Articles taken from "The VOICE" October 1998
The VOICE
October 1998
Thoughts About WMCA's Annual Institute by Joan Carr
Our 36th annual program was a bit different from our usual meetings-it was less technical. Despite the "lack of technicalities", it was an incredible learning experience for several reasons:
The information on compliance has shown all of us that billing services and other vendors will soon be under the "compliance umbrella".
What a wonderful opportunity we have through the WMCA-a forum to work this transition effectively! In my travels, I have found no other state has such an organization-too bad.
The "Cold Call Man" and Fred focused on the human side of "work". While Ron reinforced my thinking and attitudes about management of people, it was Fred's presentation that hammered home the "life lessons". This was profound for me because I was notified late Thursday that one of my hospice patients had died. I had just spent the better part of Tuesday with her so this did not come as a surprise, but it did have an impact which an extra day & the cruise helped me to gain closure.
My patient (& my friend) is gone but the life lessons shared are mine forever. In my 15 years of hospice counseling, I have been given many by people literally at the end of their lives (in some cases, hours). Since hindsight is 20-20, much can be gained from these - which I will share with you:
Everyone has 24 hours in a day, no more, no less.
Turning off the TV can be the most profound thing a person does in his life.
Regrets are bad. At the end of life they are devastating because there is no hope of undoing them.
A minute is a long time when measuring the moments between drips in your own IV bottle at 3 A.M.
Speak now or forever hold your peace is not just for weddings.
If you don't do it now, you may never get another opportunity.
I didn't tell my wife I loved her. I was too busy working for the $500,000 house with 3 cars in the garage. My wife found someone else who told her he loved her she's happy. I'm dying and just now realize what is really important. Besides, my cars have not visited me once and my banker is uncomfortable talking to me.
Death is equal opportunity.
So is procrastination.
Procrastination catches up with you at the end of life then it's too late.
Say what you gotta say - NOW!
Always, always, always tell your children you love them each day. They may be taken from you.
Ann Landers & Dear Abby columns are full of letters from people who regret their procrastination. They must live with it each & every day. They can never undo it. Don't be those people.
In closing, I would like to thank WMCA officers for putting together a wonderful program that point to a rather obvious conclusion - work occurs in life, not vice versa!
Joan Carr is President of J Carr, Ltd. health coverage & reimbursement specialists. She holds an MBA and has 20 years in both the clinical and financial aspects of health care. She is a national member of the Medical Group Management Association and a member of the Wisconsin Medical Credit Association.
Whistling a Different Tune
False Claims Act under scrutiny
It's pretty safe to assume that when Abraham Lincoln first enacted the False Claims Act, he had never even heard of such futuristic terms as, "Medicare", "hospital-based billing" or "bundling". Yet today, in the wake of an all out effort by the government to reign in fraud in Medicare billing, new life seems to have been breathed into Lincoln's civil war era law as federal enforcement officials continue to aggressively target hospital-based billings for potential False Claims Act exposure. The False Claims Act, which is often referred to as the "Whistle-Blower Act" because it provides tempting financial incentives for private citizens who bring cases concerning the fraudulent submission of monetary claims against the government to the government's attention, has recently come under closer scrutiny in Congress. A new bill, the Health Care Claims Guidance Act, which is meant to soften the False Claims Act and provide guidance on differentiating between intentional submission of false Medicare claims and honest billing mistakes, has been introduced in the Senate. The new measure is also sup ported by the American Medical Association (AMA) which stated that the bill would, "limit the use of the False Claims Act to intimidate those who are merely victims of a confusing and complex billing system."
The new bill would amend the False Claims Act and create the following health care "safe harbors" with retroactive effectiveness:
Overpayments that are below what Health and Human Services would define as a "material amount" of an individual's total claims in a particular year.
Individuals who are in "substantial compliance" with a government-approved model compliance program.
Claims based on inaccurate guidance from the government or its contractors.
Cases that fail to meet the new and more rigorous proof test of "clear and convincing evidence."
Although, the Justice Department has agreed to soften its initial correspondence with providers, it remains adamant about not changing the Act. The Department, however, has agreed to form work groups of U.S. attorneys across the nation to develop a set of guidelines and best practices for using the False Claims Act. Unfortunately, much to the dismay of associations like AMA and the American Hospital Association, these groups do not include hospitals.
Reprinted with permission of State Collection Service, Inc, Madison, WI "Pulse".
Follow Proper Procedure Before Firing
Before you decide to end an employment relationship, you should first make sure that you can answer "yes" to these questions: Is the documentary record complete? Have company policies been followed? And most importantly, has the employee been made aware that the end is near? Try to anticipate the employee's reactions. Consider issuing a clear final warning instead of proceeding with the termination. If the rules of probation are set properly-termination can occur at any time during the period, and performance must remain satisfactory even after probation ends- then the burden of waiting to shore up your ultimate position should be well justified. Being certain that the employee can't claim surprise is particularly important now that nearly all employment claims are reviewed by juries. Jurors often consider the fundamental fairness of the employer's action. If the employee wasn't made aware of your sense of expectations, and if you did not give the employee an opportunity to turn the situation around, there's a good chance the jury will stretch to find a reason to hold you liable. Some of the trickiest termination meetings involve confrontations over alleged misconduct. While firing an employee on the spot may produce a fleeting sense of satisfaction, it is almost never a good idea. If misconduct is involved, lead with questions. There are at least three good reasons why this termination meeting should start with thorough questioning about the suspected misconduct.
First, the employee may have an explanation that raises questions about his culpability. An honest mistake, a mistaken identity or some other fact may change the picture dramatically. You should take the plausible excuse into account before announcing your final decision. Second, if you ask questions before you pronounce judgement, the employee may volunteer information that would not be forthcoming after termination. The employee may say that a supervisor condoned the misconduct, that other workers are engaged in the same activity, or that he will resign, relieving you of the burden of making a decision based on ambiguous facts.
A resignation that procedes notice of termination will probably be deemed voluntary, while one that follows usually has the same legal consequences as a discharge. Third, if the meeting starts as an investigation, your final decision can take into account the employee's demeanor, candor and cooperation. The decision to terminate may be far easier to justify when the employee's inconsistent or evasive answers are taken into account.
Reprinted with permission of American Collectors Association, Inc. "Collector"
Company Helps Define Personality Traits of Successful Collectors
Top collectors possess three key traits
In most professions, successful employees possess a wide range of personality traits. This however is not the case among successful collectors says Mollie Steele, executive director of Career Assessment Center. The best collectors, she says, have very distinct personalities. CAC, based in Virginia Beach, Va., works with employers in a variety of professions to evaluate the personality strengths and weaknesses of perspective employees.
"There is generally a very high turnover in collections because not everyone can be a collector," explains Steele. "But you can go into some industries and personality traits are all over the board."
Because successful collectors posses such distinct personality traits, testing can be an effective way of assess in potential collectors. While interviews are used most often to weed out applicants, they often offer little useful insight.
Simply interviewing applicants isn't enough in collections, says Steele. The responsibilities and duties of collectors, are so specific that it takes a distinct combination of personality traits to; one, do the job successfully and two be comfortable with the job and stay.
The Comprehensive Personality Profile, available through CAC, measures seven basic personality traits through 88 true/false questions. These traits include emotional intensiveness, intuition, need for recognition, sensitivity, assertiveness, exaggeration and trust. The test usually takes about 20 minutes to complete. Using a scoring disk, results of the test are known in about five minutes.
Of the seven traits, CAC's research has turned up three that are key to successful collectors:
1. Assertiveness
2. Sensitivity
3. Trust
Ideally, collection departments should look for individuals with moderate to low sensitivity, high assertiveness and low trust will be less sympathetic to excuses given by debtors. These traits help assure detached objectivity. However, while most collectors possess the same traits, successful health care collectors often have a slightly higher sensitivity rating. This trait is almost always accompanied by a high level of assertiveness.
"People with a high level of sensitivity tend to feel the pain of other people and spend too much time listening to debtors," she says.
A collector who is going to spend the majority of the day sitting at a predictive dialer also needs to possess a low level of emotional intensity. "If the collector is going to spend six to eight hours on a dialer, you definitely don't want a type-A personality,"says Steele.
Cost of the basic testing kit is $125. This includes five questionnaires, a user's manual and an IBM-compatible scoring disk. The same package with 25 questionnaires is $500. For more information, contact the Career Assessment Center at (800) 753-7600.
Reprinted with permission of Aspen Publishers, Inc., Gaithersburg, MD with Midwest Office in Brookfield, VVI. Health Care Collector."
"Twenty-Five" Fantastic Tips to Maximize Your Effectiveness
1. Set priorities
2. Use your time wisely
3. Hire slowly... fire quickly
4. Learn to be a great listener
5. Delegate whenever possible
6. Make employees feel special
7. Criticize seldom... praise often
8. Praise in public criticize in private
9. Never accept unacceptable behaviors
10. Only give employees one second chance
11. Promise your staff only what you plan to do
12. Share your department's goals with your staff
13. There's no right way to make a wrong decision
14. Your actions always speak louder than your word
15. Your judgement is only as good as your information
16. Talking without thinking is like shooting without aiming
17. Be firm, be fair and most important, be financially profitable
18. Every employee is unique... get to know all your employees
19. If management were easy every employee would be a manager
20. Don't ask people to work for you... ask them to work with you
21. Treat employees as your most valuable resource; because they are
22. Preventative management is less painful than restorative management
23. Be brave even when you're not; employees will not know the differencev 24. Don't motivate your employees if they are moving in the wrong direction
25. If in doubt, don't hesitate, always do the right thing...call The Cold Call Man
For more great management tips call The Cold Call Man 800-274-7757
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