Density of IDTFs
(Independent Diagnostic Testing Facility) – a review of billing patterns,
provider and beneficiary profiles, and services billed in areas with high
concentrations of IDTFs.
Enrollment Standards for
– to determine whether IDTFs are in compliance with the 14 standards that
IDTFs certify compliance with in the enrollment application.
Compliance with Assignment Rules
– a review of provider compliance with assignment rules, in particular,
whether providers treat the Medicare payment as payment in full, and to
determine beneficiary awareness with their rights and responsibilities
related to Medicare billing violations and Medicare coverage guidelines.
Payments for Services
Ordered or Referred by Excluded Providers – a review of Medicare payments for
services ordered or referred by excluded providers with a focus on the
referring/ordering providers; a review of oversight mechanisms CMS has in
place to identify and prevent improper payment for services based orders or
referrals by excluded individuals.
Ambulance Services Used to
Transport ESRD Beneficiaries
– a review of the extent to which ambulance services are used to transport
ESRD beneficiaries to and from dialysis facilities.
for DME Services
– This is a review for compliance with the Stark Law. The OIG will review
DME payments to DME suppliers in which physicians held an ownership
Appropriateness of DME
– a review of the appropriateness of DME categorization in the Medicare fee
schedule in light of current costs, expected duration of beneficiary use, or
extent of servicing involved to maintain the equipment, in order to
determine whether DME are properly classified.
Medicare Pricing for
– a review of the Medicare fee schedule in comparison to fees paid by other
Medicaid Payments for
Personal Emergency Response Systems
– review of one state's payments to providers of personal emergent response
systems to determine allow-ability for federal matching funds.
Medicaid Physician and
Occupational Therapy Services: Appropriateness of Payments – review of the
medical necessity, billing, and qualification of providers of physical
therapy and occupational therapy to Medicaid beneficiaries.
Key Nursing Home Initiatives:
Oversight of Poorly
Performing Nursing Homes
– review of CMS/State use of enforcement measures (such as survey and
certification reviews) for poorly performing nursing homes in order to
determine their impact on improving quality of care.
Oversight of Nursing Home
– a review of CMS's processes for ensuring that nursing homes submit
accurate and complete MDS data.
Medicaid Nursing Home
Patients: Quality of Care
– review of certain nursing facilities who may have provided substandard
care based on conditions present in patients admitted to hospital (pressure
sores, infections, or both).
Payments for Nursing Facility Quality-of-Care Performance Measures
– review of incentive payments made by Medicaid agencies to nursing
facilities based on the nursing facility's performance on quality of care
measures to determine if the States have sufficient controls in place to
assess quality of care performance and whether the incentive payments were
made in accordance with program requirements.
Key Medicaid Managed Care Initiatives:
Medicaid Managed Care
Fraud and Abuse Safeguards
– review of State monitoring of managed care organizations' fraud and abuse
Medicaid Managed Care
– review of State oversight and monitoring of managed care organization
Key Recovery Act Initiatives:
Breach Notification and
Medical Identity Theft in Medicare – examination of CMS's compliance
with the new breach notification requirements under the HIPAA Privacy and
Payments for Electronic Health Records
– review of Medicare incentive payments made to eligible health care
professionals and hospitals for adopting electronic health records (payments
begin in 2011).
We've formed a new Local Chapter Board to assist the
AMBA in development, community growth and governance of our chapters.
Local Chapter Board Members include:
Chairperson at large – Jackie Zube
Vice-Chairperson at large – Lisa
Secretary at large – Mori West
Member at large – Deborah Yannette
West – Jennifer Brisse
Midwest – Andi Kabaker
Northeast – Jane Hyskell
South – Jennifer Snead
We'd like to thank the board members for their time and effort
The board has had its first meeting and is moving forward to help us meet
the needs and growth of our chapters. If you weren't aware of it - we have
more chapters now than ever. See if
there is a chapter near you!
Are you interested in forming a new chapter?
If so, contact
Lisa Bugsalewicz, Local Chapter Coordinator
for the AMBA.
Web Addresses and Phone Numbers to Medicare Part B Offices
CMS Guide to Medicare Preventive Services
The Guide to Medicare Preventive Services for Physicians,
Providers, Suppliers, and Other Health Care Professionals, which
provides comprehensive information about the wide array of
preventive benefits covered under Medicare, has been newly
revised and updated! The third edition of this guide provides a
variety of information on these vital benefits, including
coverage, frequency, risk factors, billing, and reimbursement.
It is now available on the Medicare Learning Network <http://www.cms.hhs.gov/MLNGenInfo/>
in a downloadable, printable format at the following address:
For more products related to Medicare-covered preventive
services, please visit our preventive services educational
products website at:
Medicare Fee-for-Service Professional Providers
Version 2.7 of the MREP
software is available for download at
on the CMS website.
For a description of the
changes in this version, see the “What’s New”
section of the MREP User Guide – Version 2.7
Provider Call with Question & Answer Session
The Centers for Medicare & Medicaid Services’ (CMS)
Provider Communications Group will host a national provider conference call
on the 2009 Physician Quality Reporting Initiative (PQRI). This toll-free
call will take place from 1:00 p.m. – 3:00 p.m., EST, on Tuesday, November
The Medicare Improvements for Patients and Providers Act
of 2008 (MIPPA) made the PQRI program permanent, but only authorized
incentive payments through 2010. Eligible professionals who meet the
criteria for satisfactory submission of quality measures data for services
furnished during the reporting period, January 1, 2009 - December 31, 2009,
will earn an incentive payment of 2.0 percent of their total allowed charges
for Physician Fee Schedule (PFS) covered professional services furnished
during that same period. The 2009 PQRI consists of 153 quality measures and
7 measures groups.
The topics covered on this national provider call will
Updates on 2008 PQRI and 2007 PQRI re-run incentive payments &
Results from the 2008 PQRI and 2007 PQRI re-run;
An update on 2010 PQRI and E-prescribing programs; and
What to expect on your feedback report.
Following the presentation, the lines will be opened to
allow participants to ask questions of CMS PQRI subject matter experts.
Educational products are available on the PQRI dedicated
web page located at,
, on the CMS website, in the Educational Resources section,
as well as
educational products are available on the e-prescribing dedicated web page
http://www.cms.hhs.gov/ERxIncentive on the
CMS website. Feel free to download the resources prior to the call so that
you may ask questions of the CMS presenters.
Conference call details:
Date: November 10, 2009
Conference Title: Physician Quality Reporting
Initiative (PQRI) - National Provider Call
Time: 1:00 p.m. EST
In order to receive the call-in information, you must
register for the call. It is important to note that if you are planning to
sit in with a group, only one person needs to register to receive the
call-in data. This registration is solely to reserve a phone line, NOT to
allow participation. Registration will close at 1:00 p.m. EST on November
9, 2009, or when available space has been filled. No exceptions will be
made, so please be sure to register prior to this time
To register for the call participants need to go to:
Fill in all required data.
Verify your time zone is displayed correctly the drop down
You will be taken to the “Thank you for registering” page and
will receive a confirmation email shortly thereafter.
Please print and save this page, in the event that your server blocks the
confirmation emails. If you do not receive the confirmation email, please
check your spam/junk mail filter as it may have been directed there.
For those of who will be unable to attend, a transcript
of the call will be available at least one week after the call at
http://www.cms.hhs.gov/pqri on the CMS website.
If you require services for the hearing impaired please
send an email to:
MedLearn Matters Article Updates - October 2009
Webinars, Chapter Happenings
PA AMBA Chapter
will have their November
meeting on Tuesday, November
10, 2009 at 11:30 a.m. at
DeNunzio's Restaurant in
Guest speaker will be UPMC
The discussion topic will be
Please RSVP with Jane at
by phone at (814) 938-8263
by Thursday, November 5,
CPC Coding Certification Prep Course through Career Coders
AMBA is hosting a CPC Prep course
through Career Coders in Colorado. The owner, Melody Irvine, who
is an AMBA National Advisory Board Member (and AAPC National
Advisory Board Member), will instruct the course. Melody is PMCC
certified and holds multiple other certifications through the
AAPC and is a CMRS as well.
This class begins February 2, 2010 and runs 10 weeks, meeting
Tuesdays and Thursdays at 7pm ET (6pm CT) for an hour to an hour
and a half.
You will need to purchase Step by Step Medical Coding - Carol
Buck (both the textbook & workbook) and a set of codebooks (AMA
Brand books preferred, ICD9, CPT4, HCPCS).
Cost is $1650 (additional fees of $370.00 for national testing
are not included) Enroll online at
Career Coders Or,
contact Melody Irvine at (970) 663-0020 or email at
firstname.lastname@example.org or you can feel free to
email Cyndee Weston at at
How is online class presented?
This class is presented online and is live. You will hear and
see the instructor and ask questions. If you are unable to
attend the live class, the class is recorded to listen to at a
later time. No webcam, microphone
is required but recommended. Student is encouraged to read
Step-by-Step book, complete exercises in book and workbook
before class to determine their weak areas. There are weekly
conference calls to discuss questions and concerns about
anything covered or learned that week.
Criteria for Class
This is not a beginners class, students must have knowledge of
CPT, ICD-9, HCPCS, Modifiers and Insurance billing concepts. It
is an intense 10 weeks class designed to prepare students for
the AAPC CPC certification test. The taking of this course does
not guarantee the passing of the CPC National Certification
Test. This is an online class - computer, internet and email
Prerequisites - Medical Terminology, Anatomy, Proficient in CPT,
ICD-9, HCPCS, Modifiers, Medicare Rules and Regulations, Coding
Concepts, HIPAA, High School Diploma/GED
Anatomy and Medical Terminology are not part of the CPC
Certification class but is a part of the certification
examination. If you fail the anatomy/medical terminology portion
of the test, you fail the entire test.
Length of Class - Class meets 2 times a week for 10 weeks
Course of Study - Coding
Guidelines, Surgery Guidelines, HCPCS, ICD-9, Evaluation and
Management Codes, Integumentary System, Musculoskeletal System,
Cardiovascular System, Endocrine System, Hemic System, Nervous
System, Male and Female Genitalia, Maternity Care, Digestive
Respiratory System, Urinary System, Ear and Eye System,
Radiology, Pathology, Medicine, Category II & III Codes.
I personally challenge AMBA members to increase your knowledge
and credentials by taking this prep course and passing the CPC
exam along with me (Cyndee Weston). We can do this!
The recent survey/poll taken in the
last quarter of 2008 were recently made available to
members on the
AMBA Members Only website. If you haven't had a
chance to review the results, take a few minutes to do
so. Thank you to all that participated!
Quick Reference Links
2009 Conference Info
AMBA Email Group
AMBA CMRS CEU List
AMBA CEU Submission Form
September 2009 Newsletter
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To advertise in this newsletter,
contact Cyndee Weston
or call 580 369-2700
Submit a letter to the editor or
an article for inclusion in the newsletter to
Feel free to send us your comments and or questions. Local Chapter
information is welcome and encouraged for free publication.
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conference? Send us the info so we can include it here.
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copyright property of the AMBA. All rights reserved. This is a
members only benefit. © American Medical Billing Association® 2009