DataPlus corporate and support offices will be closed Monday, May 31st in observance of Memorial Day.
Normal office hours will resume Tuesday, June 1st.
We wish you a safe and enjoyable holiday!
Thursday, May 27, 2010
Wednesday, May 26, 2010
Question of the Week: "What is PROVIDER ID NOT FOUND on the Transaction Error Report?"
PROVIDER ID NOT FOUND is one of the most common items to show up on the Transaction Error Report.
It is the result of a data entry error in MegaWest OR there is a provider with transactions in MegaWest that has not been added in DataPlus.
If it was a typo/data entry error then it is ok to move forward with the transaction import. Once you have made the correction in MegaWest it will be brought into DataPlus via the Revision File at the next EOM. *Note- Using this method will cause your current EOM charges to be out of balance by the total error's transactions. When the error is corrected in MegaWest and the revision file is processed during the next EOM the correction will be carried into DataPlus and you will then be in balance.
If you have a new provider with transactions that have not been added in DataPlus you will need to take a moment and add them before you continue. You will need to cancel the Step 1 Import and exit to the main DataPlus screen.
It is the result of a data entry error in MegaWest OR there is a provider with transactions in MegaWest that has not been added in DataPlus.
If it was a typo/data entry error then it is ok to move forward with the transaction import. Once you have made the correction in MegaWest it will be brought into DataPlus via the Revision File at the next EOM. *Note- Using this method will cause your current EOM charges to be out of balance by the total error's transactions. When the error is corrected in MegaWest and the revision file is processed during the next EOM the correction will be carried into DataPlus and you will then be in balance.
If you have a new provider with transactions that have not been added in DataPlus you will need to take a moment and add them before you continue. You will need to cancel the Step 1 Import and exit to the main DataPlus screen.
Adding a New Provider
- Select File Review/Maintenance from the main DataPlus screen and then Select Providers.
- Select "New" (the arrow with the asterisk button on the second toolbar)
- Enter the Provider information using the Tab key to cycle through the blanks.
- Once you have entered the necessary data select "Save" (the disk and pencil button on the second toolbar)
Now that you have added the necessary provider(s) you may again proceed with Step 1 Transactions Import and the rest of the end of month process.
If you have further questions or need assistance please call Support at 888-688-3282
Monday, May 24, 2010
House Bill Would Delay June 1, 2010 Medicare Cuts to 2014 and Provide Modest Increases In Between
by Mary Pat Whaley www.Managemypractice.com
Article by David Glendinning at amednews.com:
Medicare pay momentum shifts to multi-year fix
The House SGR proposal offers physicians possible raises through 2013. The AMA says it treats the immediate problem but is no substitute for permanent overhaul.
By David Glendinning, amednews staff. Posted May 20, 2010.
Washington -- House leaders on May 20 floated a plan to prevent Medicare physician pay cuts for the next 3½ years and replace scheduled cuts with positive pay updates. Physician organizations acknowledged that this appears to be the only politically feasible option at this point, but reiterated that a permanent solution is still needed.
The proposed plan is designed to be amended to an unemployment assistance and tax extenders bill slated for congressional consideration. If it is enacted, it would replace a 21% cut set to take place June 1 with a 1.3% Medicare physician pay increase for the remainder of 2010, followed by another 1% raise for 2011.
In 2012 and 2013, physician pay would not face cuts, and rates also could increase in each of those years under a modified formula. The proposed two-tiered modification makes it more likely that pay for primary care services would be eligible for raises, even if rates for other services remain frozen. Starting in 2014, the system would revert to the current sustainable growth rate formula unless lawmakers pass additional legislation to stop the cuts from returning.
American Medical Association President J. James Rohack, MD, said the AMA was deeply disappointed Congress would not scrap the SGR this year, a permanent solution that becomes more expensive the longer lawmakers wait. However, he said, "achieving full repeal of the payment formula is apparently not feasible at this time."
Although the proposed House plan would be a temporary reprieve for doctors and their patients, Dr. Rohack said, the AMA will keep pushing for Congress to enact a long-term fix well before cuts are projected to return in 2014.
The American College of Physicians came out in strong support of the House proposal, though the organization also said it would keep advocating for a permanent solution. The plan "recognizes the importance of ensuring that spending on all physician services be allowed to grow at a higher rate of growth than the unrealistic limits set by the SGR, while creating the opportunity to provide higher updates for undervalued primary care and preventive services," said ACP President J. Fred Ralston Jr., MD.
The American Academy of Family Physicians also backed the plan and the special consideration for primary care rates.
Related posts:
1. Medicare Cuts Delayed Again, This Time Until June 1, 2010 Close on the heels of an
affirmative Senate vote, the...
2. The Healthcare Bill, Rage, Concierge Practices, Cuts, Claims and Don Berwick (Yes!)
HEALTHCARE BILL IMPACT ON INDIVIDUALS AND RAGE A number of...
3. May 19, 2010 Centers for Medicare & Medicaid Services Special Open Door Forum:
The Centers for Medicare & Medicaid Services (CMS) will hold...
Article by David Glendinning at amednews.com:
Medicare pay momentum shifts to multi-year fix
The House SGR proposal offers physicians possible raises through 2013. The AMA says it treats the immediate problem but is no substitute for permanent overhaul.
By David Glendinning, amednews staff. Posted May 20, 2010.
Washington -- House leaders on May 20 floated a plan to prevent Medicare physician pay cuts for the next 3½ years and replace scheduled cuts with positive pay updates. Physician organizations acknowledged that this appears to be the only politically feasible option at this point, but reiterated that a permanent solution is still needed.
The proposed plan is designed to be amended to an unemployment assistance and tax extenders bill slated for congressional consideration. If it is enacted, it would replace a 21% cut set to take place June 1 with a 1.3% Medicare physician pay increase for the remainder of 2010, followed by another 1% raise for 2011.
In 2012 and 2013, physician pay would not face cuts, and rates also could increase in each of those years under a modified formula. The proposed two-tiered modification makes it more likely that pay for primary care services would be eligible for raises, even if rates for other services remain frozen. Starting in 2014, the system would revert to the current sustainable growth rate formula unless lawmakers pass additional legislation to stop the cuts from returning.
American Medical Association President J. James Rohack, MD, said the AMA was deeply disappointed Congress would not scrap the SGR this year, a permanent solution that becomes more expensive the longer lawmakers wait. However, he said, "achieving full repeal of the payment formula is apparently not feasible at this time."
Although the proposed House plan would be a temporary reprieve for doctors and their patients, Dr. Rohack said, the AMA will keep pushing for Congress to enact a long-term fix well before cuts are projected to return in 2014.
The American College of Physicians came out in strong support of the House proposal, though the organization also said it would keep advocating for a permanent solution. The plan "recognizes the importance of ensuring that spending on all physician services be allowed to grow at a higher rate of growth than the unrealistic limits set by the SGR, while creating the opportunity to provide higher updates for undervalued primary care and preventive services," said ACP President J. Fred Ralston Jr., MD.
The American Academy of Family Physicians also backed the plan and the special consideration for primary care rates.
Related posts:
1. Medicare Cuts Delayed Again, This Time Until June 1, 2010 Close on the heels of an
affirmative Senate vote, the...
2. The Healthcare Bill, Rage, Concierge Practices, Cuts, Claims and Don Berwick (Yes!)
HEALTHCARE BILL IMPACT ON INDIVIDUALS AND RAGE A number of...
3. May 19, 2010 Centers for Medicare & Medicaid Services Special Open Door Forum:
The Centers for Medicare & Medicaid Services (CMS) will hold...
Thursday, May 20, 2010
Notes from the CMS Open Door Forum on May 19, 2010: PECOS, DMEPOS and Blue Ink on Paper Forms
by Mary Pat Whaley www.Managemypractice.com
CMS held a two-hour Open Door Forum today and there was so much good information shared that I thought I’d pass my notes from the call along to you.
New EFT Form
The revised EFT (Electronic Funds Transfer) authorization form 588 is available here (pdf.) The old form will still work for a few months longer before it becomes invalid.
Changes to the Medicare Program Integrity Manual
The Program Integrity Manual (publication 100-80) will have revisions related to the changes in provider enrollment. The online-only manual here will have content moved from Chapter 10 to Chapter 15 and the provider enrollment information will be easier to understand.
The Question on Everyone’s Lips
How do I know if I’m listed in PECOS (Provider Enrollment and Chain/Ownership System) and how do I know if others are listed in PECOS? A new downloadable file is now available here (12,000 pages!) and everyone listed in this Ordering/Referring file has approved enrollment status. Anyone not appearing on this list is not in approved status, or has opted completely out of the Medicare program.
Advanced Diagnostic Imaging
Beginning in January 2012, all diagnostic magnetic resonance imaging (MRI), computed tomography (CT), and nuclear medicine imaging such as positron emission tomography (PET) must be performed in a facility accredited by the American College of Radiology (ACR), The Joint Commission (TJC) or the Intersocietal Accreditation Commission (IAC) for the technical component of the test to be reimbursed by Medicare. This rule does not apply to x-rays, ultrasound, fluoroscopy, mammography or DEXA scans and does not apply to any professional component.
Hospital Revalidations
Hospitals not enrolled in PECOS or not receiving EFT (Electronic Funds Transfer) will be contacted by CMS in an attempt to get all hospitals revalidated.
PECOS (pronounced “pay-cose”)
CMS recommends that anyone with questions or just getting started in PECOS read the “Getting Started Guide”, of which there are two versions, both available here in pdf form. One is for providers and one is for suppliers of DMEPOS (Durable Medical Equipment, Prosthetics, Orthotics, and Supplies.) You need to know your corporate structure before getting started because the business must enroll before the providers can assign benefits to the business. The 855I is for individual/solos providers and the 855B is for non-individuals (multiple owners) billing Medicare Part B and assigning benefits to a legal entity/corporation. Dentists and pediatricians who order or refer services for Medicare patients are required to have an enrollment record in the PECOS. Residents and interns are exempt from the enrollment requirement, but an attending physician needs to be identified on the claim when a service is ordered or referred. The main page for enrollment is https://www.cms.gov/MedicareProviderSupEnroll/
Two Ways to Get Into PECOS
One is to complete the paper form in BLUE INK (and if time is of the essence CMS suggests that you use the paper form) and let the MAC enter it into PECOS for you. The other is to use the internet-PECOS system directly, and sign, date and mail the certification statement to complete the process. Submit the participation form or EFT form if required. The certification form for the paper process is NOT the same as the certification from for the internet-PECOS process.
What is the 30-day rule?
The 30-day rule states that you can bill for services provided to Medicare patients up to 30 days prior to your filing date. The filing date is the date your enrollment is accepted, not the date you mailed it. Online it will say “Status Approved”, and you will receive an email, and then a letter confirming it. You will appear on the Ordering/Referring file on the CMS website.
What happens to payments for patients that were referred by a provider not enrolled on PECOS?
Even though you are enrolled, if the referring physician is not enrolled, you will not be paid for that patient’s services. However, if that referrer becomes enrolled, you can resubmit the claim and it will be paid.
What happens on July 6, 2010?
July 6, 2010 is the compliance date for Part A providers (hospitals, skilled nursing homes and home health agencies) and Part B providers (physicians, ambulance) must be enrolled in PECOS as ordering/referring physicians for payments to be made.
What happens on July 13, 2010?
DMEPOS (pronounced “demmy-pos”) providers must be enrolled in PECOS to receive Medicare payments.
What should be done if a provider leaves a group?
The provider or his Authorized Official (CEO, CFO, Manager) should file a 855R or make the change in PECOS as soon as possible.
Why do provider offices still request UPINs from our office?
Unclear. UPINs were no longer required as of May 23, 2008. The NPI is the only number accepted on Medicare claims.
Should the information submitted on a 855 be the same information in PECOS?
Yes, if it isn’t, contact the Help Desk. Their toll-free number is 1-866-484-8049 and their e-mail address is eussupport@cgi.com.
For more information on the nuts and bolts of PECOS, see my post here.
Related posts:
1. May 19, 2010 Centers for Medicare & Medicaid Services Special Open Door Forum: Medicare Provider & Supplier Enrollment The Centers for Medicare & Medicaid Services (CMS) will hold...
2. CMS to Hold Open Door Forum on Medicare Provider and Supplier Enrollment via PECOS On February 17, 2010 from 2:00PM – 3:30PM ET the...
3. CMS Announces Delay in PECOS Use Until January 3, 2011 NOTE: On May 5, 2010 it was announced that the...
Wednesday, May 19, 2010
TIP OF THE DAY: Custom Refresh Says "Not Responding"....What do I do?
While running the Custom Refresh tool in DataPlus, it has been known to take an extended period of time while trying to refresh reports for large databases.
If you see that the program has NOT given you an "Object Error" of any type, but simply states "Not Responding", then there is a 98% chance that the delay is due to the extreme size of the report and is not frozen.
- Please do not cancel the process
- If you do cancel the process you will need to open task manager and terminate all of the "Excel" processes before starting the program again.
- If you feel that your machine has locked up or you think it may be taking too long please feel free to call support at (888)-688-3282 and we can assist you.
Tuesday, May 18, 2010
May 19, 2010 Centers for Medicare & Medicaid Services Special Open Door Forum: Medicare Provider & Supplier Enrollment
by Mary Pat Whaley www.Managemypractice.com
The Centers for Medicare & Medicaid Services (CMS) will hold a Special Open Door Forum (ODF) to discuss Medicare provider enrollment issues. During this call, CMS staff will discuss:
- The May 5, 2010 provider enrollment regulation titled, “Medicare and Medicaid Programs; Changes in Provider and Supplier Enrollment, Ordering and Referring, and Documentation Requirements; and Changes in Provider Agreements (CMS-6010-IFC)”
- Medicare ordering and referring issues, including physician notification
- Documentation requirements
- Internet-based Provider Enrollment, Chain and Ownership System (PECOS)
- Physician, non-physician practitioner, provider and supplier organizations
- Upcoming availability of Internet-based PECOS for DMEPOS suppliers
- Pharmacy accreditation issues
- Advanced diagnostic imaging accreditation
- Provider and supplier reporting responsibilities
- Revalidation efforts
May 19, 2010 3:00PM – 5:00PM ET 2:00 PM – 4:00 PM CT
Open Door Forum Instructions:
Capacity is limited so dial in early. You may begin dialing into this forum as early as 2:45 PM ET.
Dial: 1-800-603-1774
Reference Conference ID 61448973
Read my post on the date change for PECOS enrollment that relates to CMS-6010-IFC here.
Related posts:
1. CMS to Hold Open Door Forum on Medicare Provider and Supplier Enrollment via PECOS On February 17, 2010 from 2:00PM – 3:30PM ET the...
2. Forget January 3, 2011! PECOS Date Moved 6 Months Closer – Referring & Supplying Providers New Date is July 6, 2010 Physicians and “eligible” providers received a jolt today in the...
CMS Announces Delay in PECOS Use Until January 3, 2011 NOTE: On May 5, 2010 it was announced that the...
Monday, May 17, 2010
New HealthPort Data Elements
HealthPort Provides New Data Elements!
If you are a CENTRICITY client, you can disregard this post.
HealthPort has recently released a lot of new data elements from their PM system to DataPlus. There are so many new elements, that there is no way for us to include all of them in one release, as it may cause some clients difficulty with hard drive space.
I am asking each and every HealthPort user to please take this short survey indicating your needs for these new data elements, so that we can prioritize the release. If you have others within your practice that you feel need to participate in this important survey, please feel free to forward this to as many users as you feel appropriate.
This survey is extremely important! Although the new data elements will only be available to clients on HealthPort V11, we are asking all clients, regardless of their current version to respond.
Thank you so much for your business and participating in this extremely important survey, this will allow us to develop a new release more quickly and efficiently. If you have any questions at all, please feel free to email me!
Sincerely,
Sincerely,
Frank Trew
DataPlus
Friday, May 14, 2010
DataBytes Newsletter from DataPlus
DataBytes
A Newsletter from DataPlus
May 2010
Communications: Changing with the times...
For a long time, I resisted the call to Facebook, Twitter and other so called "Social Media" sites, however, as Bob Dylan wrote..."These times, they are a-changing". This month, we have launched our own Facebook and Twitter accounts to better communicate and serve our clients.
Postings on either of these sites will update the other, so you do not have to subscribe to both. The postings will be in the form of support tips and reminders. Our "followers" will also be able to ask questions on either site, which will be answered for everyone to see. Expect to see these updates several times a week, directly from our support staff.
We have also partnered with my very dear friend, Mary Pat Whaley of ManageMyPractice.com (see announcement below), as a practice management resource for our clients to use, free of charge.
You can follow DataPlus on either Twitter or Facebook, by clicking the links below. As always, we appreciate your business, and welcome comments on how we can improve our products and services.
Remember, to follow us on Facebook, be sure to click the "Like" button on the top of the Facebook page.
Postings on either of these sites will update the other, so you do not have to subscribe to both. The postings will be in the form of support tips and reminders. Our "followers" will also be able to ask questions on either site, which will be answered for everyone to see. Expect to see these updates several times a week, directly from our support staff.
We have also partnered with my very dear friend, Mary Pat Whaley of ManageMyPractice.com (see announcement below), as a practice management resource for our clients to use, free of charge.
You can follow DataPlus on either Twitter or Facebook, by clicking the links below. As always, we appreciate your business, and welcome comments on how we can improve our products and services.
Remember, to follow us on Facebook, be sure to click the "Like" button on the top of the Facebook page.
Frank Trew
Founder / COO
Founder / COO
___________________________________________________________
DataPlus proudly presents a new FREE service to its clients -
ManageMyPractice.com
This healthcare practice management resource/blog will be available to you from your CustomPlus Reporting Main Menu under "DataPlus Today", as well as our Facebook and Twitter - beginning this week!
Managemypractice.com is a blog founded and edited by Mary Pat Whaley, a practice administrator in Roanoke Rapids, North Carolina. The blog, updated bi-weekly, provides a wealth of information to other practice managers, including regulatory updates, collection best practices, IT solutions, and EMR management.
Mary Pat is Board Certified in Healthcare Management and a Fellow in the American College of Medical Practice Executives. She has worked in healthcare and healthcare management for 25 years and has authored and published many peer articles and a book, "30 Days to a Front-End Patient Collection Program."
Previously the Chief Operating Officer of Eagle Physicians, Mary Pat initiated the first installation of DataPlus in 2000. She assisted us greatly in developing the some of the reports that our clients enjoy today.
This service is provided free of charge to everyone. Neither DataPlus nor Managemypractice.com receives any monies in exchange for this service. I encourage you to look for her blog updates, directly on your CustomPlus menu, and the DataPlus blog at http://www.mydataplus.com/
**Note: You must have the new CustomPlus menu (red with white background) in order to view this feed from your CustomPlus menu. All users on Excel 2007 already have this new menu.
_________________________________________________________________
Congratulations!
Congratulations!
Susan Hurst recently got married and is now Susan Dean!
Please update your email address to reflect this change to sdean@mydataplus.com.
It must be running in the family, because Susan's daughter Heather is getting married in late May and will be living in Destin, Florida!
Contratulations to you both!
__________________________________________________________________
Dashboard
Our new Dashboard reporting module has been hugely
successful...nearly every client who has seen it, has purchased it!
So why has it been so popular?
successful...nearly every client who has seen it, has purchased it!
So why has it been so popular?
- Its all the important practice information on one page that you have been asking for!
- The price is right!
So what is keeping you from moving forward with this tool?
For more information on our Dashboard, visit our products page at http://www.mydataplus.com/ where you can view and download the brochure,
and even see a video demonstration.
___________________________________________________________________
Important Information about SQL Server 2005 & 2008
If you have plans of upgrading your server to SQL 2005, you MUST call us before doing so! Several changes must be made by our support staff BEFORE the upgrade is done.
DataPlus DOES NOT yet support SQL 2008.
DataPlus DOES NOT yet support SQL 2008.
___________________________________________________________________
DataPlus Support
How do YOU prefer to contact support? Our industry leading support services can be reached many different ways, and you have the choice of contact methods!
You may:
- Call support directly 1-888-688-3282
- Email Support: support@mydaaplus.com
- Establish direct link to support via our website, or within CustomPlus
- Create / Manage work orders from our client only web portal www.mydataplus.com
Whatever makes YOU more comfortable! So take your pick from our support methods and you can be assured you will be assisted by a friendly, efficient and helpful representative
___________________________________________________________________
Excel 2007 Upgrades
We encourage our clients to upgrade to the current version of Microsoft Excel 2007. There are many, many reasons why you should, and you can read about them by visiting Our Blog.
It is imperative that you call us to upgrade your CustomPlus reports prior to using Excel 2007 on your reports.
Failing to do so will literally break the reports, and we will have to manually re-create them which is not covered under support. The charge for correcting the problem is $250.00 per hour, is very time consuming. Upgrading prior to using Excel 2007 only cost $450.00!
___________________________________________________________________
On Line Forums
On Line Forums
If you have not visited our forums yet, you really should! Our forums provide essential support information and quick tips for all our users. You can even sign up to watch a forum and receive an email anytime something new is posted. The support forums provide information on our most common support issues and "how to's".
We also have a section for each PM that we support and for every speciality that is geared just for our clients to communicate with each other.
Just to go http://www.mydataplus.com support and forums to access this very beneficial information.
___________________________________________________________________
Did you know?
We Can Help You With...
Additional Training
Custom Programming
CustomReports
Practice Consultations
Additional Modules
Conract Managment
Payment Audit
Dashboard Reports
We Can Help You With...
Additional Training
Custom Programming
CustomReports
Practice Consultations
Additional Modules
Conract Managment
Payment Audit
Dashboard Reports
Call us at 888.688.3282 or email sales@mydataplus.com
Thursday, May 13, 2010
ARRA Changes Rules for HIPAA – Did You Miss These Three February Deadlines?
by Mary Pat Whaley
www.Managemypractice.com
With so much going on in healthcare, it would not surprise me if a lot of practices missed the February 2010 deadline for three expanded HIPAA rules. This expansion was dictated by the Health Information Technology for Economic and Clinical Health (HITECH) Act passed by Congress in February 2009.
If you haven’t already, get started now with the new requirements.
1. New obligations for business associates (BA) – February 17, 2010
Remember that a BA is a person or organization outside of your entity with whom you share protected health information (PHI) so they may provide services to you. Good examples are your billing service, collection agency, attorney, consultant, computer vendors, attorneys and providers of documentation abstracting or coding services. Under HITECH, BA have the same responsibilities for breaches as the healthcare entity does, but it is the healthcare organization’s responsibility to have an updated, signed BA agreement in place that describes this new responsibility. Here is an excellent example of a BA agreement (first link under Publications) that you can download and tweak for your practice.
2. New disclosure agreement provision – February 18, 2010
This is a big one! Patients now may waive their right to have you file their medical insurance, pay for your services themselves and request that their medical information NOT be disclosed to their insurance plan or any other entity. In other words, patients may elect to become “self-insured”. I recommend that you create a new financial class for these patients so they neither fall into the standard self-pay/financial assistance class or into their actual insurance class. These patients, if you have any, will need to be identified according to their wishes, which could mean that they want you to file insurance for some services and not for others. This means their record must be tagged for what records can be released and what records cannot. There could be an argument made either way for whether or not these patients should receive self-pay discounts that you have in place for your non-insured patients. I would be interested to know how different groups have decided to handle this. There are sample forms for PHI disclosure accounting and for patients to request an accounting of PHI disclosures in the Manage My Practice Library under Operations.
3. Information breach notification – February 22, 2010
We’ve heard a lot about this one as the media (along with HHS) must now be notified if a PHI breach involves 500 people or more. Breaches are being reported weekly as non-encrypted laptops are stolen or repurposed, and as copier hard drives (story here) go unnoticed as a security risk. If a breach involves 500 people or less, each individual must receive written notice with details of the breach, the information disclosed, and the steps being taken by the practice or entity to avoid any future breaches, as well as explaining the rights of the patient(s) in protecting their private healthcare information. Several of my employees have received notification letters from health plans and they have been horrified that this could happen. Note that entities that secure health information through encryption or destruction don’t have to provide notification in the event of a breach!
Enforcement is also beefed up.
Criminal penalties will apply to covered entities that violate privacy rules AND to those organizations’ individual employees (can you track who accesses whose records when?) Civil penalties have been increased and harmed individuals may share in the booty. Probably most importantly, HITECH gives state attorneys general the power to enforce HIPAA rules.
Other resources:
HHS FAQ on HIPAA Privacy
AMA HIPAA Resources
AAFP HIPAA Resources
Healthcare Blog Listing
Related posts:
SubroShare®: Is This the New Way to Bring Value to Payer Contract Negotiations? Click here for the December 9th UPDATE I posted on...
View article...
www.Managemypractice.com
With so much going on in healthcare, it would not surprise me if a lot of practices missed the February 2010 deadline for three expanded HIPAA rules. This expansion was dictated by the Health Information Technology for Economic and Clinical Health (HITECH) Act passed by Congress in February 2009.
If you haven’t already, get started now with the new requirements.
1. New obligations for business associates (BA) – February 17, 2010
Remember that a BA is a person or organization outside of your entity with whom you share protected health information (PHI) so they may provide services to you. Good examples are your billing service, collection agency, attorney, consultant, computer vendors, attorneys and providers of documentation abstracting or coding services. Under HITECH, BA have the same responsibilities for breaches as the healthcare entity does, but it is the healthcare organization’s responsibility to have an updated, signed BA agreement in place that describes this new responsibility. Here is an excellent example of a BA agreement (first link under Publications) that you can download and tweak for your practice.
2. New disclosure agreement provision – February 18, 2010
This is a big one! Patients now may waive their right to have you file their medical insurance, pay for your services themselves and request that their medical information NOT be disclosed to their insurance plan or any other entity. In other words, patients may elect to become “self-insured”. I recommend that you create a new financial class for these patients so they neither fall into the standard self-pay/financial assistance class or into their actual insurance class. These patients, if you have any, will need to be identified according to their wishes, which could mean that they want you to file insurance for some services and not for others. This means their record must be tagged for what records can be released and what records cannot. There could be an argument made either way for whether or not these patients should receive self-pay discounts that you have in place for your non-insured patients. I would be interested to know how different groups have decided to handle this. There are sample forms for PHI disclosure accounting and for patients to request an accounting of PHI disclosures in the Manage My Practice Library under Operations.
3. Information breach notification – February 22, 2010
We’ve heard a lot about this one as the media (along with HHS) must now be notified if a PHI breach involves 500 people or more. Breaches are being reported weekly as non-encrypted laptops are stolen or repurposed, and as copier hard drives (story here) go unnoticed as a security risk. If a breach involves 500 people or less, each individual must receive written notice with details of the breach, the information disclosed, and the steps being taken by the practice or entity to avoid any future breaches, as well as explaining the rights of the patient(s) in protecting their private healthcare information. Several of my employees have received notification letters from health plans and they have been horrified that this could happen. Note that entities that secure health information through encryption or destruction don’t have to provide notification in the event of a breach!
Enforcement is also beefed up.
Criminal penalties will apply to covered entities that violate privacy rules AND to those organizations’ individual employees (can you track who accesses whose records when?) Civil penalties have been increased and harmed individuals may share in the booty. Probably most importantly, HITECH gives state attorneys general the power to enforce HIPAA rules.
Other resources:
HHS FAQ on HIPAA Privacy
AMA HIPAA Resources
AAFP HIPAA Resources
Healthcare Blog Listing
Related posts:
SubroShare®: Is This the New Way to Bring Value to Payer Contract Negotiations? Click here for the December 9th UPDATE I posted on...
View article...
Monday, May 3, 2010
DataPlus Support Open During Severe Floods
May 3, 2010
Due to severe flooding in Nashville over the weekend, parts of our service center will be closed today, however, our support system is fully functional and staffed.
Our office lines are on auto answer, so by pressing 1 you will be automatically be routed to a support representative. You may all access support by email at support@mydataplus.com, or via direct connect through our on line support system at mydataplus.com.
We appreciate your patience during this time, as you may experience delay's in obtaining a live person, however, we assure that every call will be returned within a reasonable time, as our support staff are located throughout the southeastern United States and not necessarily affected by this disaster.
Our accounting and administrative offices will re-open when conditions permit.
You may reach our support staff directly as well:
Susan Hurst: 731-988-5994
Gabe White: 772-879-0444
Thank you for your patience during this situation, and as always, thank you for choosing DataPlus!
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