Summer 2012

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Most of us enter the professional world understanding that we PRESIDENT’S MESSAGE




must work with other people but not really understanding that means working with other people. I was lucky to begin my career in hospice care because our services were delivered through an interdisciplinary team of professionals. Most working teams are









actually multidisciplinary. In other words, they are groups of professionals who work together and each professional focuses on his/her area of expertise independent of the others. An interdisciplinary team, on the other hand, integrates the work of each team member as a way to enhance the services to the customers, or in the case of hospice, the patients. (cont on page 10)

LESSONS LEARNED FROM THE 2011 MO DISASTERS - MHA No one could have predicted the number and magnitude of the natural disasters that affected



Missouri in 2011. But, such is the nature of disasters, and that is why planning and preparedness pays off.



Many hospitals throughout Missouri activated their emergency operations plans and the hospi-



tal command centers because of the 2011 disasters. (Cont on page 8)

Upcoming Events You Won‘t Want to Miss July 25-27

Summer Conference Camden on the Lake, Lake Ozark MO To Register: Reservations—call 888-365-5620 (be sure to mention you are with HFMA to receive discount)

See Page 16 for more information on the Summer Conference For a list of webinars offered by National see page 5 October 24-26 Joint Fall Conference

Hilton Garden Inn, Columbia, MO

November 7-9

Tan-Tar-A, Lake Ozark. MO

MHA Conference



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PRESIDENT’S MESSAGE It is with great honor and excitement that I take over the Show-me Chapter Presidency from Kory. 2011-2012 was a great year and your leadership team has plans to make 2012-2013 an exciting year as well. Since we are "geographically challenged" as we encompass the whole state of Missouri other than St. Louis and Kansas City, it is very difficult for us to have networking social events. We have decided to try having a function in Columbia and/or Springfield to see if we could attract attendance from those members that are close to those locations. Our chapter demographics are concentrated in Boone (Columbia) & Greene (Springfield) so we thought we would try with those locations to test it out. We plan to have a few hours of education followed by a social gathering. Please contact one of the officers if you have ideas for this or would like to serve on a planning committee for either of these events. Our Summer Conference at Camden on the Lake that is being held July 25-27 will feature an additional day that is dedicated to education for those that are new to healthcare finance. The Summer conference is put on by just the ShowMe Chapter so it is smaller than our joint conferences and it is a good time to get to know those in our chapter a little better. It's summer and we're all a little more relaxed! Hopefully the weather will be beautiful and we'll be able to have our receptions outside & enjoy the beautiful weather as well as the lake views! The educational sessions look very interesting & informative. The joint Spring Conference with the Greater St. Louis Chapter at Harrah's in St.Louis was a great success. Everyone enjoyed the entertainment as well as the educational sessions. I didn't hear of anyone winning a great fortune in the casino, but I think everyone had fun & hopefully didn't lose as much as I did!! We are planning to try to become a presence in the accounting departments of local colleges & Universities. As I stated above, the predominance of our memYear in Review bership is in Columbia & Springfield, so we will begin our efforts at MSU in Springfield & MU in Columbia. We plan to have an HFMA booth at their career fairs and speak to the accounting clubs or classes. If you have ideas or wish to 2011-2012 was a great year for the Show-Me chapter! Although membership numbers were down this year, our eduparticipate in these efforts, contact me or one of the officers & we would welcome your help. cation hours reported for the 2011-2012 year were over 4000 hours…that‘s an average of 15.1 hours per member! I look forward to leading the chapter this year. I hope that you will consider We also teamed up with other chapters to offer more webigetting more involved in the chapter by becoming a committee member. The more involved you get, the richer your experience with this association will be- nars and our chapter participated in the annual MHA concome. There are so many great people in this chapter with a wealth of knowlference. edge in the Healthcare industry. All it takes is getting involved & getting to know the other members. A huge thank you to our chapter sponsors! They are terrific and we would not be able to put on the conferences and Janet Taylor webinars that we are able to, or send our chapter leaderShow-Me HFMA President ship to LTC. Our officers gain a lot of insight into what other chapters are doing and they are able plan strategic goals for our chapter for the upcoming year. Also, another huge thank you to all the officers, board members and committee members for the time they devote to making the Show-Me Chapter so successful!


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Janet Taylor

President Elect

Kyle Lee

Vice President

Jon Branstetter


Susan Duncan


Jennifer Ogden


Josh Wilks

Greg Shaw

Jean Nyberg

Ed Clayton

Roger Dix

Jennifer Doll

Kory Stout—Past President

Installation of Officers The 2012-2013 Officers and Board of Directors were installed at the Annual Joint Spring Conference held in St. Louis May 16-18. Teri Reger, our current Regional Executive performed the installation of officers. Kory Stout, the 2011-2012 president recapped the successful year the ShowMe Chapter had and presented Janet Taylor with her incoming President‘s pin. Kory also received his outgoing President‘s plaque and a huge thank you for all of his hard work this past year. If anyone is interested in joining a committee or participating on our board, please contact Janet Taylor, [email protected] for more information. The best way to make new contacts and get the most out of your HFMA membership is to be involved!!

Gold Sponsors

Left: Kory Stout 2011 -2012 president and Janet Taylor 20122013 president Below: 2012-2013 Officers and Board of Directors



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340B Drug Purchasing Program – A Focus on Compliance Author: Brad Brotherton, Partner, BKD LLP Since the inception of the 340B drug purchasing program in the early 1990s, program compliance has been the responsibility of participating organizations with relatively little oversight. It appears those days are quickly coming to an end. The program‘s exponential expansion in recent months has caused many stakeholders and legislators to look more closely at compliance with the program. Much of the recent expansion is a result of the health care reform law passed in March 2010, including: Allowing all critical access hospitals (CAHs) to participate in the program Reducing the Medicare Disproportionate Share (DSH) criteria for sole community hospitals and rural referral centers to 8 percent from 11.75 percent Allowing covered entities to contract with multiple retail pharmacies to provide prescription drugs for covered outpatients Recent communications from the Health Resources and Services Administration (HRSA) and its Office of Pharmacy Affairs (OPA) discuss the plans in place to oversee compliance with certain areas fundamental to the program. These plans include: Requiring compliance testing of the 340B drug purchasing program in A-133 federal grant audits Increasing the number of targeted and random audits of covered entities Requiring covered entities to annually recertify enrollment forms for participation in the program An expectation that all covered entities with contract pharmacy arrangements perform some form of annual compliance audit of the program Participation in this program can yield significant financial benefits for providers. With so much at risk, providers must review their compliance with key elements of the 340B program, including verification of the following: All patients provided drugs purchased through the 340B program comply with HRSA‘s definition of a ―covered patient‖ Covered patients are receiving services included as reimbursable on the hospital‘s Medicare cost report A double discount has not been paid by the drug manufacturers through reduced prices on purchased drugs for the covered entity and inclusion of those drugs in the state‘s Medicaid drug rebate calculations Contracted pharmacies are following appropriate procedures as instructed by the covered entities, and the DSH percentage continues to exceed the required thresholds after the recent release of the updated Supplemental Security Income percentages For more information on complying with the federal regulations surrounding the 340B program, contact your BKD advisor.

“Participation in this program can yield significant financial benefits for providers.”


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NATIONAL’S WEBINAR CALENDAR The webinars listed below are offered by National HFMA. All webinars offer exceptional education and CPE credits for members and most are FREE for HFMA members! To access the list of webinars for more information and to register, click here: Read More July Assessing the Impact of the ACA Supreme Court Decision Wed., July 11: After this webinar, you will be able to assess the implications of the Supreme Court‘s ACA ruling; review the current political and economic climate and the impact on value; and offer strategies providers should pursue to be successful. Patient Revenue Cycle Best Practice Benchmarks Wed., July 18: After this webinar, you will be able to learn macro revenue cycle trends for various hospital/system types; deconstruct root causes of claim denials; identify correlations to superior payment velocity; and drive goals or focus for investigation within your hospital/health system. Preparing for the Future: The Value of Integrating Physician Practice Data Thurs., July 26: After this webinar, you will be able to centralize and integrate physician practice data with the hospital's core analytics system; strengthen user understanding and practical applications of that data; and use predictive modeling tools to model future payment structures. August Patient Statements: Telling a Story to Collect More in Less Time Wed., Aug. 8: After this webinar, you will be able to identify the 10 most common patient statement design mistakes; and use patient statement design guidelines to accelerate patient receivables cash flow for your organization. Employee Engagement in the Midst of Rightsizing Tues., Aug. 14: After this webinar, you will be able to understand the key elements of an effective employee engagement strategy; determine the cost differential of retraining vs. hiring talent from outside of the organization; and create a new role of the recruitment department. Eliminate Payroll Checks with Debit PayCards Wed., Aug. 15: After this webinar, you will be able to understand how unbanked employees continue to be a part of your payroll; understand why some employees shun traditional banking; and know how payroll debit cards work and how they eliminate checks and check-cashing fees. Creating and Integrating a Finance Structure in Nursing Thurs., Aug.16: After this webinar, you will be able to discuss methods for creating collaboration between nursing and finance; identify improvements that can be made by having financial expertise embedded within nursing; understand and overcome the potential challenges to having a finance resource within the nursing structure; and recognize how technology can support the collaboration between finance and nursing. How to Control Costly Physician Preference Items** Thurs., Aug. 23: After this webinar, you will be able to capture all supplies outside the official MMIS to gain visibility and control of costly PPI.

Silver Sponsors



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Teri Reger, Region 8 RE conducted the officer installations

Jon Branstetter and Susan Duncan were recognized for obtaining their certification.

Rita Dew and Kyle Lee received their Follmer Bronze Awards

Terri Winning, John McGuire and Keith Bull Janice Janssen, Greg Johnson and Rita Dew

Spring Conference Summary— This year‘s conference was held at Harrah‘s May 16-18 and contained a terrific lineup of speakers! The Show-Me Chapter did their officer and board installations during lunch on Thursday. Networking receptions, dinner and a DJ on Thursday night rounded out the event. Overall, it was very educational and a lot of fun!!



One of the terrific educational sessions on Thursday

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Shirley Mason drawing for prizes during the vendor fair.

Presenter Mark Murphy, Leadership IQ

Paul Taylor, Janet Taylor, Todd Lutes, Beth Hill and Susan Duncan at dinner Thursday evening.

Kristen Prenger and Brian Kenney from Lake Regional

Rita Dew working the registration

Clockwise from the top—Connie Warnat, Janice Janssen, Phil Fichter, Glen Beussink, Rita Dew, Greg Johnson, Jon Branstetter, Joe Wewers, and Ed Clayton



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(Cont from pg 1) In situations such as the January blizzard and the floods in southeast and northwest Missouri, the activation of both the emergency operations plan (EOP) and incident command (IC) were by all accounts very successful. There was adequate notice and time to prepare, and the communication systems were uninterrupted. Although the financial damage for all three events was substantial, the impact on the health care system was manageable. Even the sudden and serious tornadoes that struck St. Louis on April 22 and Sedalia on May 24 were disasters that were managed effectively by using existing EOPs and incident command structures. Incident command also was used effectively to manage the response and recovery following an air ambulance crash in northwest Missouri. It is reasonable to state that the preparedness efforts of the past several years have resulted in hospitals being able to effectively activate EOPs and ICS to respond to noncatastrophic disasters. However, plans and exercises did not fully address the devastation and overwhelming patient surge that resulted when an EF-5 tornado wiped out much of the Joplin community, including nearly one-half of the health care resources. Although they did not have step-by-step instructions for a response of this magnitude, the EOPs and exercises provided staff with the skills needed to critically think and react with calm, purposeful actions that saved lives. Key Lessons Planning – it is unlikely that an EOP will ever provide exact response instructions, but it does provide staff the critical thinking skills needed to anticipate and respond to a disaster. Emergency preparedness planning must not be an exclusive process; all employees and medical staff must know and understand the EOP. Further, regional and state coordination are essential – know your partners. Plan and exercise together. Communication – the number one lesson learned always centers on communication. Strategic communication is necessary for coordination with employees, the public and the media, and social media must be part of this strategy. Tactical Communication requires redundant forms of equipment that hospital employees are competent to use. Resources and assets – Just-in-time delivery systems are not reliable in disasters; blizzards, floods and catastrophic damage can prevent re-supply or quickly deplete resources. Establishing a dedicated person at the onset of a disaster to evaluate supply levels, monitor use and anticipate needs beyond supplies is a critical responsibility. Safety and Security – In every Missouri disaster in 2011, the safety of staff, patients and visitors and securing critical resources were urgent needs requiring immediate action. Be aware of imposters and opportunists. Staffing – Perhaps the single most important planning consideration is how to manage and support hospital staff during a response and throughout the recovery. Take care of your staff. (cont on page 12)



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(cont from page 8) Volunteers – During a disaster, people and volunteers will self-present. Have a plan to divert or accept, credential and use volunteers who arrive on scene without basic lodging and food accommodations. The plan should include situations without a coordinating agency to verify individuals‘ names, credentials and competencies. Utilities – The requirement of a hospital to plan for a safe environment and manage a sudden or sustained influx of patients is not dependent on utilities. Consider redundant systems and agreements for auxiliaty sources of water and power. Medical Surge – The need to understand the balance between managing a surge of patients and recognizing the need for regional, state or federal resources or support is critical to ensuring patient safety. EOPs must establish detailed procedures for providing patient care in conventions, contingency or crisis settings, and transition plans must be clearly delineated. Planning for medical surge requires innovative solutions to the inherent linitations of staff, supplies and space. Evaluation – Plan of failure! Test to failure! Identify break points. Revise and correct the plan. Retest to failure! Hospital leadership and management and emergency planners must continue to make emergency preparedness a top priority within their organizations. The principles of emergency preparedness must be integrated into all aspects of patient care and business operations. The critical roles and responsibilities needed during disaster responses must be thoroughly understood and routinely practiced by those who may assume such roles. Failure to plan and prepare and failure to execute EOPs are the basis for a strong case for litigation against hospitals and their leaders. This report is a compilation and synthesis of group debriefings, presentations, surveys and interviews from hospital staff involved with the 2011 Missouri disasters, especially Joplin. It is intended to provide further reflection and synthesis while identifying the key lessons learned based on the Joint Commission‘s categories for hospital and health care system emergency preparedness. The lessons learned already have been broadly shared throughout the state and nation, and work is well under way to strengthen organizational and regional emergency operations planning in health care facilities. The results of the annual Missouri Hospital Association hospital capacity assessment conducted in February 2012 document significant improvements for Missouri hospitals. This information specifically is focused on hospitals and does not include the extensive lessons learned from key partner agencies and organizations such as the Missouri State Emergency Management Agency, the Missouri Department of Health and Senior Services, the Missouri Disaster Response System and numerous local and regional organizations. The overall effective responses to each 2011 disaster can be attributed to a strong partnership with many organizations at the local, regional and state levels. Coordination among these partners is the cornerstone for effective emergency preparedness planning, response, recovery and mitigation. This report, coupled with lessons learned from other agencies, will guide further planning and preparedness for hospitals and the communities they serve.

To view the entire article: Source: MHA Lessons Learned from the Missouri Disasters of 2011, retrieved May 25, 2012 from

For more information on becoming certified or opportunities for the Show-Me Chapter to help you obtain certification, please contact Janice Janssen, [email protected]



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Our hospice team included a nurse, a doctor, a social worker, a chaplain, and other professionals as needed. We met weekly and when we worked with a patient or family, we consulted each other as a way to improve each of our individual services. So if a patient was not interested in seeing the chaplain, the nurse and social worker would consult with the chaplain to learn how to meet any spiritual needs that might come up. We weren‘t giving communion or performing exorcisms but we did learn how to use our colleagues‘ expertise within our own work.

May 1, 2012.Ron‘s

The problem with most organizations is that there is inherent competition

newest Book Do it

between team members. Often we‘re vying for the same bonuses, the same

Well. Make it Fun.

promotions, or even that same bag of Cool Ranch Doritos that someone left

is now available on

on the counter in the break room. This can get competitive and antagonistic.

Amazon, and

So while we talk a good game about being a team player, we‘re often just trying to outshine our colleagues.

Barnes and Noble. Check it out!

Banding Together In college, I was part of the University of Virginia Pep Band. We were the highlight of the football games back in the 70‗s and 80‗s because the football team was terrible. However, today, the Pep Band no longer performs because once the football team improved, the university wanted a ―real‖ band. Prior to that, our band was a funny, satirical band that told jokes during halftime instead of performing the usual regimented (see ―boring‖) marching shows. The halftime shows were so funny, many people came to the game just to see the band. As one of the Pep Band writers once said, ―The biggest challenge for the band was writing something funnier than the first half of football.‖ Now that‘s funny. Not surprisingly, whenever an opponent came to our stadium, we made fun of them. However, whenever we traveled to an opponent‘s stadium, we made fun of their rival. We knew that if we made fun of them in their stadium, we would not succeed in winning them over. We weren‘t idiots. We weren‘t going to set ourselves up for failure. From a team perspective, you could say that we were joining together with our opponents, as a team against their rivals. That‘s how teams work. They work together, not against each other. For instance, when we played Georgia Tech, we made a joke about the girls at the University of Georgia. The Georgia Tech fans loved it. They loved it so much, in fact, when their own band started performing, the fans started chanting, ―Bring back Virginia.‖ It doesn‘t get any better than that. The Obligatory Sports Analogy As of 2011, the overall assist leader of the NBA is John Stockton, the former point guard for the Utah Jazz. Over the course of his career, he made 15,806 assists, meaning that he passed the ball nearly 16,000 times to someone else who scored. He also holds the record for steals, for most games played, for most seasons played, and for most consecutive games played. However, John Stockton is not even in the top 25 for total points scored - which is the stat that most players and fans cherish. (Cont on page 11)


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Do It Well, Make It Fun (Cont from page 10) To me, John Stockton is the essence of teamwork. He holds five major records in the NBA but most of us don‘t think of him as a superstar. Instead, we think of Michael Jordan, Kareem Abdul-Jabbar, and Kobe Bryant. Stockton, however, consistently showed up more than any other player. He created more opportunities for others to score than any other player, and he stole the ball more than any other player. He worked hard to assist the team rather than stealing the spotlight for himself. How often do you see that in your own work environment?

Membership Renewal!! Don’t forget to renew your HFMA membership! It’s fast and easy — Just go to: and renew online or print an application...Don’t miss out on valuable information and promotions! National‘s Member-Get-A-Member Program RECRUIT ONE OR TWO MEMBERS (NEW* OR FORMER**) AND RECEIVE YOUR CHOICE OF: • An HFMA apparel item (approximate retail value of $25). • $25 Visa prepaid card good anywhere Visa debit cards are accepted worldwide. RECRUIT THREE OR FOUR MEMBERS (NEW* OR FORMER**) AND RECEIVE: • A $100 Visa prepaid card good anywhere Visa debit cards are accepted worldwide. • An entry into a drawing (among those recruiting three or four members) to receive a $1,000 cash prize. RECRUIT FIVE OR MORE MEMBERS (NEW* OR FORMER**) AND RECEIVE: • A $150 Visa prepaid card good anywhere Visa debit cards are accepted worldwide. • An entry into a drawing (among those recruiting five or more members) to receive a $2,500 cash prize. NEW! MEMBER iPAD 2 DRAWING For every new or former member you recruit, you will receive one entry into a drawing for a brand new iPad 2! There are three chances to win! Drawings will be held in October, January and March.*** You will be contacted if you win, and your name will be announced in the following month‘s Membership Marketing Brief! MEMBER MAKE A DIFFERENCE GRAND PRIZE For every new or former member you recruit, you will receive one entry into the drawing for the Member-Get-A-Member Make a Difference Grand Prize worth $5,000. You will receive $3,000 in cash for yourself and a $2,000 donation in your name to the charity of your choice. The more members you sponsor, the greater your chance to win!

We are on the web—

Ron Culberson

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HFMA greetings! My name is Mike Dewerff and I am honored to introduce myself as your Region 8 Regional Executive for the June 2012 through May 2013 chapter year. I am a member of the Iowa Chapter as well as your representative on the HFMA Regional Executive Council. The purposes of HFMA‘s Regional Executive program are: • To serve as the primary volunteer and policy link between the chapters and HFMA National; • To assist chapter leaders in serving members; • To foster a dialogue and effective communications between the national and chapter levels of HFMA; • To represent the needs and interests of chapter leaders to the HFMA Board and management, and • To encourage chapters to collaborate and help other chapters. I would like to extend a sincere thank you to my predecessor, Teri Reger, for her service as our Regional Executive this past year and for being a wonderful leader, organizer, and mentor. She represented our region extremely well, and has set the stage for continued success! In addition, please welcome Randy Hoffman from the Nebraska Chapter as your Regional Executive-Elect. HFMA‘s Region 8 is made up of nine very strong chapters. They are: Greater St. Louis, Heart of America, Iowa, Minnesota, Nebraska, North Dakota, Show-Me, South Dakota, and Sunflower (Kansas). Congratulations to each and every one of them for completing a successful year with outstanding achievements that will be honored at this year‘s Annual National Institute in Las Vegas in June. All nine chapters in Region 8 earned multiple awards totaling 35 awards across the region! What a testament to the dedication and commitment of our chapter leaders to providing exceptional service to their members!! This year‘s Chairman‘s Theme is ―Leadership Matters‖. I have had the privilege of working with each of your chapter Presidents over the past year, and more recently each President-Elect at HFMA‘s 2012 Leadership Training Conference. I know your chapter leaders have you, the members, in mind when they develop their chapter goals. However, every member in HFMA has the opportunity to be a leader on a daily basis, even when you perform in routine, everyday situations to facilitate organizational change during these uneasy times in healthcare! As regional executive, I commit to being engaged in the success of each chapter during the coming year by making myself available as consultant, collaborator, and biggest supporter!

HEALTHCARE HUMOR A lady went to a doctor‘s office where she was seen by a Doctor. A few minutes into the examination, screeching could be heard from the room, and then the lady burst out of the room as if running for her life. After much effort a nurse finally managed to calm her down enough to tell her story. The nurse barged into the office of the Doctor and screamed, ―shame on you, Mrs. Smith is 82 years old, and you told her she‘s pregnant.‖ The Doctor continued writing calmly and barely looking up said, ―does she still have the hiccups?‖ Jerry was in the hospital recovering from surgery when a nurse asks him how he is feeling. ―I‘m OK but I didn‘t like the four-letter-word the doctor used in surgery,‖ he answered. ―What did he say,‖ asked the nurse. ―Oops!‖


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Customer Service Excellence -It‘s More Than Just a Motto Steve Chrapla, CHFP, Director 3rd Party Solutions, Avadyne Health Customer Service within the healthcare industry has become one of the most critical components supporting the delivery of care to patients. Whether in a clinical or administrative setting, with the advent of The Patient Protection and Affordable Care Act, HCAHPS scores, Healthcare Consumerism, and general market competition, customer service has become crucial in all aspects of patient interactions. However, merely saying we provide excellent customer service does not suffice! Customer service needs to be more than a motto, a plaque on the wall, or words on a website. Customer service is a state of mind. It must reside in the heart and soul of an organization‘s culture. All of us have experienced poor customer service at one time or another, so let‘s talk about how to achieve customer service excellence, as well as the actions required to be a World Class Customer Service provider. First and foremost, you must set an organizational standard that, in every encounter with a patient, you will go above and beyond what the patient expects. It is not simply answering a question or dealing with an issue. Instead, you must reach the next step: establish a level of comfort in the mind of the patient that all their needs (realized and unrealized alike) are being addressed. Setting these substantial expectations - and maintaining the support necessary to carry them through – requires leadership. Communicate the message and expectation loud and clear: Post it prominently on your website that customer service is paramount. Post it throughout your organization and departments, where patients and staff alike will be constantly reminded of its importance. Reflect your commitment to world class customer service in Every communication that goes to patients: letters, billing statements, clinical reports, and so forth. Emphasize your organization‘s care and concern for patients and their needs. That‘s the easy part. What‘s next is the hard part . . . . . Walk the talk! As leaders, you need to ensure that your staff has the resources to be successful. This includes outsourced processes with

external vendors, which is sometimes overlooked because it is incorrectly perceived as someone else‘s responsibility. In reality, it is more important that external partners are just as committed (if not more committed) because of the challenges of being a separate organization. This means that customer service-related interactions need to be part of every job description. You can‘t simply say ―I want you to provide excellent customer service‖ and then evaluate staff performance based on other criteria. Patient interactions need to be evaluated based on an established level of customer service that can be measured and monitored. Ultimately, customer service-related criteria can be used to support compensation levels. Along with revised job descriptions, you need to establish productivity measures that encompass the time required to interact with patients the very interactions necessary to provide that extra level of service you are aspiring to. A critical aspect to achieving excellent customer service is to ensure that all staff interacting with patients demonstrates specific abilities. An empathetic-yet-calm personality lends itself to these interactions, as do solid communication skills, and what some experts have referred to as ―emotional intelligence‖. This means they have developed the personality characteristics as well as the emotional control to deal with extremely sensitive patient issues. It is critical to train staff to interact very empathetically (and not over-emotionally) to assist in finding solutions to issues and patient challenges. Remember that two of the most sensitive emotional factors that people face are health and money. Our healthcare environment places the patient in the crossfire, simultaneously dealing with both these sensitive topics; such a situation has the potential to devolve swiftly into a major customer service challenge.Even a 5-minute phone call allows for the building of a positive relationship with the patient. Such a relationship creates the opportunity to achieve excellent customer service. However, to achieve this you will need to recognize 4 basic personalities and/or communication styles that patients exhibit: Spontaneous – likes to talk Agreeable – avoids conflict Directive – to the point Logical – wants to see data

(Cont on page 14)

estimated 40% of the population estimated 25% of the population estimated 25% of the population estimated 10% of the population



Customer Services Excellence —

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(cont from page 13)

These personality types are important to identify, because correctly identifying the patient‘s will best guide successful interaction with that patient. Spontaneous people will respond emotionally to points discussed, and will question rules unless they understand –and agree- with those rules. Agreeable people are people oriented; with ―nurturing‖ and encouraging interactive style, they will respond positively. Directive types need to see the big picture, act independently, and may come across as impersonal. Finally, and least commonly, patients of the Logical type are responsible, structured, like to see facts, and follow rules. Recognizing these personalities in early interactions is not always easy, and people typically have some blend of these characteristics, and may even display different types across multiple interactions. Nevertheless, accurately identifying the closest type in a given situation –and knowing how to react and respond to the differences– can go a long way in winning consensus over a difficult situation. Even taken together, Communication skills, emotional intelligence, and good listening abilities do not completely constitute the ideal staff member. There are additional levels of knowledge that must be mastered. These require development of technical skills and ongoing training to be knowledgeable enough to deal with the challenges that arise. Proper training is a constant and never ending circle.Call centers operating in healthcare facilities need to ensure that their staff is educated and trained on all the organization‘s current policies and procedures, as well as the healthcare industry revenue cycle and payers processes. These technical skills, along with the aforementioned empathy, communication, listening, and other interpersonal skills, are essential components of all training programs. For staff to become –and remain– proficient, following the ongoing training circle is a must. Avadyne Health, a national healthcare revenue cycle management firm, has implemented a training model to provide specific focus in the customer service area to all patient account representatives. This model designed to enhance the patient experience and assist patients, centers around a very specific approach to each call and contact with the patient. The telephone call is guided by addressing the personal desires of the caller through this approach labeled SMART. S – Set the Tone/Actively Listen M – Meet/ Acknowledge with Care & Empathy A – Ask the Right Questions R – Resolve/ Recommend/ Resolve T – Thank the caller/ Effectively end the Call Each call is reviewed for evaluation and training purposes and then ongoing QA is conducted and a weekly review/coaching session occurs with each rep to score the call‘s effectiveness towards patient resolution of the issue. Scores are tracked to monitor continued compliance and performance improvement. To enhance your level of patient satisfaction and achieve a world class customer service operation you should ensure you have these areas addressed within your organization. Establish and communicate your commitment to customer service Your organizations and department mission statement should describe your commitment to excellent customer service Senior leadership must endorse and publicly support the initiatives Foster an environment where staff recognizes the commitment/customer service mission statements need to be visible in all work areas Evaluate job descriptions and requirements to support excellent customer service Staff performance measures need to recognize customer service initiatives Ensure you have the right people with the right skills in all patient contact areas Establish training initiative focused on customer service techniques Develop QA process to review staff interactions with patients Utilize telephone call recordings as both training opportunities as well as recognizing successful interactions with patients Recognize and celebrate successful customer service calls and promote the positive experiences throughout the organization For more information on how to enhance your patient experience and achieve a world class customer service operation please contact Avadyne Health.



News from National

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Thanks for the Memories


Joseph J. Fifer, FHFMA, CPA, its new President and Chief Executive Officer. Fifer will assume the role in June 2012. For the past 11 years, Fifer has been Vice President of Hospital Finance at Spectrum Health, located in Grand Rapids, Mich. Fifer has been a keynote speaker on healthcare finance and reform for organizations including the Center for Medicare & Medicaid Innovation and The Governance Institute. His industry insights have been featured in Forbes, Business Week, The Wall Street Journal, and many other leading publications. Fifer was Chair of the HFMA Board of Directors in 2006-2007. ―As a healthcare industry spokesman, a finance executive, and an HFMA leader, Joe has demonstrated a clear vision for the role that finance professionals play in improving the healthcare system,‖ says HFMA 2011-12 Chair Gregory M. Adams, FHFMA. ―I am confident that Joe will bring the same vision to his position as HFMA President and CEO.‖ The HFMA Board chose Fifer after an extensive search by a professional recruitment firm overseen by a committee of HFMA volunteer leaders. ―Finance is in the spotlight as never before,‖ says Fifer, ―with healthcare organizations challenged to drive down unsustainable costs while improving quality. I am honored to assume this HFMA leadership role at a time when finance professionals can deliver significant industry improvement. HFMA is in an outstanding position to lead these changes because of the foundation built by strong staff leadership, board vision, and member commitment.‖ From HFMA National Website

After 26 years as President and CEO of HFMA, Richard L. Clarke is handing over the reigns to Joseph Fifer. ―I have a lot of wonderful memories as HFMA‘s CEO for 26 years. I had a terrific opportunity as a fairly young CEO to run a national association during an amazing period of time.‖ From his last HFM column as president of HFMA.

RALPH LAWSON ASSUMES HFMA BOARD LEADERSHIP Mr. Lawson is Executive Vice President and Chief Financial Officer, Baptist Health South Florida, Coral Gables, Florida. He is also Chairman of the Board of Catholic Health Services in Fort Lauderdale, Florida. A member of HFMA since 1980, Mr. Lawson‘s involvement with the National Association includes serving on the Matrix (1987-88), the National Advisory Councils (2006-07), the Audit & Finance Committee (2007-12), serving as chair 2010-11, the Strategic Planning Committee (2010-12), serving as chair 2011-12, the Healthcare Leadership Council (2010-12), serving as chair 2011-12, the Executive Committee (2008-12), and the Board of Directors (2007-12). Mr. Lawson also served the Colorado Chapter as Vice President and Program Chair, Treasurer, and President. He has received the Follmer Bronze, Reeves Silver, and Muncie Gold merit awards. Mr. Lawson, a Fellow of HFMA and a Certified Public Accountant, received his Bachelor of Business Degree (Cum Laude) from the University of Colorado School of Business, Boulder, Colorado, and his Masters Degree of Business Administration (with distinction) from The Wharton School of the University of Pennsylvania, Philadelphia, Pennsylvania. He has selected the theme ―Leadership Matters‖ for his year as National Chair. ―The need for leadership in health care has never been greater... ―Leadership matters‖ conveys the idea that we are all accountable for the fulfillment of our organizations‘ missions.‖ One person‘s acts of leadership—however small-—can make a difference. Good leadership can spell the difference between success and failure or mediocrity. It‘s important to stay vigilant for opportunities to exercise a leadership role. Taken from HFMA National‘s website


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Summer Conference Overview July 25-27 On Wednesday, July 25, we will provide a ―New to Healthcare‖ Education session FREE to any provider (HFMA member or not) with less than three years experience in the healthcare field. The session will start at 9:00 Wednesday morning and go until 2:00 covering topics including Accounting, PFS Revenue Cycle, Reimbursement, Managed Care, IT, Decision Support and Internal Audit. We will limit this opportunity to the first 50 registrants. They are also invited to attend the first Conference session, a CFO panel discussion, at 3:00 that afternoon as well. For more information, contact Kyle Lee, [email protected] Conference will continue Thursday and Friday with: Key Note speaker—Kurt Mosley on Healthcare Reform and the Private Practice Physician Audit and Reimbursement update from WPS ACO Early Adopter 340(b) Compliance Medicare Dependent Hospitals Federal Update Employment Discrimination

Of Course, we will have networking opportunities and new this year, we will have a vendor fair featuring Show-Me Chapter sponsors on Thursday. This is one of the benefits of being a chapter sponsor—if anyone would like information on becoming a chapter sponsor, please contact Jennifer Ogden, [email protected]

NEW MEMBERS Michelle Beckett Bourbon, MO

Tanya Porter Saint Robert, MO

Jeffrey Elliott McKesson Corporation

Lisa Neuendorf Audrain Medical Center

Kelly Dolan Capital Region Medical Center

Kurt Seiter GHX

Don Leibert Missouri State University

Natalie Reynolds Sisters of Mercy Health Systems

Kurt Ebers Hannibal Clinic

Mitchell Cox CoxHealth

Patricia Nowlin Cooper County Memorial Hospital

Mary Beasley Professional Credit Management

Sara Lowry Skaggs Community Health Center

Patricia Williams Skaggs Regional Medical Center

Hubert King SoutheastHEALTH

Michael Sanders BKD, LLP

Mark Mountjoy University Hospitals & Clinics

Robin Darr Preferred Family Healthcare, Inc

Jennifer Lintner First American Equipment Finance

Steve Aungst Summit Funding Group

William Page HEI Consulting, LLC

We would like to extend a warm welcome to our newest members of the Show-Me Chapter!


ANI 2012— Janet Taylor

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Ralph Lawson, HFMA Board Chair, Kory Stout, and Greg Adams

ANI was held in Las Vegas, NV June 24-27, at Mandalay Bay and featured a terrific lineup of speakers. I wanted to share a few of the highlights of the Annual National Institute that Kory & I attended last week in Las Vegas. In the opening session, the HFMA Chair from the UK addressed the attendees. She spoke of the many years of collaboration that the US & UK HFMA organizations have enjoyed and that the problems we each face are different, but similar in ways. Carl Lewis, Olympian athlete gave the Sunday keynote address. It was fun to hear his story and how he stressed that a strong focus and very hard work are the keys to success. We heard the last words from outgoing HFMA Chair Greg Adams and the first (actually 2nd as we also heard him speak at LTC) words from Ralph Lawson as he takes over as the 2012-2013 Chair. He discussed his ―Leadership Matters‖ theme for the year. Chelsey (Sully) Sullenberger III, the pilot that landed the airplane in the Hudson River several years ago gave an excellent presentation and talked of the value of leadership in our Day 2 keynote. Joe Fifer, The incoming CEO of HFMA, spoke to us and of course, Dick Clark, outgoing CEO was honored by as many people as could do so. They told him to just get over it and accept all the praise as they were not going to let him go out ―low-key‖ as he had asked!! Mr. Clark spoke to the attendees as well. It was a bittersweet moment to hear his final address to us. At the Presidents‘s Dinner, we sat with other members from Region 8. Kory was great as he accepted the awards on behalf of the chapter which included the Bronze Award of Excellence for Education, the Henry Hottum Award for Educational Performance Improvement, an individual chapter Helen M. Yerger Special Recognition Award and two Multi-chapter Yerger awards for the Show-Me Chapter!. Thank you for allowing us to be part of this huge HFMA event.

Accepting one of the Multi-chapter Yergers.

Paul Taylor, Janet Taylor, Kory Stout, Tom Hogan and Terry Currie

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Thank you to our Corporate Sponsors Gold Sponsors

Silver Sponsors





Human Arc

Kramer & Frank

Missouri Medical Collections

Bronze Sponsors Account Resolution Corporation Avadyne Health D-MED Corporation

Consumer Collection Management

Commerce Bank Professional Credit Management

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Emdeon HRS Erase

Midland Group

I've learned that people will forget what you said, people will forget what you did, but people will never forget how you made them feel. - Maya Angelou

SHOW-ME HFMA NEWSLETTER If you have items of interest or suggestions for our newsletter, please contact me. All feedback is appreciated!! Jennifer Ogden Audrain Medical Center 573-582-8095 [email protected]