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With COVID-19 demolishing any semblance of order in hospital operations, now’s the time for teamwork to make a difference. It may not be front and center during the pandemic but the relationship between HIM and the business office looms large as organizations try to maintain some form of revenue flow.
This month’s E-News Exclusive spotlights how patient demand for medical records is making a unified effort between these two departments an essential component of hospital operations.
— Lee DeOrio, editor |
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ROI and Revenue Cycle Crossover Calls for Collaboration
By Dawn Crump
The crossover between the release of information (ROI) process and revenue cycle involves multiple touch points and considerations, particularly for HIM professionals responsible for the secure disclosure of protected health information. With increased requests for audits and access to EHRs, collaboration between HIM and the business office is more important than ever before.
Audit Update for 2020
For hospitals, the increase in targeted commercial payer audits is especially troubling as those audits are not subject to the same guidelines as government payer audits requiring experienced staff and established processes. Making sure all commercial payer audit information is sent to a single department or individual is difficult. As a result, communications about the same audit request may go to HIM and the business office. The following are strategies to help HIM and the business office improve communication, collaboration, and efficiency.
- Create a team featuring representatives from both departments to establish standardized, centralized processes and procedures.
- Track audits by payer—eg, type, prepayment or postpayment, dollar value, service line, volume, timelines.
- Review payer guidelines to understand the requirements for medical necessity.
- Evaluate your managed care contract and update language to close loops.
- Set policies to make sure records are complete before sending to the payer—proper signatures, notes, and queries to substantiate treatment.
As the COVID-19 crisis continues to wreak havoc on the US health care system, providers are struggling to meet unprecedented patient care demands while also protecting revenue cycle operations. To ease the potential economic impact, Medicare and commercial payers are expediting payment to providers. Many payment integrity audits have been suspended as resources are funneled toward COVID-19 treatment.
Full story » |
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Libman Education Releases Accelerated Cross-Training Coding Curriculum
Libman Education announces the release of the Accelerated Outpatient to Inpatient Coder Training program in response to demand by hospitals dealing with the disruption of COVID-19. With outpatient services and elective procedure volumes down across the country, hospitals are seeking a way to quickly cross-train their existing outpatient coders to deal with the surge of COVID-19 medical-surgical cases. The Accelerated Outpatient to Inpatient Coder Training program builds on an outpatient coder's valuable on-the-job experience and knowledge, while supplementing their skills with the essential training necessary to assume inpatient coding responsibilities. Delivered as online, self-paced, interactive courses, the program allows the organization to fast-track the coder training and quickly respond to demand. The program features Libman Education's exclusive materials that may be taken sequentially or concurrently. Learn more »
Sharecare Launches Free Platform to Enable Providers With Telehealth
Sharecare has launched Sharecare Telehealth, a comprehensive HIPAA-compliant solution that instantly enables providers, practices, and health systems of all sizes to care for their patients remotely. In an effort to help health care providers better support their patients’ well-being during the novel coronavirus pandemic, the digital health company is making Sharecare Telehealth available for free through September 1, 2020, to health care providers in the United States that sign up by June 1. Sharecare Telehealth—powered by Updox—features video chat, which allows patients and care team members to connect face-to-face; secure text, which enables practices to communicate with patients through HIPAA-compliant secure text and transmit forms, pictures, and videos; and a personalized well-being platform to empower patients to manage their health every day. To access Sharecare’s latest content and tools for COVID-19 preparedness, awareness, and prevention, visit sharecare.com/covid19. Learn more »
Free Platforms Address COVID-19 Coding and Documentation
Beyond patient care and staff safety demands, the COVID-19 crisis has evoked unprecedented health information challenges to medical coding and billing and clinical documentation integrity (CDI). Intellis is providing three avenues for information and education from trusted health care sources: one site for information, one source for online training, and one team for COVID-19 education. On the Intellis website, the team developed a single source where HIM professionals can obtain current COVID-19 directives and latest news from AHIMA, the American Medical Association, the Centers for Disease Control and Prevention, and the Centers for Medicare & Medicaid Services (CMS), as well as coding tipsheets and FAQs. IQ Center, the company’s education portal, offers several free courses to all industry professionals. Intellis’ subject matter experts present coding- and CDI-related updates and webinars based on AHIMA and CMS information. Learn more »
VisiQuate Launches COVID-19 Revenue Cycle Resource Center
The VisiQuateCOVID-19 Revenue Cycle Resource Center highlights step-by-step plays that specifically address revenue cycle management (RCM) issues presented by the COVID-19 pandemic, including solutions for Medicare Telemedicine Services, New COVID-19 CPT Codes, and Appointment Cancellations. Each has been designed to help hospitals and health systems eliminate waste and loss, improve operational efficiencies, capture full net revenue, reduce manual intervention, and maintain productivity, even when workers are challenged to work from home. The plays can be performed by any health care organization, whether they're VisiQuate clients or not. The resource center also includes a dedicated blog with posts from VisiQuate's RCM experts offering in-depth insights into the financial and business issues caused by COVID-19, as well as recommendation on how to manage them. A third section of the resource center offers links to carefully curated articles from health care experts across the industry so RCM leaders can find all the information they need in a single location. Learn more »
Interbit Data Helps Health Systems Access Crucial Patient Data Remotely
Interbit Data announces new options for hospitals and health systems to access patient data from anywhere, at any time, to coordinate care during the COVID-19 pandemic. Interbit Data’s NetSafe is an automated software solution that ensures uninterrupted, HIPAA-compliant access to patient data during system downtimes, including planned updates, power outages, natural disasters, and cyberattacks. Now, to better address COVID-19-related data accessibility needs, Interbit Data will give its nearly 300 NetSafe customers across North America the added option of internet-based access to critical patient information. This additional capability maintains the same HIPAA compliance and makes it easier to ensure patient safety from remote and makeshift locations, which are now approved under CMS’ new COVID-19 regulations. Existing NetSafe customers who choose to take advantage of this feature may access it free of charge through June 30. Customers are also deploying Interbit Data’s automated report distribution solution, NetDelivery, in innovative ways to manage the challenges associated with COVID-19. For example, some health systems send appointment cancellations and postponements through NetDelivery to all referring physicians in response to COVID-19 protocols, while others route incoming COVID-19 test results and restrict general access to that information through Interbit Data’s DesktopFax solution (which enables unlimited faxing across the enterprise from PC-based applications). Learn more »
University Health System Launches Gozio Health COVID-19 Fast Track Solution
Patients of University Health System now have access to a full-featured mobile app that meets the critical communications demands of the COVID-19 crisis. Developed in collaboration with Gozio Health, the platform allows University Health to deliver real-time push notifications directly to smartphones and gives patients immediate access to virtual triage, real-time notifications, navigation to locations, and more. Gozio's Fast Track solution is a focused version of a health care system’s digital front door platform that can be quickly deployed to respond immediately to the communication and operational challenges posed by COVID-19. Once hospitals have launched Gozio's COVID-19 Fast Track solution, they can build out the platform to include appointment scheduling, physician directories, EMRs, and indoor navigation featuring locations of doctors' offices, cafes, pharmacies, and the closest restrooms. The University Health System Go mobile app is available for free on the Apple App Store and Google Play. Learn more »
MyTelemedicine Launches New Telehealth Virtual Care Platform
As doctors search for ways to serve patients effectively while people are encouraged to stay home and prevent the spread of COVID-19, the newly launched Zeally Health (Zeally) virtual care platform offers a much-needed solution. Powered by MyTelemedicine, Zeally allows health care providers to rapidly deploy a telehealth option. The software as a service lets doctors consult with a patient in a HIPAA/HITECH-compliant environment via video or phone, and can be licensed to an individual provider, practice, physician group, or hospital. Health care providers who license Zeally can begin offering virtual consultations immediately after uploading their patient and practitioner data into the system. The cloud-based platform uses state-of-the-art encryption technology, so doctors can log in whether working at their office or from home supporting initiatives to self-quarantine. Patients, likewise, can log in online or via the Access a Doctor mobile app to manage their personal medical records and connect with their doctor in a secure environment. The end-to-end virtual care solution is both HIPAA and HITECH compliant and includes patient scheduling and management tools for practitioners, as well as an integrated e-commerce payment system and electronic prescribing. Learn more »
Verato Debuts Verato Enrich to Accelerate COVID-19 Response
Verato announces the launch of Verato Enrich, an identity information service that makes demographic and social determinants of health data more complete for public health and contact tracing. Verato Enrich is powered by the company’s cloud-based enterprise master person index (EMPI). It can append a wide array of data ranging from basic contact information such as missing phone numbers and addresses, to lifestyle data such as income, ethnicity, race, occupation, and interests to patient records. Approximately 80% of positive COVID-19 test results are submitted electronically and as many as 50% lack enough contact data to support contact tracing. With Verato Enrich, health systems, commercial labs, and public health teams gain an increased understanding of people and the critical nonclinical factors that impact health. Enrich acts as an accelerator, enabling contact tracing and analysis to be more efficient and effective. Verato Enrich extends the value proposition of Verato’s next-generation EMPI, providing a critical infrastructure backbone for contact tracing and public health analytics, enabling health organizations to accurately integrate information from a wide variety of sources and efficiently drive actionable workflows and information sharing. Learn more »
AHIMA’s New COVID Query Templates Available as Electronic Forms
Given the urgent need to care for and treat COVID-19 patients, AHIMA has released two query templates that will help clinical documentation integrity professionals ensure the integrity and quality of a patient’s health record. Quest Diagnostics, a provider of diagnostic information services, is providing the templates as electronic forms that can be accessed through its Quanum Enterprise Content Solutions product line. Quest is providing the templates for its customers to promote quality documentation supporting COVID-19 response. The templates provide clear guidelines for the type of data, such as symptoms and risk factors, required to accurately document the virus. Health information professionals can download PDF versions of AHIMA’s templates. Learn more » |
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Big Tech Companies Cast Large Shadow in Health Care
New technology from Amazon and others looms over the documentation sector. What will be its long-term impact on hospital decision makers and HIM processes? Read more »
SDoH: Behind the Buzz Is Real Potential
There’s no denying social determinants of health play a role in overall health. How the industry approaches their integration into the care process will be key to taking advantage of the data. Read more »
Records for Ransom
One of the most effective forms of infiltrating a hospital’s infrastructure, ransomware forces organizational leaders to weigh the merits of meeting the kidnapper’s demands. Read more »
Can AI Turn the Corner Into Clinical Settings?
Artificial intelligence has made inroads in health care, but the technology is facing hurdles and challenges gaining a foothold in actual practice. Read more » |
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Patients Prefer Digital Consent to Share Their Data
Patients preferred using a digital consent application over current methods when giving consent to their data being shared between medical practices, according to research by the University of Warwick.
Health Officials Say Contact Tracing Involves HIPAA, Won’t Violate Your Privacy
Contact tracing can identify cases of communicable diseases such as COVID-19, but any information that patients tell contact tracers is confidential under HIPAA, KXLY reports. |
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AMA, Nuance Partnership Focuses on Documentation Burden
Nuance Communications and the American Medical Association (AMA) recently announced a strategic collaboration that will pilot test the combination of each organization’s respective technologies in an effort to reduce documentation burden that distracts from patient care and demoralizes highly trained physicians.
The collaboration will leverage Nuance’s expertise in ambient clinical intelligence (ACI)—which securely facilitates the transformation of clinical conversations between patients and physicians into reliable medical chart notes—with AMA’s expertise in physician burnout prevention and health care informatics in a shared exploration of innovations to empower clinical decisions, enhance the quality care, and boost physician well-being.
Read more » |
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Have a coding or documentation question? Get an expert answer by sending an email to edit@gvpub.com.
This month’s selection:
Do we have an ICD-10-CM for Personal History of COVID-19? Are they developing one? Also for sequel of?
Jen M. Growney, CPC
Fee Abstractor II
Response:
AHIMA and the AHA Central Office, representing two of the four members of the Cooperating Parties for the ICD-10-CM, jointly published guidance for the correct reporting for history of COVID-19 should be assigned to Z86.19, Personal history of other infectious and parasitic diseases. Following similar logic, the correct code for sequela would be coded to B94.8, Sequelae of other specified infectious and parasitic diseases. Based on Official Guidelines for Coding and Reporting, generally coding of sequela will require two codes. The first code will be the nature or condition of the sequela followed by the sequela code, B94.8. More specific codes can potentially be added to the ICD-10-CM code set in the future. Unfortunately, there was no specific code created for personal history of COVID or any sequela for emergent use.
Reference:
https://journal.ahima.org/ahima-and-aha-faq-on-icd-10-cm-coding-for-covid-19/
ICD-10-CM Official Guidelines for Coding and Reporting
— Janice Tarlecki, MBA, RHIA, CCS, is director of internal education and auditing at Ciox. |
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