HHS Secretary Kathleen Sebelius sent a letter to state governors July 10 reiterating HHS’ willingness to work with states to help them implement the ACA, to provide assistance and funding to states as they move forward with the establishment of their exchanges, and to...
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OCR Reveals HIPAA Audit Protocol
The U.S. Department of Health & Human Services' Office for Civil Rights (OCR) has made public its long-awaited HIPAA audit protocol, posting it on its website June 26.nnThe Health Information Technology for Economic and Clinical Health (HITECH) Act, which amended...
Patient Protection and Affordable Care Act
Recently, the United States Supreme Court issued its long-awaited decision on the constitutionality of the Patient Protection and Affordable Care Act (the “Act”). In a 5 - 4 decision, with Chief Justice Roberts writing for the majority, the Court upheld the...
Participation In Care By Out Of Network Providers, Vendors, Facilities
The health plans are increasingly putting pressure on providers (especially surgeons) to utilize IN-network providers, vendors, facilities, etc.nnOne Example: For years, it has become common place for Out Of Network (OON) surgical assists (many of whom are SA’s or...
Supreme Court To Rule On ‘Obamacare’ Tomorrow
THIS WEEK — The Supreme Court of the United States should be ruling on four separate issues:nn If the court should even consider the case in the first place, there is a possibility the justices will rule the constitutionality of the law cannot be challenged until...
Health Reform Explained— Health Reform Hits Main Street
Health care reform explained in "Health Reform Hits Main Street."nnConfused about how the new health care reform law really works? This short, animated movie -- featuring the "YouToons" -- explains the problems with the current health care system, the changes that are...
CREDENTIALING ALERT
Medicare has started the 3 year effort to re-validate ALL Medicare providers!nnYou will be receiving a notification letter. You (the provider) only have 60 days to complete and submit the proper forms that must be completed.nnCredentialing is NOT just filling out...
Revenue and Expense – Can’t have one without the other?
Some practices may find that they cannot increase revenue as easily as they can decrease expenses. Both or a combination of the two can make a practice more profitable.nnExpenses:nRent, personnel, supplies, equipment, etc. What if you could lower the cost of one or...
Mapping Out Revenue-Cycle Solutions
The following is a portion of the article "Mapping Out Revenue-Cycle Solutions" as provided by Health Leaders Magazine.nThe full version may be found here. nnThe payer and provider communities are still dealing with HIPAA 5010, and trying to shift attention to ICD-10...
Coding Alert: The Proper Use of CPT 99211
As you may be aware United Healthcare and its Secure Horizons product line has recently taken interest in the use of CPT code 99211 with a sudden increase in audit activity. Along with UHC, more and more payers are requesting notes in an effort to verify proper...
Revalidating and Importance of Credentialing
Medicare Revalidation - Medicare requires that ALL enrolled providers and Suppliers to revalidate enrollment information every 5 years. The revalidation initiative is currently in process and will continue through March 2015. You have 60 days from the date of the...
How the New iPad Will Help Physicians
Exploring the New iPad – The primary update is the addition of a new high resolution ‘retina display’. This 9.7″ screen has a resolution of 2048 x 1536 which is sure to appeal to to the wider medical community. Radiologists will now be able to view images in unrivaled...