Kareo and Healthcare Business Consultant, Aimee Heckman, have teamed up to inform you of the latest tools and resources to help get your practice and billers/billing company get ready for any obstacles that may come your way in the new year. Aimee Heckman will: -Review the state of the industry in 2021, including surprise billing, data breaches, and penalties. -Explain the normalization of telehealth and getting paid for telehealth. -Expand on patient collections and run the business as a business. This includes setting up your practice with a variety of payment options to treat patients more as consumers to improve patient satisfaction. -Prepare your practice for 2022 with best practices for MIPS, security audits, financial policies, insurance waivers, and patient eligibility

1. Aimee Heckman, CPB, CPPM
President, Ease RCM Solutions
Getting Paid in 2022: Adapting
Your Practice to Thrive Within
the Healthcare Evolution

2. Safe
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3. • Welcome & Introductions
• Looking Forward to the Dawn of 2022
• State of the Industry in 2021
• What’s Next for Independent Practices
• Preparing Your Practice to Thrive in 2022
• How Kareo Can Help
• Q&A

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Supporting Your Professional Development
• PAHCOM has approved 1 CEU credit
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6. Aimee Heckman, CPB, CPPM
President, Ease RCM Solutions
Aimee Heckman is a Healthcare Business Consultant
with more than 30 years of experience in Medical
Practice Management, Revenue Cycle Management,
PM/EHR implementation, and business development.

7. Looking Forward to the Dawn of 2022

8. “It’s always darkest before the dawn!”

9. State of the Industry in 2021

10. Public Health Emergency
Continuation of Public Health Emergency
throughout 2021.
Many CMS waivers remained in place.
CMS Telehealth Expansion.
Vaccines allowed for return to more in-person
activities including healthcare.

11. Surprise Medical Bills
No Surprises Act passed late in 2020.
Applies primarily, but not exclusively, to
emergency services.
Independent practices should be aware of the
rules that apply to non-emergency out-of-
network services.
Effective January 1, 2022.

12. HIPAA – Patient Right of Access
Patient Right of Access Investigations
continued in 2021.
Office for Civil Rights announced the 25th
enforcement action.
HHS Proposed Modifications to HIPAA Privacy
Rule – reduces time to provide access from 30
days to 15.

13. HIPAA – Data Breach Investigations
Vast majority of breaches were reported by
healthcare providers.
Email and theft or loss of phones, tablets, or
laptops appear to be most common cause of
breach.
Malware, ransomware, and email phishing
continue to be on the rise.

14. Don’t Get Hit with Penalties
Patient Right of Access Data Breaches
Reduction from 30 days to 15
21st Century Cures Act prohibits information
blocking and establishes fees and penalties
Breaches of 500 or more must be reported
Tighten up policies for remote workers and
mobile devices

15. What’s In Store for Independent Practices?

16. New Payer Tricks to Slow Payment
Have you noticed an increase in denials of
Coordination of Benefits?
Some insurance payers are requiring quarterly
COB updates instead of annual.
Watch for denials that state that information
requested from subscriber has not been
provided.

17. Staffing Challenges
“The Great Resignation”
Turnover in medical practices impacts revenue.
Automation can reduce staffing burden.
Document all processes to facilitate better
training for new and existing staff.
Consider outsourcing tasks traditionally handled
in house such as benefits verification.

18. Telehealth Is Here to Stay
In 2021, 98% of Medicare
Advantage plans included
telehealth benefits.
98%
Claim lines for telehealth in
December 2020 were 2,817%
higher than December 2019.
2,817%
August 2021 telehealth claim
volumes were still 2,529%
higher than August 2019.
2,529%

19. Telehealth Is Here to Stay
Be sure that you are using a HIPAA-complaint
telehealth platform.
Integrated solutions improve efficiency and
effectiveness of your telehealth visits.

20. Telehealth Is Here to Stay
Make sure that you continue to get paid for
telehealth .
Not all telehealth benefits are the same!
Confirm your patients have benefits for YOUR
services, not just preferred vendors.
Review payer policies monthly.
Be aware of new place of service code 10 for
telehealth services provided in the patient’s
home.

21. Telehealth Is Here to Stay
Collecting payment when patient is not
physically present can be challenging.
Verifying benefits for every telehealth visit is
critical.
Copay policies should be the same for
telehealth as for in person, be sure to collect
before the visit begins.

22. Patient Collections
Nobody likes asking patients for money.
Like it or not, a medical practice is a business.
Even though more visits are delivered in
person, getting payment is still challenging.

23. Patient Collections
Delivering statements in the way patients
prefer is more critical than ever.
People move more frequently, but cell phones
and email stay the same.
If you are not using email and text statement
options, you are leaving money on the table.

24. Consumers prefer e-payments
for medical bills
63% 66%
Consumers are interested in
using a mobile payment system
Consumers would consider
switching providers for better
healthcare payments
experience
Mobile Payment System Better Healthcare Payments
E-Payments
83%
Source: JP Morgan/Instamed Trends in Healthcare Payments

25. Patient Collections
Use multiple methods for sending balance
notifications to patients:
• e-Statements
• Text Statements
• Paper Statements
• Patient Portal
Provide patients their preferred statement
method to get paid faster!

26. Patient Collections
Automate as much of the patient billing
process as possible.
Keep credit cards on file using a secure PCI
compliant system.
Capitalize on software integrations that allow
statements to go out as soon as patient
responsibility is determined.
Offer multiple payment methods and options
for payment plans.

27. Preparing to Thrive in 2022

28. MIPs Hardship Exception
Small Practice Hardship Exception is
automatically approved, but you must request
it via the HARP QPP Portal.
If you are part of an ACO/APM, check with
them to see if you should apply for Promoting
Interoperability Exception only.
December 31, 2021 is the deadline to request.
Submitting data after applying will void the
exception.

29. Prepare for Surprise Billing Rules
Out-of-Network Providers must provide a
good faith estimate for non-emergency
services.
Patient cost-sharing for emergency services
can’t be more than in-network cost sharing.
Out-of-Network Providers may not bill more
than allowed amount without prior consent.
Provider must request arbitration within 30
days of payment offer if they feel it is too low.
All providers must provide a good faith
estimate to uninsured/self-pay patients.

30. Capture Every Dollar You Can
Accurate coding and charge capture are more
important than ever.
If you are providing the following services, be
sure you are billing for it:
• Chronic Care Management
• Depression Screening
• Tobacco Screening and Cessation
• Pediatric Vaccine Counseling
Don’t “double dip” if you are using time-based
options for E/M codes.

31. Fine Tune Patient Collections
Use every point in the revenue cycle as an
opportunity to collect:
• Appointment reminders and confirmations
• Check-in for both in-person & virtual visits
Offer multiple payment methods at each of
these phases.
Implement modern statement options to
increase the rate and amount of collections.

32. Year End Housekeeping
Conduct your HIPAA Risk Assessment
Apply for MIPS/QPP Exception
Review your Financial Policy
Prepare for Cost Sharing Reset
Refresh Eligibility Verification Policies

33. Awards and Rankings

36. Questions
Answers
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