December 10, 2008

Experts Cover RAC Issues Large and Small

By

by Chuck Buck

Even as The Centers for Medicare and Medicaid are preparing for the launch of the permanent Recovery Audit Contractor program, subject matter experts in healthcare information and technology are now reporting on crucially important issues in RacMonitor.Enews, a bi-weekly publication from RACMonitor.

 

Guiding and shaping the editorial content is a group of leading authorities on RAC-related issues including compliance, reimbursement, coding and documentation provides the content.

 

Editorial board members include Duane Abbey, Ph.D., CFP, president of Abbey & Abbey Consultants, Inc., Bret S. Bissey, director, IMA Consulting, Patricia Dear, CEO and president of eduTrax, Samuel A. Donio, Jr., president of CBIZ KA Consulting Services, Leo D’Orazio, managing director of Withum Smith +Brown, Linda Fotheringill, Esq., co-founder and president of Washington & West, LLC, Nancy Hirschl, president of Hirschl & Associates and Cheryl Servais, vice president, compliance and Privacy Officer for Precyse Solutions, LLC.

 

These experts are featured in our bi-weekly e-newsletter Their articles are written to help providers prepare for RAC activities when the program begins sometime in February, pending the outcome of a dispute arising from two unsuccessful bidders for the RAC program.

 

Duane C. Abbey, Ph.D., CFP, is an educator, author and management consultant working in the healthcare area.  He is president of Abbey & Abbey, Consultants, Inc., a firm that specializes in healthcare consulting and related areas.  His firm is based in Ames, Iowa.  Dr. Abbey earned his graduate degrees at the University of Notre Dame and Iowa State University.

 

His work in healthcare related areas now spans more than 25 years.  He spends about half of his time developing and teaching workshops and making presentations to various professional organizations.  The other half is devoted to consulting by performing chargemaster reviews and compliance reviews, providing litigation support, conducting reimbursement studies, and conducting coding and billing audits.


 

Bret S. Bissey, MBA, FACHE, is a nationally recognized expert in healthcare compliance.  He is the author of the Compliance Officer’s Handbook, published in 2006, and has presented at 40+ regional and national industry conferences/meetings on numerous compliance topics.  He has over 25 years of diversified healthcare management, operations and compliance experience.  He has presented compliance-focused education sessions to numerous audiences in the last 10 years.

 

During Bret’s nine year tenure as the Chief Compliance and Privacy Officer at Deborah Heart and Lung Center, he was responsible for the development and ongoing management of the Corporate Compliance Program at a specialty hospital with 90 + employed physicians.

 

Leo D’Orazio, MBA, FACHE, is the managing director for WithumSmith+Brown where he manages the healthcare consulting practice for the firm. Mr. D’Orazio began his career in healthcare administration and consulting in 1973 at Mercy Catholic Medical Center in Darby, PA. He then became Senior Vice President and Assistant Administrator at St. Mary’s Hospital in Philadelphia where he was responsible for all clinical and support departments. In 1983 he became Senior Vice President and Chief Operating Officer for Roxborough Memorial Hospital, Roxborough, PA, where he established a Medicare-certified home healthcare department. Leo later served as Executive Director and Chief Executive Officer at the Northwestern Institute of Psychiatry, Fort Washington, PA, and then became Principal-in-Charge of the healthcare consulting practice for the Philadelphia office of Arthur Young (Ernst & Young).

 

Sam Donio, MBA, is president of CBIZ KA Consulting Services, LLC.  He has been an innovator in the healthcare industry for 25 years.  An authority on sound and compliant healthcare financial management, Mr. Donio has developed numerous products and services to meet the ever-changing needs of healthcare providers. Mr. Donio was one of the first consultants to work with the Medicare DRG system and has developed software platforms that help hospitals improve their clinical coding and financial performance through better documentation and compliance.


 

Patricia Dear is CEO and president of eduTrax®, the provider of educational programs for RACMonitor.com. Ms. Dear has more than 30 years experience in the healthcare industry working within corporate healthcare entities; for-profit and non-profit hospital systems; legal defense and plaintiff counsel; and is a national speaker on reimbursement and compliance.

 

Linda Fotheringill, Esq., is a founding member of Washington & West, LLC, and is a nationally recognized expert on Denial and Appeals Management.  Ms. Fotheringill successfully assists hospitals across the country, overturning “hopeless” denials and generating millions of dollars in otherwise lost revenue.  Ms. Fotheringill’s experience includes overturning RAC audit denials as well as other Medicare denials, particularly in the area of Inpatient Rehabilitation.  She has also represented clients in insurance contract disputes and medical malpractice litigation.  Ms. Fotheringill began her career as a hospital-based Physician Assistant in the areas of general surgery, oncology, neurosurgery, and trauma. She also has fourteen years of experience in the insurance industry as a Claims Representative with Medical Mutual Liability Insurance Society of Maryland.

 

Nancy Hirschl, BS, CCS, has over 30 years of experience in the fields of health information and revenue management. As president and founder of Hirschl and Associates, Nancy develops, administers, and manages services that address best practices in revenue integrity.

 

Ms. Servais, MPH, RHIA, has more than 25 years of experience in Health Information Management. In her position at Precyse Solutions, Ms. Servais’ responsibilities include planning, designing, implementing and maintaining corporate-wide compliance programs, policies and procedures, and updating them to accommodate changes in federal and other regulations.  In addition, she oversees training and development programs related to ethics, compliance and patient privacy; develops and chairs compliance and privacy advisory committees at the Executive and Board levels; and takes an active role in professional organizations.

 

When you consider the expertise represented by our editorial board, we believe that RACMonitor is the single most important source for RAC news and information


###
Chuck Buck

Chuck Buck is the publisher of RACmonitor and is the executive producer and program host of Monitor Mondays.

This email address is being protected from spambots. You need JavaScript enabled to view it.