As the industry approaches ICD-10 implementation, end-to-end testing becomes more critical. Testing allows organizations to determine the efficacy of their preparations. It also answers critical questions for ICD-10 stakeholders: Can applications accommodate ICD-10 codes correctly? Does data flow seamlessly between internal and external interfaces? Are payers able to receive, adjudicate, and pay claims correctly?
There are times when state privacy and security laws trump HIPAA, and healthcare organizations and their business associates (BA) should have a clear understanding of their compliance obligations in the midst of what can be a complex web of regulations.
In the first article in this series, we provided an introduction and overview of the PSI 90 measure, which is included in two CMS pay-for-performance programs. Because PSI 90 is a claims-based measure, performance is largely determined by ICD-9-CM codes on the claims.
Finding themselves at the center of a tumultuous, dynamic healthcare environment, physicians are becoming increasingly frustrated and anxious, frequently questioning their career choice. Preparation to be a lifelong healthcare provider inadequately prepares clinicians for the emerging value-based healthcare world to which they are being subjected. Physicians believe that they have little control over or input into the metrics that are rapidly determining their fates with healthcare organizations, third-party payers, and inevitably patients themselves.
There are compelling reasons with which to make a case to company executives of the benefits of a good data security program. It starts with return on investment calculations.
If your organization experiences a data breach—an increasingly likely scenario—and PHI is exposed, chances are you will be hit with a lawsuit in short order.
