U.S. District Court Judge Michael H. Simon issued preliminary approval on July 29 of an agreement that would require Premera Blue Cross to pay $74 million to settle a class-action lawsuit resulting from a 2015 data breach.
OCR in 2013, through the Health Information Technology for Economic and Clinical Health (HITECH) Ac,t issued a final rule identifying provisions of the HIPAA rules that apply directly to business associates (BA) and those provisions for which BAs are directly liable.
Behavioral health is a highly specialized area of coding that many coders and billers are unfamiliar with. There are hundreds of ICD-10-CM codes for mental disorders with unique characters to specify symptoms and complications.
Even if a hospital is not a teaching hospital, it may have services that require National Clinical Trial (NCT) reporting. It is logical for revenue integrity leadership to own this issue, but an explanation of the requirements for NCT reporting should be shared with all staff within the revenue cycle so there is a better appreciation of the fact that clinical trial billing rules apply more broadly than merely just to research or clinical trial studies.
The field of case management is rapidly evolving as hospital leaders look to case managers to help them meet a host of new regulatory requirements and financial goals. But too often this has put undue pressure on case managers and taken focus off their most important job—coordinating care.
