The THA finance division serves as a financial and reimbursement resource to THA member hospitals as they address governmental and commercial innovations in healthcare reform, with particular emphasis on Medicare issues.
The division reviews and analyses Medicare reimbursement issues, including strategic recommendations for maximizing program benefit and analysis of risk-based programs, with a strong emphasis on Medicare pay-for-performance models. It also provides member support on cost reporting and compliance issues, including the Medicare recovery audit contractor (RAC) program and other safeguard contractor programs.
In addition, this division assists THA members on issues of patient access, patient accounting, chargemaster, billing compliance, credit and collections, charity policies and discounts to the uninsured.
It also is responsible for development and ongoing enhancements of the statewide hospital price transparency initiative at www.tnhospitalsinform.com
THA Insurance Division
The THA insurance division provides resources and services to THA member hospitals regarding insurance (governmental, commercial, workers' compensation, etc.), healthcare compliance and new payment initiatives.
The division provides member support through education and appropriate representation with government agencies (payers and oversight) and other non-government payers. Issues addressed include operational and administrative insurance issues, communication and coordination with governmental oversight agencies and payers, educational needs on new initiatives and changes to related healthcare policies/programs. It also works with THA's insurance task force.
In addition, member support is provided on the Medicaid integrity program and other compliance initiatives, including quarterly meetings for compliance officers and periodic statewide educational programs.
THA Insurance Task Force
The purpose of this task force is to look at the growing number of uninsured and under-insured individuals and the impact on Tennessee hospitals. This task force meets on as as-needed basis.
THA Reimbursement Committee
This committee recommends to the THA board of directors policies and association positions related to the Medicare program and the Tennessee TennCare or Medicaid program. This committee meets quarterly or as needed. Beginning in 2005, this committee is a consolidation of the former THA TennCare task force and THA Medicare committee.