November, 2015:

Culbert Healthcare adds Regional Account Manager to Mid-West

Culbert has experienced tremendous growth which is largely attributed to the company’s reputation of providing quality insights and service paired with proven integrated, cohesive solutions to the challenges that face the healthcare industry today.

 Art Lopez is a senior healthcare professional with over 10 years of experience in sales and market development. His background spans the field of healthcare, working closely with physicians, provider organizations, employers, health plans, channel partners and consultants – providing value through his strong understanding of all healthcare segments.

 Most recently, Art was part of the Business Development Team at Telcare, an early stage mobile health technology company focused on improving patient engagement and risk management by leveraging real-time data and analytics. While at Telcare, Art was an integral member of a small team responsible for commercializing a new and innovative diabetes management solution into the marketplace.

 Art attended Loyola University in Maryland, where he earned a degree in Business Administration and was co-captain of the Men’s Division 1 Soccer Team.

 Art Lopez pic



Join our Webinar December 4th 12:30-1:30 EST- Mitigate Patient Risks with New Physician Onboarding

Join us for a free webinar on Friday December 4th, 12:30-1:30 EST

Introducing new providers to a practice can be a daunting process, with credentialing and marketing being just two of the numerous areas of concern. Equally important is how patients react to the new provider. Culbert Healthcare Solutions invites you to join Randall Shulkin, FACMPE, Executive Consultant, and a special guest, Donald Callahan, MBA, FACMPE, Director of Operations for Robert Wood Johnson Physician Enterprise, for a FREE webinar  on Friday, December 4th at 12:30 pm Eastern for an insightful look into the potential pitfalls of replacing physicians and how to effectively introduce new providers without significantly increasing overhead or sacrificing productivity while maintaining strong patient satisfaction. This webinar will provide you with the knowledge to:

  • Apply methods to maintain patient satisfaction during transitional periods
  • Design a cost-effective onboarding process for new providers to your practice
  • Utilize existing resources to transition patients among providers

Date: Friday, December 4, 2015 Time: 12:30 – 1:30 EST


The Competitive Advantage: IT and Operations Building a Shared EHR Vision

HIStalk Practice:  Culbert’s Jaffer Traish discusses aligning IT & operations

You can access the story here, or by clicking the link below.

The Competitive Advantage: IT and Operations Building a Shared EHR Vision:

Director Epic Practice

Director Epic Practice



The Revenue Cycle after ICD-10

Author: Jill Berger-Fiffy , MHA, FACMPE

The planning and implementation of the ICD-10 felt much like a race to the finish. Now in operational mode, it is helpful to begin your “After Action Review” in order to identify potential next steps.    The following will help you craft your “to do list” when managing the revenue cycle.

  • Cash flow-Regardless of whether you submit your claims through a clearinghouse or directly to the payer, be sure to reconcile that every claim reaches the clearinghouse and/or payer.   Delays in payment may be the new reality. Develop a plan as to when and how you will begin to use your line of credit should you have one. Consider the need to reduce or hold the salaries and reimbursements to physician owners.
  • Expense Management-Organize your payables and hold them for as long as possible. Transition from writing checks to the use of bank transfers which can be set up in advance. This allows the practice to hold the cash as long as possible but expedite your payment by the “due date.”
  • Flexible Staffing-Consider the need for temporary staff to review claims and/or work the Accounts Receivable (AR). Productivity for physicians and staff is likely to decrease, thus increasing the overall cost to do the same work. This may be reflected in increased patient wait time and decreased patient satisfaction. If this is the case, workflow verification, analysis and optimization will be essential to ensure the work is completed efficiently.
  • Risk Sharing-Consider the staffing compliment in the practice.       Does the practice have the right staff/enough staff to support the effort required under the new payment schemes and the ICD-10 world?  If you have Certified Coders, prioritize the work to be completed. Ensure Coders are focusing on the “big ticket” items; as well as, those diagnosis categories in which the practice may be at financial risk or in a cost sharing with an ACO reporting effort.
  • Auditing-When auditing medical records, show the physician how the requirements and clinical documentation differ from the ICD-9 to ICD-10. Be aware of the pitfalls of provider documentation. Ensure notes comprise the highest level of specificity and match the diagnosis code selected. Another pitfalls can include the note not capturing the level of specificity reflected in the code or the documentation being very specific and non-specific code is selected. Auditing and compliance review will be crucial in an environment in which specificity, quality, cost and efficiency are all factors.
  • Key Performance Indicators Watch the metrics closely. Carefully monitor changes. Alert your team about potential changes such as increased Denial rate with the clearinghouse and from the payer, percentage of 1st Pass Submission, Days in A/R, Charge Lag, Collection Rate, and Net Revenue per FTE Physician.       Compare past performance by the month to date and to the year over year. Monitor trends by building a dashboard with key measures. Consider using software to assist with denial analysis and analytics in order to maximize revenues.
  • Quality Metrics– It is likely the practice is involved in at least one pay for performance program. Given the many such as Meaningful Use, PQRS, Value Based Modifier, and HEDIS Measures to name a few. You may need to manipulate your data to compare a prior period to the new “current state”. Data manipulation and business intelligence tools will track progress of the practice and provide “actionable” steps. Look for opportunities to improve patient care through workflow redesign.
  • Technology-Ensure the practice is optimizing all of the features of the Electronic Health Record. Confirm the templates and their associated diagnosis codes are updated. Verify departmental and individual lists of “favorites” been updated and are they shared across the department. Review questionnaires, encounter forms, order sets, referral and authorization forms, pick lists for diagnosis used to populate for surgical scheduling forms and of course admissions and discharges. Consider the process for communicating changes and if additional training is now needed. IT staff will need to understand the needs of the end user and be able to “build” the system to meet the requirements.
  • Software-Review the edits/rules in your Electronic Health Record, are they up to date?       Adding coding tools can be helpful, but many times it can lead to the selection of a “non-specific code” which would ultimately be rejected by the payer.   Educate staff on how to use the system and when they should refer to the coding book?
  • Interfaces-Are you using devices or other have programs which interface with your system? If so, has the interface been tested and updated? Confirm if the manufacturer has offered an update version?

In summary, the go live date has passed, but the work has just begun. It will take a multi-faceted approach to remain solvent in this new revenue environment.



Jill Berger-Fiffy

Elevate the Patient Experience to Prevent Leakage-Becker’s Hospital Review

Brad Boyd, VP Culbert Healthcare Solutions,  discusses elevating the patient experience to prevent leakage in Becker’s Hospital Review.


You can access the article here, MIR_3989-Brad Boyd