Rybar Group
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RGI News and Welcome

The Rybar Group is pleased to announce that Julie Hardy, MSA, RHIA, CCS, CCS-P has joined us as a Physician Services Lead Consultant on our Data Integrity and Compliance team.

Julie offers the clients of The Rybar Group a range of expertise in the area of Professional Service Documentation, Coding and Reimbursement in both the ambulatory and inpatient settings. As the Lead Physician Services Consultant in our Data Integrity and Compliance Department, Julie brings over ten years of results-driven leadership experience and a high level of technical knowledge to the clients ranging from primary care to a variety of surgical specialties and nearly everything in between.

Julie has worked as a Professional Coding and Documentation Auditor and Educator for a variety of provider types, including private practices, teaching facilities, and hospital based practices, in several states and with a variety of payors. Julie’s experience includes coding inpatient, outpatient and surgical procedures. By partnering with physicians and their staff, Julie assists with documentation needs, including providing training on how to apply coding and reimbursement guidelines to documentation, how to simplify documentation to meet both clinical and coding needs, appropriate coding practices and ways to achieve optimal reimbursement and compliance.

Having worked extensively in the daily functions of professional revenue cycle, Julie has a strong understanding of the needs and challenges related to professional reimbursement and strives to help providers and their staff streamline processes to ensure that the workflow is efficient and that payments are being optimized. She has helped develop policies and procedures related to coding, documentation and auditing, as well as designed and created documentation templates for efficient coding and billing processes.

To learn more about how Julie may be able to assist your facility, click here or contact her directly at 810.853.6171 or via email at jhardy@therybargroup.com.

Industry News and Updates

Are you unsure of what decreased uncompensated care costs mean to your entity?
Are you holding reserves for future re-distributions of pool payments or Upper Payment Limits?
If so we can help~
As the State works to collect the data necessary to calculate the 2014 Step II DSH pool payments and settle the 2014 cost reports, hospitals are left to account for estimates for over three years of potential redistributions and settlements.
As Uncompensated Care Costs decline redistributions of DSH payments are expected to increase. Also, as other supplemental pool payments increase and patients shift from Title XIX to HMP hospitals are left to account for multiple open settlement years.
If you have concerns of the impacts these items will have to your entity please reach out to us today.


Cash and Point-of-Service Collection Risks:
Although more Americans have health insurance coverage, 25% do not have money or liquid assets to cover their deductible, according to an article in U.S. Money on March 3, 2015. Even if your state has expanded Medicaid, according to the IRS regulation for 2016, HDHP individual policies have out-of-pocket maximums as high as $6,550 and family policies as high as $13,100.  HDHP are also required to have deductibles not less than $1,300 for an individual or $2,600 for a family.

Incident to vs. Split/Shared
There tends to be a lot of confusion surrounding services performed by mid-level providers, such as nurse practitioners and physician assistants….Read More



National Conference for Behavioral Health

Michael Felczak Exhibiting

Great Lakes HFMA – April 28, 2017

Shawn Armbruster speaking on Networking

BDO Alliance Conference – April 30 – May 4, 2017

Claudine Hildreth Speaking, Michael Felczak Speaking

Michigan Rural Health Conference – May 4-6, 2017

Steve Sprague Exhibiting, Shawn Armbruster Attending

MHIMA Annual Meeting / Conference – May 17-19, 2017

Shawn Armbruster and Sarah Goodman Speaking on Chargemaster

Jennifer Ishmael Attending, Julie Hardy Exhibiting

RGI Congratulations

Keith Poniers has earned HFMA’s Certified Healthcare Financial Professional (CHFP) credential.  This credential is geared toward financial professionals whose job requires a deep understanding of the new financial realities of health care.

Congratulations to Keith who has earned this achievement and who will use it to better serve our clients.

Shawn Armbruster, RHIA will spend the next three years serving MHIMA in a leadership role. This upcoming year she will be serving as President – Elect.

Congratulations to Shawn who will continue to be a dedicated resource for her industry.

December 2016 Kim Smith earned the Master of Science in Information Technology Management (MSITM) at Oakland University.

Congratulations to Kim who has earned this distinctive degree.


Laura Lovett

Contributions by Laura Lovett CPC, CPCO, CPMA, CPC-I, CANPC, CEMC.  Laura can be reached directly at llovett@therybargroup.com or 810-853-6173

MACRA Participation is Voluntary…Sort of
MACRA (Medicare Access and CHIP Reauthorization Act) is the legislation that was introduced to replace the not sustainable SGR (Medicare Sustainable Growth Rate). It is said to be simpler than the current PQRS (Physician Quality Reporting System) but this remains to be seen and clearly shows the relativity of the word “simpler.” Read More

Mid‐level Provider Services
Coding and billing for mid‐level providers, NP/PAs, can seem like a daunting task. The reality is it is not
difficult if you take time to understand the guidelines and develop practices to utilize these providers
appropriately.  Read More

What it means to be a medical coder…….
You have to stop and think when someone asks you a question like “how old are you?” but can rattle off the codes for things like DM, HTN, COPD, GERD, etc. without batting an eye.
You find humor in the strangest things “this gentleman presents today after having accidentally introduced a foreign body into his left knee”. (FYI, he shot himself with a nail gun) Read More

Industry Trend: Probe Audits and Data Mining

Nobody wants to be audited. Nobody has time to be audited. Unfortunately that is the reality that
healthcare providers face; external audits can be initiated at any time. Read More