SHIPS JULY 2008
Decoding Provider Taxonomy
Practical Uses for Providers, Payers and Partners

80 minutes; standard DVD format (NTSC, SD).

Includes live resource links document.

Catalog ID:
BI-TAX08A-0106
$395.00 USD

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For payers accustomed to assigning proprietary identifiers to their providers, taxonomy is seen as a possible “tie breaker” for reconciling one-to-many NPI matching problems. For providers attempting to balance the conflicting needs of multiple payers’ contracts and billing requirements, taxonomy could help them build an NPI strategy that satisfies them all. In fact, as payers begin to define their post-NPI companion guides, they may have to.

With real-world experience in taxonomy implementation and over three years of subject matter research and analysis, Martin Jensen will share with participants how the code set can be used effectively in the context of multi-trading partner exchanges.

• Providers will learn how to evaluate whether their systems are at risk, and how to work with their payers and vendors to resolve issues.
• Payers will learn what they can reasonably expect from a taxonomy-dependent NPI strategy, and how to more effectively deal with the realities of the provider universe.
• Vendors will learn how to sort out – literally – diverging trading partner requirements, and provide solutions that add value on both sides of the transaction.

Participate in the live video tapings July 15 and 16, via Flash Point Webinars!

[ More details | Order Online | Download Fax/Mail Form ]

NPI Crunch Mode Series

Research in a three-DVD, one-CD-ROM set, also available separately (below).

Includes live resource links documents.

Catalog ID:
DVD-NPICM-0099
$595.00 USD

[ Order Online ]

CMS’s regulators have soft-pedaled National Provider Identifier enforcement and even given mixed signals on who needs to use NPI and when, and Medicare has played hardball...

Will CMS balk again? Perhaps, but even if they do, it may not matter to billers, vendors and other payers. Some of the Medicare decisions seem to be hard-coded, and others are just plain hard-headed.

No matter what happens, this hard-hitting, three-session suite presents independent, actionable and up-to-the-very-last-minute insights into NPI implementation. Even if CMS issues new edicts, or if Medicare changes its contingency plan (again – and they will), you can be assured of unfiltered, unvarnished truth you simply can’t get anywhere else, from one the nation's leading authorities on the National Provider Identifier.

So please don’t expect another “play nice and try harder” fundamentals talk here – these three sessions skip past the Good and get straight to the Bad and Ugly aspects of NPI implementation that may already be disrupting your operations and revenue streams. We don’t stop there, of course. Once we get to the root causes, we’ll give you tools, intelligence and Weapons to Prevent Mass Disruption. Click here to order the $595 set, with free 2-day shipping in the U.S.

Each 50- to 55-minute video is free-standing, and may be ordered separately:

• NPI: Facts in Evidence
• NPI: Medicare Insights
• NPI: Final Status

[ Order Online | Download Fax/Mail Form ]

NPI: Final Status
Analysis of the Current State of the National Provider Identifier

50 minutes; standard DVD format (NTSC, SD).

Includes live resource links document.

Catalog ID:
DVD-NPIS0805-0098
$295.00 USD

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Based on results of the NPI Contingency Status Survey.

We heard the reports of the Medicare crosswalk failures, the conflicting demands of different payers, the holdups in enrollment updates.  We read the stories of small clinics in financial turmoil over stalled payments. Somebody said, "We need to know what's really going on!" Big organizations move slowly, but we realized we were in a position to move very swiftly. So we issued a survey and asked it to be passed along to everyone involved. In this low-cost webinar, we'll present our own analysis of those findings, and make our recommendations to avoiding the worst consequences of an NPI train wreck.

• Survey results for providers, payers and clearinghouses  
• Crosswalk processes and problems as reported by payers and providers
• Critical issue: Secondary providers without NPIs (Referring, Ordering, Attending, etc.)
• A bird's eye view from the clearinghouse level
• Recommendations for organizations and the industry as a whole
• More insights that will only come clear as the results come in

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NPI: Medicare Insights
Crosswalk Failures and Secondary Providers

55 minutes; standard DVD format (NTSC, SD).

Includes live resource links document.

Catalog ID:
DVD-NPIM0804-0097
$295.00 USD

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Medicare has aggressively followed through on its NPI Contingency Plan, which would be a good thing if the plan were not flawed from the outset. We’ll deal with the problems everyone knows about (crosswalk failures) and add the one that few are yet to fully appreciate (secondary providers with no NPIs). Will they go through with it? Can it work?

• Up-to-the-minute status of the Medicare contingency (including stories you won't read in the public announcements)
• Crosswalk failures and Catch-22s (and how to fix some of them)
• Hope on the horizon? Aligning Medicare enrollment and NPPES data
• The self-referral mandate: What to do about Medicare’s May 23 instructions for secondary providers (Referring, Ordering, Operating, etc.) without NPIs
• Hell, and where to raise it: The case for breaking the crosswalk logjam before it gets any worse

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NPI: Facts in Evidence
What to Do When What Medicare Wants Doesn't Work

55 minutes; standard DVD format (NTSC, SD). Produced 4/22/2008.

Includes live resource links document.

Catalog ID:
DVD-NPIF0804-0096
$295.00 USD

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Identify systemic failures that are being built into payer systems, and learn how to fight your way through.

“Doing whatever it takes” to get claims through isn’t much of a strategy if doing what Medicare or other payers ask is impossible. This session focuses on authoritative points of reference for all things NPI. We identify systemic failures that are being built into payer systems and how to fight your way through to a workable and rational resolution – even if you work for one of those payers.

• Top 10 links for free and almost free help
• Surprising things the regs and standards don’t say
• False NPI perceptions and why they must change
• Providers Without Number – representing the un-enumerated on a compliant claim
• Hidden Hazards: Prescribers, TPAs and Provider Networks
• NPPES fixes you can apply today to improve payments

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Real-Time Adjudication
Drivers and Deliverables

70 minutes; standard DVD format (NTSC, SD); chapter menu. Produced 2/10/2008.

Includes accompanying CD-ROM with handouts in PDF format, slides in PPS format, and RTA resource links page.

Catalog ID:
DVD-RTA08A-0058
$395.00 USD

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Real Time Adjudication (RTA) may just be The Next Big Thing in healthcare information technology.

Unlike standards-based implementations, there is no regulatory push for adoption. Instead, it’s a pure economic pull. This 70-minute video presents Healthcare IT Transition Group's independent, vendor-neutral analysis of the RTA environment.

Learn why payers want to implement it for their own cost savings and competitive advantages and why providers need it to soften the impact of the High Deductible Health Plan phenomenon. You'll gain insights from numerous success stories and learn about the outstanding challenges. We’ll also suggest a design approach that might help resolve them for the benefit of all concerned.

• What’s in it for me? Why payers, providers and employers are so gung-ho for Reat Time Adjudication (RTA): Payer business case, provider business case, employer business case
• High Deductible Health Plan (HDHP) market facts and figures
• Understanding the business process – why can’t providers just collect the money?
• Proprietary RTA solutions: Lessons learned
• Are new standards necessary? What the industry collaboratives are doing to enable universal RTA systems
• Conceptual architecture: A standard-based RTA that just might work today

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Getting ROI
from Health IT
An Independent Analysis

75 minutes; standard DVD format (NTSC, SD); chapter menu. Produced 2/15/08.

Includes accompanying CD-ROM with handouts in PDF format, slides in PPS format, written report with links to the underlying scientific materials and reflective analyses by physicians and administrators.

Catalog ID:
DVD-ROI08A-0059
$395.00 USD

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Research sponsored independently by Healthcare IT Transition Group and a national nonprofit organization is at the heart of the revealing analysis in Getting ROI from Health IT.

In a six-month research project, Healthcare IT Transition Group found strong evidence of investment returns from Electronic Medical Records (EMR), Computerized Physician Order Entry Systems (CPOE), Computerized Decision Support Systems (CDSS), Electronic Medication Administration Records (eMAR) and other health IT applications. The findings point to ways that these implementations can reduce costs and increase profits for small physician offices and group practices, as well as large health systems. In fact, investigators focused much of their efforts on physician practices. Not only are practices lowering costs and improving personnel satisfaction, but the evidence shows that many are boosting profits significantly.

But what is it about thesuccessful health IT projects that makes them work? By reviewing the evidence, with reviews from the field and the words of the physicians and administrators themselves, this analysis is designed to provide both the general concepts behind successful implementations, and some very specific pitfalls to avoid. The investigators present their findings from a deep review of the academic literature and through thirteen case studies of actual implementations in physician practices, hospitals and other settings reviewed in depth.

Unlike much of the available information on health IT economics, HITTG's electronic health records research was undertaken free from any potential influence from technology vendors or service companies. The analysis presented by Martin Jensen and Michael Christopher is a bold and refreshingly independent view of the HIT ROI landscape, offering actionable information for nonprofit and for-profit providers.

Among the topics covered:

• Rationale: Reasons providers seek automation
• Return on investment: Definitions from multiple perspectives
• Getting Granular: What to measure
• Key data points in tracking ROI
• Second-layer effects: Hidden ROI
• Where to begin: Starting with the low-hanging fruit
• What to ask for from vendors to optimize for ROI
• Case studies from thirteen provider environments
• Health IT ROI down the road: Patient responsibility, P4P, defensive quality tactics, POA rejections, "denial engines," RAC's, competive advantages...

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Defeating the Denial Engine
How a New Breed of Software is Bleeding Providers Dry,
and How to Build, Buy or Demand Tools and Techniques
to Put a Stop to It

85 minutes; standard DVD format (NTSC, SD); chapter menu. Includes accompanying CD-ROM with handouts in PDF format, slides in PPS format, links to additional resources, schematic of "Approval Driver" system for piercing payer armor.

Catalog ID:
DVD-DE0802A-0063
$395.00 USD

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Correct Coding Initiative Edits. Duplication of Services Edits. Bundling and Unbundling Edits. Pretty familiar territory in the world of healthcare claims, right? They’ve got their edits; we’ve got our edits. Right? Think again.

There is a new category of software tools that payers are bringing to bear on the adjudication process that is an order of magnitude more sophisticated than providers have faced in the past. So sophisticated that some of the vendors don’t even charge a license fee – they just collect a contingency on the millions of dollars that get stripped out of providers’ monthly checks. So deep and so broad is the technology that it allows the payer to set a tolerance level – what percent of outbound paymants do you wish to retain? How much will your providers put up with?

It’s time to put a stop to it. We’ll show you how in this two-disk video set.

A Denial Engine runs in addition to and before the regular adjudication process – even before the payers’ own automated claims filtering systems. It can also be applied to claims history – capturing “overpayments” and deducting dollars from current remittances. And the engine has a throttle – throttle up the engine to engage more obscure edits to boost payer profits; throttle it down if providers get too peeved. Payers can now simply decide how much they want to pay out. Quarterly profits sagging? Deny more claims.

The presentation reveals the systems and the economics involved, lays out a methodology for providers and software vendors, and provides a schematic overview of the “Approval Driver,” an application designed to pierce payer armor and get claims through to adjudication. The nonexclusive right to adopt or expand upon this design is included with your paid registration.

Among the Topics Covered:

• How Denial Engines differ from traditional claims editing approaches
• Why payers are rushing to implement these tools
• FRAUD! (and abuse) vs. (fraud and) ABUSE
• Where Denial Engines enter the claims process
• Who are the players?
• Getting Claims Paid Despite DE
• “Approval Driver” – an exclusive HITTG design schematic you can use to develop an anti-Denial Engine system

[ More details | Order Online | Download Fax/Mail Form ]

Funding Health IT with Grants
Moxie and Resources from a 20-year Veteran

96 minutes; standard DVD format (NTSC); chapter menu. Includes accompanying CD-ROM with handouts in PDF format, slides in PPS format, national private funders directory, more.

Catalog ID:
DVD-GNT0803-0060
$395.00 USD

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Looking at funders, examining their requirements and best approaches, we arm participants with the knowledge they need to hit the grantwriting ground running.

Presented by a veteran capital development executive with twenty years in nonprofit finance emphasizing IT expansion and capital projects, this title provides 90 minutes packed withactionable information, plus substantial additional resource materials.

The video includes an overview of funding resources, particularly for the newly-attractive health information technology area, as well as other health technology projects, and additional information about how to find others. As a special bonus, registrants will receive a listing of 362 national foundations and corporate grantmaking programs with full contact information.

This video is designed for administrators, finance personnel, capital advisors, RHIO/HIE organizers, government leaders and funding organizations to point out alternative funding approaches for vital projects. The sessions provide an opportunity to ask questions following the presentation.

Audience

• Nonprofit healthcare providers
• Health information exchanges
• Regional provider organizations
• Hospital associations
• Funding organizations

Among the Topics Covered

• Overview of current health IT funding practices
• Show me the money: Analysis of available public and private resources
• Helping customers develop capital (to spend with you)
• Economics of capital development counsel
• Where to find the expert personnel and resources
• Building fundraising counsel into the sales operation
• Ethical issues: Who does what for whom and how

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Grantsmanship for Vendors
How a new breed of Health IT vendor is using grantsmanship to fuel sales & build market share

Shipping May, 2008
Order Now!

80 minutes; standard DVD format (NTSC, SD); chapter menu. Includes accompanying CD-ROM with handouts in PDF format, slides in PPS format, more.

Catalog ID:
DVD-GV0804-0084
$395.00 USD

[ More details | Order Online ]

There's a new breed of health IT vendor using grantsmanship to fuel sales & market share by helping their provider customers find the money to pay for systems.

Vendors: Learn how they do it to compete with you. Providers: Learn how to demand it.

Putting this specialized expertise within customers' reach, some well-known companies are boosting their value proposition by overcoming that most daunting of buyer objections: "Who's going to pay for this?" Software vendors need to know how to create a vendor-based grantsmanship operation. Learn how to pull in grant researchers, grantwriters, and all about the tools required to build an in-house Grants Assistance Program for the long term, or on a case-by-case basis.

Audience

• IT sales managers and personnel
• Systems vendor executives

Among the Topics Covered

• What is a Grant Assistance Program?
• Reasons Vendors Develop a CAP
• Ethical Considerations
• Program Components
• New Environments
• Grantsmanship: Skilled Resources
• Building an Effective Program
• Resource Development

[ More details | Order Online | Download Fax/Mail Form ]