HITECH Act Explained

HITECH Act Explained

HITECT Act was created aside from the pre-existing HIPAA laws to strictly implement the patients’ security of information. Nitin Chhoda explains the difference between the two, and how they are connected to each other.

HITECH act explainedHITECH Act Protections for Patients

HITECH Act or the Health Information Technology for Economic and Clinical Health Act expands on the already existing HIPAA regulations protecting patient health information.

The result is that healthcare practice management providers must take certain steps when privacy issues arise.

If sensitive and personal health information has been stolen or possibly viewed, HIPAA covered hospitals or medical facilities must notify their patients within 60 days.

Within the HITECH Act, the term breach is used to mean

“unauthorized acquisition, access, use or disclosure of protected health information which compromises the security or privacy of such information, except where an unauthorized person to whom such information is disclosed would not reasonably have been able to retain such information.”

A breach of patient health information not only requires the medical clinic to report to the patients, but also to a major media outlet and to the Secretary of the Dept of Health and Human Services.

The HITECH Act even outlines what must be included in the notice, including the date of the breach as well as the date of discovery of the breach along with a description of what happened. Other information that must be included:

  • Steps that patients can take to avoid potential harm.
  • Description of what was stolen or viewed.
  • Description of what is being done by the medical clinic to minimize damage, investigate what happened, and avoid a similar incident in the future.
  • Contact information so patients can call, email, review, or write to the company for more information or if they have questions.

HITECH Act explainedWhile some of the information in the HITECH Act may be familiar because it relates to pre-existing regulations from HIPAA, the major difference will be enforcement.

HIPAA is thought to provide these protections, but it is also considered to be very poorly enforced.

The HITECH Act puts enforcement as a top priority and includes hefty fines for what has been termed “willful neglect”, a very imprecise term that will be defined by cases in the future.

Additionally, the HITECH Act puts more pressure on “business associates” of healthcare providers. HIPAA allows these business associates to have access to information via contracts.

But now they will be held responsible for breaches in a more comprehensive way. Providers of EMR or EHR systems are considered business associates and will have to consider HIPAA security and privacy rules when designing EHR or EMR systems.

Incentives for Healthcare Providers

The HITECH Act isn’t all focused on procedure, however, and as it is part of the American Recovery and Reinvestment Act (ARRA), there are also some incentives for healthcare providers.

Most of the incentives focus on promoting the use of electronic medical records and electronic health records. Because electronic records cut down on long term costs, but require an initial investment that many clinics don’t want to make, ARRA and the HITECH Act offer financial benefits if you make the switch.

HITECH Act : Economic Stimulus for EMR Adoption

HITECH Act : Economic Stimulus for EMR Adoption

Nitin Chhoda reveals a few ways that the HITECH Act can help a private practice switch to an electronic medical records system using a limited budget.  He also shares the requirements needed so that the practice can qualify with the HITECH Act incentives.

HITECT Act While the HITECH Act may help improve the safety and security of electronic medical records keeping systems, the aspects that clinicians and healthcare providers are excited about is the incentives.

The HITECH Act provides financial encouragement to clinicians, hospitals, and medical practitioners for the “meaningful use” of electronic medical records. A total of $19 billion has been allocated for incentives.

Financial Benefits

There are some great financial benefits to switching to electronic medical records anyway, but the HITECH Act makes things even easier. Physicians could qualify for as much as $44,000 for electronic health record implementation and use over the five years that the Act is funded.

The incentives only apply to the Medicare and Medicaid programs, but they can only get incentives through one program at a time. This means that they can also accrue incentives through one program and then when that runs out, they can accrue the same amount through the other program.

The incentives were also meant to encourage providers to adopt EMR systems for HITECH Act as soon as possible. One deadline was for 2012, and next year the incentives will be lower than they are this year.

And after 2015, medical practices will start to incur penalties if they have not switched to an EMR, starting with a 1% Medicare fee reduction. After 2017, that fee reduction is increased to 3%, an after 2019 the fee reduction will be increased to 5%.

Regional Extension Centers

In addition to financial incentives for adoption of EMR, the HITECH Act also funded 70 regional extension centers that can provide administrative help and guidance for health care providers attempting to make the switch to EMR.

Specifically, these regional extension centers will help “providers select the highest-value option, defined as that which offers the most favorable cost of ownership and operation, including both the initial acquisition of technology, cost and implementation, and ongoing maintenance and predictable needed upgrades over time.”

However, there is no requirement that health care providers use the regional extension centers unless they need help implementing an EMR.

HITECH Act stimulusQualifying for HITECT Act Incentives

The most important requirements for qualifying for HITECH Act incentives for EMR adoption are the proper selection of an EMR system and understanding “meaningful use”.

There are a total of 25 meaningful use criteria, and health care providers must demonstrate 20 out of those 25. Fifteen criteria are pre-determined by the HITECH Act, and out of the final ten, you must choose five. The criteria are measured in three stages over five years.

The first stage of HITECH Act requires that you use a certified EMR system and document set percentages of criteria electronically.

You will also be required to use the reminders and warnings systems that certified EMR systems have, share patient information, and report public health information and quality measures.

The second state of HITECH Act requires that you also send and receive lab results and other information using the EMR.

The third stage of HITECH Act requires that you also enroll patients using public health records, access patient data, improve population health, and report on national high priority conditions. Other criteria may be added in the future.

Medical Management Streamlined with EMR

Medical Management Streamlined with EMR

Streamlining medical management is now possible with the use of EMR. Nitin Chhoda enumerates the benefits of EMR including the efficiency of billing, scheduling and managing productivity reports.

medical management EMRClinicians, practitioners, and other private practice owners that use medical management are being forced to take certain steps toward efficiency.

The financial pressures of an increasingly hostile and uncooperative health insurance industry, combined with the fact that more and more patients are unable to pay their bills, has put clinicians in an uncomfortable bind.

How can you provide the best medical care possible if you are restricted by financial considerations? The transition may be a bit rough, but it looks as though private practices are going to get some major help by adopting electronic medical records.

Electronic medical records cut down on administrative costs, making it just a bit less expensive to run the clinic. But more importantly, they can streamline medical management and help the practice to run more efficiently.

Billing and Scheduling: Efficiency Traps

It turns out that much of an clinic’s efficiency is decreased because of errors and delays in billing and scheduling. The ways that EMRs can streamline the billing aspects of medical management may be obvious to some.

A billing system that tracks unpaid bills and sets reminders for the medical management personnel responsible for billing will increase the likelihood that bills will not be forgotten.

This is true for patients as well as health insurance companies. Most medical management and health insurance companies have very particular requirements for the filing of claims. These forms can be time intensive and frustrating to complete. EMRs that are designed to streamline medical management will include options for filing the appropriate paperwork and will include reminders so the paperwork is filed in the required timeframe.

Increased efficiency in scheduling is less obvious at first, but the benefits are certainly easy to understand. When a patient cancels an appointment, that time slot is easily lost and left empty. Scheduling components of EMR programs will ensure that all empty slots are filled when possible. They also allow for re-scheduling with a few clicks of the mouse.

medical management streamlineReporting and Medical Management

On the other hand, medical management professionals will tell you that one of the biggest challenges to improving efficiency is the lack of useful data.

On paper, it is overwhelming to attempt to compile reports that detail how many appointments have been missed, how many bills are left unpaid or the collection percentage, and productivity as measured by the number of patients scheduled for each medical professional.

EMRs offer reporting tools and instruments for medical management systems that make evaluation of the practice quick and efficient. Imagine if you could print a referrals report with a few clicks or figure out how many visits each patient typically schedules.

More Productive and Efficient

Medical management can be more productive and more efficient if these kinds of figures can be analyzed. Without EMR and reporting capabilities, this kind of analysis is overwhelmingly challenging and presents time barriers that are insurmountable.

Rather than relying on the business to continue as usual, medical management professionals and EMR systems learn what is working at your practice and what is not working. Once you know how things are actually going, you can take action to change it for the better.

Medical Coding As A Modern Necessity

Medical Coding As A Modern Necessity

Nitin Chhoda provides reasons why medical coding is necessary and the role it has in a private practice setting.  By defining what medical coding is and what codes are involved, it helps simplify the process for practice owners and staff.

medical codingWhat is medical coding?

Medical coding is an important step between the treatment of a patient and medical billing for the procedures, tests, and services. Clinicians will talk to patients, administer or order tests, and write down notes about each visit.

Those notes may describe what the patient needed, and in turn a medical coding staff member will translate each billable item into the assigned medical code.

Every doctor, medical clinic, and hospital must record a patient visit and include any procedures and tests performed. No matter whether the patient, their health insurance company, or another party is paying the bill, medical coding will take place to document how the bill should be drawn up.

What are the codes that are used?

There are a few kinds of necessary codes that medical coding staff members handle. The first is ICD-9 codes, or the International Classification of Diseases codes.

The number 9 refers to the version of this form of classification, and in 2013 a new version will be introduced, ICD-10.  CPT codes, or current procedural terminology codes provide a list of alphanumeric codes used by medical coding professionals in the United States.

HCPCS codes, or Healthcare Common Procedure Coding System codes, are used for Medicare and other insurance programs. All codes were developed in an attempt to streamline and standardize the way medical procedures and tests are described and billed.

Why is this necessary?

The most interesting thing about medical coding is that it comes from an interest in standardization. The fact is that most medical procedures can be described in a single way – medical tests and processes have been developed over time, and while that development continues, clinicians are taught a right way to do things fairly consistently.

modern medical codingMedical coding allows a medical facility to bill for anything using a standardized system.

If one hospital performs a surgery and describes it differently from another hospital, even though the procedure is essentially the same, a health insurance company is going to have a hard time determining whether or not they truly are the same procedure.

Rather than spending the time guessing about the appropriate amount that should be billed, medical coding allows everyone to agree in advance that a certain code can be billed at a certain rate.

Does that really work?

The sad thing is that this attempt at a system works in some ways and fails in other ways. The first problem is that health insurance companies change their billing requirements constantly.

Even if a certain medical code is used for a certain test, the billable amount for that test may have changed. Laws attempt to keep things flexible and reasonable, but everyone is still trying not to spend any more money than they absolutely have to.

On the other hand, medical coding has made it possible for trends in diseases and public health and safety problems to be tracked at local and national and even international levels. This kind of information and the data collected through medical coding can help to improve medical care.

Medical Coding Latest Trends

Medical Coding Latest Trends

Medical coding is a complicated task, and requires constant updating. NItin Chhoda shares the main tasks of a medical coder and the importance of using certified people.

medical coding trendsBecause medical coding is such an important task, many clinics assign a medical coder to do the job. Sometimes the medical coder and the medical biller are the same person, especially in a smaller clinic.

But medical coding is a complex task that requires a detail oriented approach and specific knowledge. Some of the most recent trends in medical coding have shown an increase in the demand for certified medical coders.

Updates to Codes

A certified medical coder for physical therapy billing is required to spend a certain amount of time studying medical coding before they become certified.

You don’t have to have a degree or certification to work as a medical coder, but you do have to understand medical terminology and have a good education in physiology and anatomy.

Reading what a clinician has written and assigning the appropriate medical codes would be hard if you don’t know what the clinician is talking about.

But another advantage of hiring a certified medical coder is that they will be required to take continuing education courses and re-certify regularly. That means that when changes are being made to medical coding websites, the medical coding staff member will be updated through courses.

One very important change that is coming soon is the switch from ICD-9 codes to ICD-10 codes, which will occur in October of 2013. An additional 100,000 codes will be introduced into the system, and the ICD-9 codes only number about 13,600 codes. This change is going to affect every single health care provider in the country.

Education and Job Outlookmedical coding latest trends

As a result of the need for skilled medical coding professionals, the job of a medical coder is looking pretty steady for the next decade and beyond.

Competitive certification programs are popping up all across the country. For people looking for a steady and well-paid job, medical coding is a good option these days.

There have been a few recent trends in medical coding education. Most significantly, more and more medical clinics want to hire certified medical coders rather than someone they will have to train themselves.

A skilled and experienced coder will be able to handle the job efficiently and they will be learning how to deal with changes and updates as part of their re-certification courses. With this kind of confidence-inducing education, certified medical coders are a well-respected part of successful medical practices.

Paperwork vs. Electronic Medical Records

Another big adjustment that is rapidly changing the way medical coding is done is the introduction of electronic medical records. For some coders, this sounds like the best idea yet. EMR systems might make their jobs faster and more efficient, allowing for coding and billing to occur side-by-side within the computer program.

Some medical coding professionals are not so enthusiastic. They see plenty of potential for problems with security and privacy. But as electronic systems evolve and the need for better electronic security arises, it seems that security companies are developing the proper privacy measures to accommodate a paper-free medical coding environment.

Medical EMR Solutions Give Clinicians More Power

Medical EMR Solutions Give Clinicians More Power

Clinicians who already use medical EMR know that this technology is helping them and their staff work more efficiently. Nitin Chhoda shares the many benefits that EMR can offer to your physical therapy practice, helping it succeed.

medical EMR solutionsThe ability of any clinician in any medical practice is limited by financial factors. If a practice doesn’t make a profit, or at least break even, nobody can continue to provide healthcare.

Because the prices of healthcare in the United States are so high, patients cannot afford to pay for their own healthcare.

The majority of U.S. citizens cannot afford to pay the average prices for healthcare. As a result, both patients and clinicians must rely on healthcare insurance companies.

Insurance companies provide a sense of financial safety to patients, and patients can better afford to make monthly payments towards healthcare than they can afford to pay a $20,000 hospital bill all at once.

About Medical EMR

For medical EMR clinicians and health care practice management, knowing that part of every bill will be covered by insurance provides some financial security, even in a market where the patients who need the services cannot pay for those services.

Medical EMR systems make everything about a healthcare provider practice run more smoothly and efficiently if implemented well. The upfront cost of a medical EMR may seem restrictive, but the benefits tend to outweigh those costs relatively quickly.

A medical EMR system can bring stability to a practice and can turn into a tool that clinicians use to better serve their patients.

Spending More Time on the Important Stuff

Most clinicians would spend a whole lot less time handling paperwork if they had the choice. The truth is that everyone who works in healthcare has to know how to fill out forms and make correct notes about their patients.

The same should be applied when it comes to medical EMR. This can even get in the way of how well a clinician can care for patients, especially in a busy practice where limited time is given for each appointment.

medical EMR cliniciansBefore and after each appointment, a clinician needs time to review the previous patient’s file as well as refresh their memory with information about the next patient’s medical history.

Medical EMR software makes doing these tasks faster and more intuitive. Rather than requiring that a staff member find a paper file and have it ready, the clinician can pull up the information on the computer in seconds, or even on a hand-held tablet computer.

Advanced Technology

Software is becoming more and more advanced, and not just because using computers is fun or flashy. Clinicians who use successful electronic medical records systems find that they are more efficient and can spend more time with patients when they use a medical EMR.

And of course, that staff member who used to pull files and return them to their place all day long can now spend time doing other, more important things.

Perhaps that staff member can now handle a more efficient and time-saving induction process, so that new patients’ health insurance information is more complete.

Medical EMR companies and billers benefit because they can reduce the number of rejections and denials. And patients can be better prepared for the costs that will come their way – allowing them to focus on their treatment plan.

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