Failing to Prepare for ICD-10 is Preparing to Fail: Part III of III

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The Coming ICD-10 Cash Flow Crisis and How to Avoid It

By Terry Kile, Senior Sales Executive, BridgeFront

The transition to ICD-10 will not be without its issues.

Mona Engle, RN, CEO/Practice Administrator of Drs. May Grant Associates, is concerned about coding outcomes. “If something is not coded correctly, the insurance company will not pay — so we have to do it right…The ICD-10 transition will [be] a difficult and costly endeavor,” she says.

By nine months from your deadline, your team should be documenting, coding and billing in both ICD-9 and ICD-10. For most of us, that timing falls around the end of 2013. Beginning the process of dual coding should consist of:

• Chart review by an ICD-10 trained medical coder to help you identify documentation needs for ICD-10.
• Increased training for the entire team.
• Implementing changes to processes and forms pertaining to your present coding and billing procedures.

At first, your coders may spend many hours “crosswalking” codes. That is, doing a side-by-side comparison of an ICD-9 code to its closest match in ICD-10. This is a challenge when the ICD-9 code for Extrinsic Asthma-unspecified (493.00) has 16 different code choices in ICD-10. Making the correct choice requires additional documentation detailing a number of factors.

“Crosswalking” requires referencing coding books, which is time consuming, so several software options are now available to make this process more efficient. Check out Simple Solutions, from Complete Practice Resources, or have your coders use ICD-10 Code Search, found online here.

Another key to success is communicating with all system vendors and business partners that use DRG codes to receive and send data to your systems. These may include pharmacies, labs, your EHR, etc. This is imperative to complete as you approach the deadline because a vendor’s plan for conversion to ICD-10 will directly affect your bottom line.

Some practices and hospitals are planning to test for internal ICD-10 compliance a full six months before the deadline, probably long before most of their external partners are ready to convert. If your vendors are not ahead of the game, you will need to develop conversion strategies or risk losing cash.

The ICD-10 transition is challenging, but it is not impossible…and it doesn’t end on October 1, 2014. Your ongoing job is to make sure that cash flow over the first three months of the new processes is affected as little as possible. Be ready to do immediate charting, coding and billing triage during the last half of 2014 and to immediately change the systems, habits and processes responsible for any problems. Ongoing issues cost very real money.

Reach out to industry organizations, professionals and your vendors to help make this transition a success. We are all trying to work as fast as we can to ensure that your practice come through this process with as little loss as possible. With your devoted time and attention, we can make that happen.

Terry C. Kile is a Senior Sales Executive for BridgeFront, an online education provider for healthcare. For information about BridgeFront, go to www.bridgefront.com. Contact them directly by calling 1.866.447.2211.


Failing to Prepare for ICD-10 is Preparing to Fail: Part II of III

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The Coming ICD-10 Cash Flow Crisis and How to Avoid It

By Terry Kile, Senior Sales Executive, BridgeFront

How can your practice avoid having cash flow issues in the last part of 2014? It will take planning, training and support from your employees, partners and vendors. This will certainly not be solved with a simple EHR software change—especially since you don’t yet know when or if your EHR vendor will be ready to test ICD-10 documentation and codes prior to October 1, 2014.

To begin, choose a person in your practice to head the process—it may be your practice manager or one of your partners. Their qualifications should include a thorough understanding of the complexity and financial significance of the ICD-10 transition, someone who can delegate effectively and motivate others to accomplish their assignments, and one who will hold others accountable if they do not.

Your “internal champion” may even be a committee, as long as one person is responsible for the entire transition. When you look into the tasks involved, you may feel as if you don’t have anyone available to take on the assignment. That’s okay, too. While you need still need an in-house point person, the champion may very well be an outside consultant.

Training is the next step in the process. Besides the obvious training needed for medical coders, physicians also need to be brought up to date as soon as possible. The earlier you start training, the more frequently your team can train on the material, and the earlier you can begin dual coding. Dual coding (the process of coding patient encounters concurrently in ICD-9 and ICD-10) will provide you with an overview of what needs to be fixed prior to the deadline. Online training alternatives let staff learn remotely. An inexpensive set of courses is provided by BridgeFront.

Frank Musso, of Francis C. Musso, CPA, MPA, P.C., notes that “the move to ICD-10-CM will increase documentation activities for medical support staff and physicians. This is a permanent change, not a learning curve change, and translates into an increase in physician time spent on documentation for ICD-10-CM with no expected increase in reimbursement.”

Planning the transition process for your practice takes time, and your team lead may not have enough time to work out the schedules, milestones and assignments required. Several simple project management software programs and whitepapers are available to simplify and accelerate the planning process, among them The ICD-10 Checklist from AHIMA.

Stay tuned for Part III of this ICD-10 blog series next week!

Terry C. Kile is a Senior Sales Executive for BridgeFront, an online education provider for healthcare. For information about BridgeFront, go to www.bridgefront.com. Contact them directly by calling 1.866.447.2211.


Failing to Prepare for ICD-10 is Preparing to Fail: Part I of III

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The Coming ICD-10 Cash Flow Crisis and How to Avoid It

By Terry C. Kile
Senior Sales Executive, BridgeFront
ICD-10
ICD-10 is the tenth revision of the International Statistical Classification of Diseases and Related Health Problems (ICD). ICD is a diagnosis classification system whose initial version goes back to the Black Plague, when European governments and medical professionals were trying to compare causes of death with those of other nearby countries in order to understand and combat reoccurring disease.

Today, the World Health Organization maintains this comparative information, and since the United States is the only country still using ICD-9, the move to ICD-10 will enable more accurate comparisons of healthcare data with other countries. But the most important part of this change for your practice is that federal regulations will require more and better data tracking to measure the quality and safety of care—something enabled by ICD-10. There are a number of benefits to this transition, says Charles D. Krespan, M.D. of the Drs. May Grant Associates practice.

According to Krespan, “ICD-10 gives us more data about our patients’ medical conditions and the hospitals’ inpatient procedures. Better data leads to better decisions, which leads to better patient care.”

Many prudent hospitals and practices are already preparing for the shift to ICD-10, but most will still make the transition with significant effort and cost.

Frank Musso, of Francis C. Musso, CPA, MPA, P.C., believes the transition will be substantial. “Not only does the new code set include five times as many codes as the ICD-9 code set,” he says, “but the different arrangement of codes will require more documentation, revised forms, retraining of staff and physicians, and changes to software and other information technology. I would also expect changes in reimbursement patterns …. “

“We are very concerned about the ICD-10 transition,” echoes Mona Engle, RN, CEO/Practice Administrator of Drs. May Grant Associates says. Even though she feels confident about the progressiveness and preparedness of her practice, she says “I know that ICD-10 will be very costly in terms of training our staff, implementing the codes and retraining our physicians. It is extremely important that we do it right, because if we don’t it will impact our patients—and that’s something we never want to happen.”

There are only 16 months leading up to the October 1, 2014 deadline. All HIPPA-covered entities must make the change to the new system, or will not be reimbursed by any payer—commercial, Medicare or MA. This would put a severe cramp in your practice cash flow, but can be avoided as long as your practice takes the correct steps to implement ICD-10.
Important note: If making diagnoses prior to October 1, 2014 to be billed or completed (surgical, testing, medication) after October 1, 2014, your deadline for ICD-10 transition is the first time you make that diagnosis. If not, you run the risk of losing the reimbursement or doing all of the medical coding and charting twice for those patient encounters.

Stay tuned for Part II of this ICD-10 blog series coming next week!

Terry C. Kile is a Senior Sales Executive for BridgeFront, an online education provider for healthcare. For information about BridgeFront, go to www.bridgefront.com. Contact them directly by calling 1.866.447.2211.


Take the 10-Question Patient Satisfaction Quiz

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The author for our Customer Communication Skills online education program, the Telephone Doctor, often sends helpful tips and newsletters on customer service and patient satisfaction. Here’s the latest:

Nancy Friedman, The Telephone Doctor“A long ago a good friend once told me, ‘Nancy, the training your company provides is common sense that’s actually NOT very common!’

There’s a lot of truth to that statement. Yet years later, rudeness and low service levels still plague businesses in every industry. We hope you enjoy taking this customer service quiz to test how common your common sense is.”

Take the quiz:

1. “How can I help you?” belongs:

A. In the initial greeting.
B. In the message taking scenario.
C. Nowhere. I’m not able to help anyone.

2. When I’m not able to help a customer, I should:

A. Tell them honestly & thank them for their business and hang up.
B. Give whatever information I can, right or wrong. Wrong information is better than no information.
C. Get help immediately and advise the person help is on the way.

3. When I’m having a bad day, I should:

A. Not bother coming into work.
B. Leave my troubles at the doorstep like the song says.
C. Tell all my co-workers my troubles to get it off my back.

4. Chewing gum at work is:

A. OK.
B. A bad breath refresher.
C. Downright rude and obnoxious. Fugetaboutit!

5. A mirror at my desk will:

A. Keep my ego in check.
B. Remind me to smile BEFORE I pick up the phone.
C. Give me bad luck if it breaks.

6. Basic customer service skills are important to me because:

A. Everyone needs a refresher.
B. I need a lot of help.
C. I never learned any.

7. Internal customer service means:

A. Be nice to others who come into my office.
B. The customer is giving me a stomachache.
C. Treating my co-workers as customers.

8. When using voice mail and leaving a message I should:

A. Leave my phone number twice and slowly.
B. Leave a good clean joke to keep them smiling.
C. Not leave a message…just call back till I reach them.

9. Irate customers are important to our company because:

A. It’s fun to handle those kinds of calls.
B. At least we get a second chance to make it right.
C. I finally get to yell back.

10. Asking questions of the customer will:

A. Aggravate them.
B. Show I’m interested in helping.
C. Be considered being too nosy.

I.Q. Quiz Answers

1. Correct answer is B.

Anything after your name…erases your name. And on initial greetings, your name is very important. You have answered the phone to help them. It’s a given. Those words are best used in a message taking scenario.

2. Correct answer is C.

Be sure you let the customer know that help is on the way. That’s the most important part.

3. Correct answer is B.

We need to leave our troubles at the door. Arguments with a spouse or a bad hair day is your problem. Telephone Doctor calls that “emotional leakage.” That’s getting angry at Peter and taking it out on Paul. Not fair, not right and no fun.

4. Correct answer is C.

No gum at work – ever. End of subject. If you have bad breath – use mouthwash.

5. Correct answer is B.

The old Telephone Doctor adage…”smile BEFORE you pick up the phone,” is the way to make every phone call, or customer contact, a great one. Remember, it’s hard to be rude when you’re smiling.

6. Correct answer is A.

Everyone can use a brush up course. There’s a great saying: “When you’re through learning…you’re through.” Never stop taking those little basic skill lessons you’re offered. Even if you do know it all…look how good you’ll feel about that!

7. Correct answer is C.

We need to treat our co-workers as well as we’re going to treat our external customers. Remember: We Are Customers To Each Other. We sure don’t need any internal conflicts between co-workers and departments.

8. Correct answer is A.

Voice mail was meant to take an effective message. Give details and speak conversationally so the person receiving the message will enjoy it. Effective messages have concrete information – dates, times, names, situations. Leave your phone number – twice and slowly. Make voice mail work for you…not against you.

9. Correct answer is B.

Getting a second chance is golden. And irate callers, while certainly not pleasant, can be the challenge of the day. And they can be satisfied.

10. Correct answer is B.

Listening and questioning skills are very important to excellent customer service.

# # #
Nancy Friedman, president of Telephone Doctor, is a featured speaker at association and corporate meetings. For an information packet on Nancy, please email Donna.Bryan@telephonedoctor.com or call 314.291.1012.

For more information about our Customer Communication Skills online education program, click here or contact us directly. Call 1.866.447.2211 or email info@bridgefront.com.


A Sneak Peek at our 2-Part HIPAA Omnibus Webinar Series – Starting Tomorrow

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Tomorrow we begin our two-part webinar series on the HIPAA Omnibus Rule discussing the critical changes for covered entities and business associates. We’re excited to have Susan A. Miller, JD, a leading consultant and attorney, presenting for us.
BridgeFront 2-Part HIPAA Webinar Series

  • Part I for Covered Entities is on Tuesday, April 9: Attorney Miller addresses the critical updates and changes that affect covered entities.
  • Part II for Business Associates is on Thursday, April 11: Attorney Miller addresses the critical updates and changes that affect business associates.

Here’s a sneak peek at what you’ll hear in the presentation for covered entities.

Below are ten practical steps covered entities should start today to comply with the HIPAA Omnibus Rule:

  1. Revise breach notification policies and procedures
  2. Security Risk Analysis – revisit (or do)
  3. Develop or revisit Security Incident Response Plan
  4. Pay special attention to portable media and personal devices
  5. Train entire workforce
  6. Prepare incident response team
  7. Be ready to respond to news media attention – have a designated spokesperson
  8. Consider tightening Business Associate Agreements, particularly for agents
  9. Encryption! Make the most of the encryption safe harbor, and Verify document destruction
  10. Audit access to PHI and enforce policies

Haven’t registered yet for our two-part webinar series? Don’t delay. Registration is limited.

Register Here >>>
Learn More >>>

BridgeFront offers HIPAA online education, now updated with the HIPAA Omnibus Rule information. For more information about our solutions, visit our website at www.bridgefront.com or contact us directly. Email info@bridgefront.com or call 1-866-447-2211.


6 Secrets of Thriving Patient Satisfaction and Staff Productivity

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This February we hosted Gaylyn Sher-Jan, President of OnCourse Group consultancy, in a webinar focused on how to improve employee behaviors for greater patient satisfaction. She listed six key employee behaviors as important:

1. Trust: Trusting individuals tend to believe that the motives of others are honorable.
2. Tact: How you say something to a customer or patient can be just as important as what you say.
3. Empathy: Customers and patients need to feel that someone cares about their experience.
4. Conformity: The key is understanding your customers’ objectives and expectations, and then aligning your employees.
5. Focus: Customer service is about relentless focus.
6. Flexibility: Organizations providing the best service think in terms of the customer and patient, and this requires employee flexibility.

She said, “In both good times and bad, the value of a positive customer experience can exponentially effect both the organization and the customer. Organizations have higher performing teams when customer and patient experience is consistently positive.”

Another critical factor in improving staff productivity and the patient experience, is how employees communicate with each other in the workplace. Problems with workplace and interpersonal communication can lead to low productivity and increased stress between co-workers and management.

Educating staff on proper office etiquette and communication tactics in the workplace can improve staff productivity. This ultimately improves the bottom line and patient satisfaction.

BridgeFront now offers a new online education program on Workplace Communication Skills.

This new e-learning program includes 4-5 hours of training to empower employees with proven methods to navigate a wide variety of interpersonal challenges, such as ethics and personality conflicts. There are 14 course topics and it includes 7.0 CEUs.

For more information on this new education, go to www.bridgefront.com or contact us directly. Call 1.866.447.2211 or email info@bridgefront.com.


An Oasis in a Sea of Vendors, BridgeFront Booth 4774 at HIMSS13

By Kent Lane, COO of BridgeFrontBridgeFront Booth 4774

There will be three million square feet in the exhibitor area at HIMSS this year. When you’re ready for a break, drop by our booth and try your luck at a game of Plinko and win instant prizes.

To make your visit even more productive, read these recent blog posts from HIStalk and Billian’s HealthData on why:

“… everyone in the booth needs to know the three reasons to spend five minutes in the booth, the three reasons why their product has an impact, the three reasons why they are better than [the] competitor, [and] the three reasons customers buy from them.”

So, BridgeFront came up with our “threes” for the upcoming HIMSS13 show:

3 Reasons to Spend 5 Minutes in Booth #4774

1) Find out how to educate staff on today’s critical topics like Coding, ICD-10, Revenue Cycle and HIPAA in less time, for a fraction of the cost of classroom training.
2) Leave with a chance to win a $100 VISA gift card.
3) Play the game PLINKO with us for prizes! Have a little fun!

3 Reasons BridgeFront Products Have an Impact

1) Reduces staff training time and cost of staff training.
2) Increases revenue through greater staff productivity and fewer errors.
3) Lowers risk of costly data breaches and non-compliance penalties.

3 Reasons BridgeFront is Better than the Competition

1) You can customize our e-learning to include your organization information and author your own e-learning courses using our tools.
2) 100% of our clients rate our customer support as second to none.
3) Our e-learning is easy to access and designed for the adult learner, yet interactive and engaging.

3 Reasons Customers Buy from BridgeFront

1) Price points are the lowest you will find amongst online education companies.
2) We’ve been a trusted provider of online education for over 10 years.
3) Our e-learning is easy to access, implement and track for leadership.

For more information about BridgeFront, stop by our booth #4774 at HIMSS13 or visit us online at www.bridgefront.com.


3 Critical ICD-10 Questions Answered

3 Critical ICD-10 Questions AnsweredBy Kent Lane, COO of BridgeFront

On January 29, 2013 we hosted a webinar with HCPro’s Senior Regulatory Specialist, Jennifer Avery, CCS, CPC-H, CPC, CPC-I. In the webinar, she discussed the key differences between ICD-9 and ICD-10 that could impact a successful migration to ICD-10.

The presentation also highlighted the education needed for your clinical staff, CDIS, billers, and coders to ensure they understand the changes and their role in the conversion – bringing your organization closer to the goal of a smooth transition.

View the recorded presentation in our Archive Webinar Library on our website.

During the questions and answer time at the end of the presentation, there were many questions addressed. Here are the top three questions for all providers and health plans to understand while planning for the ICD-10 transition.

1. We know the AMA is a powerful lobby and has already affected the implementation date once. I understand the AMA is actively pursuing a delay or even cancellation of ICD-10 implementation. Do you think they will be able to affect the date again?

“I hope not, but right now it is out there that AMA is trying to push off implementation by another couple of years – or not implement at all. I hope there are enough of us opposed to this and we can strong arm them right back. We are way behind in our processes and we have out-grown the current system. We cannot ignore the problem.”

2. To what extent do you expect Computer Assisted Coding Systems (CACS) to impact ICD-10 transition?

“Whether good or bad computer-assisted coding will have a major impact on coding and how coders are utilized in the future, especially with ICD-10 transition. The versions of CAC actually make me feel more secure as a coder as I have not found one yet that I think will actually ‘replace’ coders- it will just change how we are utilized. We may actually be doing a lot more ‘clean-up’ after the computer assigns the codes as it cannot replace the coder’s logic.”

3. Before ICD-10, do I need to be certified on ICD-9? If so, what online courses are available?

“I always think it’s a good idea to become ‘certified’ if you are involved in any aspect of coding. If you are proficient in ICD-9 and not currently certified – you may want to go ahead and set for the exam prior to the changes.”

“Then you would be required (depending on organization you get certified through) to either sit for a proficiency exam (AAPC) or get CEUs in ICD-10 (AHIMA). As for the education component to prepare for certification – there are several organizations out there that have various online products and some are dependent on whether you plan to focus on the inpatient, outpatient world, or both. BridgeFront/HCPro alone has several online learning tools to help you prepare for certification.”

“I definitely would encourage you to pick based on reputation and endorsements and not on price, as some promise to give you everything for a small fee – but fall short on content and we have seen a number of students go through other vendors only to be forced to spend additional money with a more reputable training company to gain the knowledge/skills they need.”

BridgeFront has partnered with HCPro to offer a complete ICD-10 and Coding Online Education Program. Learn more at www.bridgefront.com.


Tips on Attending HIMSS13 and Visiting the Exhibition

By Kent Lane, COO of BridgeFronthimss13-logo3

We’re excited to learn about the new Knowledge Centers for 2013 in the exhibit hall at this year’s HIMSS Conference. This is a great opportunity to gain valuable insight into key topics like ICD-10, Mobile Health, and Clinical and Business Analytics/Intelligence.

In each Knowledge Center, there’s a packed schedule of peer-reviewed presentations, case studies, experts to speak with, HIMSS resources, and much more.

If you’re interested in ICD-10, go to the ICD-10 Knowledge Center in booth #4581. Make sure to attend one of the presentations on topics like, “Measuring ICD-10′s Impact on Coder Productivity” on March 4 at 1:15pm and “ICD 10: Bigger Than an IT Issue” on March 5 at 3:30pm.

While there, take a minute to meet the BridgeFront staff nearby in booth #4774. Ask about our newly expanded Coding and ICD-10 Education Program for your staff. Our staff is ready to discuss your organization’s ICD-10 education plan and how we can help.

Here are some tips from HIMSS on visiting the exhibition:

1. “Pre-plan your exhibition experience.”
2. “Don’t miss any of the HIMSS Specialty Pavilions on the show floor.”
3. “Check out Conference Deals and Targeted Exhibitor Listings prior to conference.”
4. “Be ready to network and start developing business relationships.”
5. “Be comfortable. Comfortable walking shoes are a must.”

For more information about BridgeFront’s HIMSS13 booth #4774, read the news here or contact us directly. Call 1.886.447.2211 or email info@bridgefront.com.


Health Plan Improves Compliance through Online Education

By Kent Lane, COO of BridgeFront

Goals

During our 2013 Virtual Client Conference, we had the opportunity to chat with Ellen Dunn-Malhatro, the Director of Compliance and Regulatory Affairs from the Health Plan of San Mateo on how they used BridgeFront to improve compliance.

This 30-minute webinar session discusses how they implemented BridgeFront education, why they chose online training versus classroom training, and the impacts of their training initiatives.

View the free on-demand webinar here >>>

Below is the transcript of the webinar and conversation.

LORRAINE:
Welcome to our Virtual Client Conference. I’m so glad you’re joining us for this session with Ellen Dunn-Malhatro, the Director of Compliance and Regulatory Affairs from the Health Plan of San Mateo. During our time together, she’s going to discuss how they implemented BridgeFront’s compliance education and the resulting impact. It’s with great pleasure that we welcome Ellen.

ELLEN:
I’ve been at the Health Plan in San Mateo for going on 12 years and the Health Plan of San Mateo began in 1987 as a Medicaid managed health care plan. Since then, we’ve grown considerably and we have a Medicare Advantage special needs plan which is for our dual-eligible – those who both have Medicare and Medicaid. And if I say Medi-Cal, for those of you in other parts of the country, that is the California Medicaid program…In addition to the Medicare and Medicaid products, we also have two products for children – again, low income children and a program for some workers in the county who provide services to recipients of in-home supportive services. Those are services, again, provided to disabled residents who are living in the community. And finally, we work as a TPA for a county indigent care program. So, I hope that gives you sort of a broad idea of who we are. We are small, we have a hundred thousand lives, but I think we are a rather complex organization.

LORRAINE:
Thank you so much, Ellen. So let’s get started and get a little bit more information about what was that issue at San Mateo that resulted in you selecting BridgeFront as your education partner.

ELLEN:
Yes, when I first started back in 2000 at Health Plan of San Mateo, we had 75 employees. We changed remarkably in the time that I’ve been here. Even though we’re still small, we have 200 staff. Going from 75 to 200 presented numerous problems for me as the compliance officer. We have training requirements, both for HIPAA, as well as for CMA, which meant we had to do compliance and fraud, waste and abuse training, as well as training around Medicare. Very difficult when I began with HIPAA training with 75 employees, I would do it in a classroom situation. In some ways, it was a lot of fun. I got to see all the staff on a regular basis. But, with 200 staff and with the addition of all the other things going on with compliance, classroom training became an impossibility. And, I realized I had to look for a different kind of solution to be compliant with both the HIPAA requirements, as well as those that were coming from CMS.

LORRAINE:
So, did you have a budget for that or how did you create, perhaps, a business case to determine that I need to look outside the box and it just can’t be me standing in front of a classroom?

ELLEN:
Exactly, I didn’t have a budget. Some of the advantages of being a small organization is I have a little bit of flexibility – actually, I have quite a bit of flexibility, and I also report to the CEO. I started going basically on the internet and just started looking around at what kind of programs were available. I knew nothing about web-based programs at the time and I just started hunting around and basically that’s how we came across BridgeFront. I was looking for a company that offered the kind of courses that I needed and that did it in a way that was financially doable for a small organization.

LORRAINE:
Wonderful and what were the important key sound bites that helped you kind of pitch the concept that you needed to invest additional time and resource in delivering this education? Were there a couple things that you can share with our guests today?

ELLEN:
In my communication with my CEO?

LORRAINE:
Yes.

ELLEN:
It wasn’t all that difficult because as we’ve grown and as the issues confronting us and the time that we need to meet the regulatory requirements, she understood that my time was just really stretched and so her biggest issue for me was the financial piece of it. Could we find a company that provided us a solution that we thought was really adequate for our staff and in a way that was affordable for an organization that is? We are a government-type organization and so we don’t have a lot of extra funds. I also worked very hard with my compliance committee. There were some members of the compliance committee who helped review vendors…and they really weighed in on the fact that they just liked the way the HIPAA program was from BridgeFront and so I had the backing of first of all my compliance committee and they also weighed in on what program they liked and my CEO really understood the time frame and the commitment on my time.

LORRAINE:
Wonderful! Well that’s a great transition to solutions. So can you tell us a little bit more about what you selected from our course and product line that helped you address your issues?

ELLEN:
Absolutely. The first one that I really wanted to look at was HIPAA. As a health plan, we really have to be very concerned about how we protect the member’s information and HIPAA…and I don’t know, those of you in health care and know about HIPAA and know how serious this is becoming, and we had a small breach. I was looking for a solution that really went into the details, that would really provide staff an understanding and really emphasize the importance of HIPAA and our protection of information for our members. The second focus had to do with the ability, as I said before, to provide a compliance in fraud, waste and abuse training.

LORRAINE:
And since you have been delivering this in classroom, did you take the courses that were available from BridgeFront? Did you modify or create any of your own courses to support any of your learning objectives?

ELLEN:
To modify and create courses was one of the selling points that BridgeFront offered me. I looked at, as I said, a number of programs. None of them allowed me to go in and make changes. I must say that the HIPAA course is excellent and I had incredibly good feedback from staff. But I wanted to personalize it. I wanted people to know and to recognize me, so I wanted to be able to put up a picture of who I am and who our security officer is. I wanted to put information that was relevant to this particular agency. So I was able to, after very little training, to go in and be able to modify slides and to add some slides. This was really important to me because I felt that if I could personalize it and make it just a little bit more relevant to my agency, that it would really help them and also achieve my purpose…which really was to be able to understand how HIPAA worked in our agency. And that was the same for compliance in fraud, waste and abuse.

LORRAINE:
I know that you did that and I’m curious, Ellen, if you’d be interested in sharing with our audience what has happened since?

ELLEN:
I would really like to because one of the things that has really happened…I didn’t mean to cut you off. But it was really, very wonderful that establishing really a partnership about the kind of courses that can be offered. When I did the addition in the compliance in fraud, waste and abuse I had some conversations with staff, in fact, with Lorraine about the fact that those courses did not really meet my needs, that I had to do too much editing. That the courses weren’t focused so much on a health plan, but were focused for a different venue and I said that it would really be helpful to have courses that were more focused on a health plan for compliance and fraud, waste and abuse because of the training requirements by the centers for Medicare and Medicaid services that require health plans to provide this type of training to staff. So I will be using the HIPAA, the compliance and fraud, waste and abuse and with much less editing than I had to do because of the work that BridgeFront has done.

LORRAINE:
Well your feedback was wonderful because those courses, as they originally stood, were really built for hospitals and physician providers and other people and organizations in health care, so your feedback on the health plan really helps us to create something that was more specific and we really appreciated you giving us that feedback. Can you give us a little bit more feedback on what the positive results – all of this has had on your organization?

ELLEN:
First of all on my time, I feel a little overwhelmed by the amount of work that we’re doing at this plan so I just don’t have the time to go in and create a course, I don’t have the time to be really focused on this. I need something that will meet the needs of the agency, but there will be less need for me to be intervening. So what I was able to do, which has been a tremendous help, is I have an administrative assistant and because it’s easy to send out the courses that even though we do our annual trainings, I’m able to delegate to someone else who’s learned the system and he’s responsible for sending out on a sometimes weekly basis. I don’t worry about this at all because I know that I have someone now trained who can send it out. I am just focused on looking at the courses that are going to be done annually to the staff. I’ll take a look, as I have, the compliance, fraud, waste and abuse and I know that there’ll be some changes in the HIPAA because things are always changing with HIPAA – that will be updating the course that we use. And it just has relieved me of a responsibility that…it has just made it easy to meet my compliance obligations.

LORRAINE:
How about from tracking and documenting and reports? How did you do it before when you were delivering in a classroom and how do you do it now and effective?

ELLEN:
Yes, it was rather difficult as I’m sure others on the call probably appreciate, you have to keep sign in sheets, so you’d have to go through and you’d have to keep the sign in sheets and then there was no way to really test whether or not anyone was really understanding the information. So by going to a web-based program, first of all, you can give them a time frame for doing it and so it’s helped. The feedback I received was from the user’s standpoint, they were able to take the course at a time that was convenient for them, so not everyone from one department would be taking it at the same time. They could also, as the HIPAA module has three different pieces, they could take one and then wait and take the other one the following day or the following week so there was a little more flexibility in terms of the staff time and so that was one thing. I no longer had to keep anything in paper. Everything is documented, so if I get documented by OCR – the Office of Civil Rights who comes into my organization, I can easily show them when people took the course and that they all passed a post test and that’s a very important thing because I heard the feedback was from many people, “gee, I really had to read those questions.” “I didn’t really pass the first time. I had to go back and really spend some time on this.” And I think with the web solution, where they have to take a post test, I just thinks it’s a better solution than what I was able to offer.

LORRAINE:
I think you made a good point from the standpoint that not everybody gets it the first time, right?

ELLEN:
Well yes, and I did a couple of things. One is I engaged my compliance committee. So I have a compliance committee, we meet very regularly – basically eight to nine times a year. We had discussions about this, so I had the buy in initially from my compliance committee and my committee has a lot of senior staff, so by having my senior staff – my colleagues on board, that already gives me buy in at that level. And I asked the managers to talk in their meetings to prepare the staff for the fact that they would be receiving this. So there was a bit of a roll out. I was surprised, I had absolutely no negative feedback from anyone and the only feedback I got was very positive, frankly.

LORRAINE:
Well it sounds like you did a really great job engaging everybody from the top down to the middle managements to really help you kind of extend this out to your audience.

LORRAINE:
Ellen, is there anything else that you’d like to share with regard to maybe the results, the outcomes? How does your CEO feel today?

ELLEN:
I think, again, because we’re small and we have the same obligations that any health plan does, so in the state of California, I have to report to the Department of Managed Health Care, well so does Aetna’s and so does Kaiser, so we’re under the same compliance requirements of any health plan, even though we’re a small plan. So what I say is I need to work more smartly because I can’t keep adding staff, there’s a limit to how many staff one can have, so one has to find other solutions to meet the compliance and regulatory requirements that we have. So I think that’s really the key in what I do in looking for solutions.

LORRAINE:
Is there anything else you’d like to share?

ELLEN:
The three courses that I’ve mentioned and the other one – I will probably be looking at Medicare trainings cause we do have to do that, so I’ll probably take another look at the Medicare trainings that you have and we might expand beyond the three that I’ve already mentioned that we’ll be doing to maybe a fourth one, cause that’s also a requirement since we have the Medicare Advantage Program and we keep expanding in staff and I think we need to put something together, so that would be my next move.

LORRAINE:
Wonderful. Well Ellen, thank you so much for joining us this afternoon. We really appreciate it. Your story is a great one to tell and we really appreciate having you as a client here at BridgeFront because you do great things and you’re awfully fun to work with. Everyone have a great day. Thank you so much.