Providers setting charges based on an understanding of their costs is not a new concept, says Jugna Shah, MPH, president and founder of Nimitt Consulting. However, providers struggle with this or fail to do it correctly, and then stand to deteriorate their future payment rates since CMS relies on provider data to set payment rates not only for inpatient and outpatient services, but also for laboratory services.
Q. We are a claims repricer and maintain a secure claims department. When outside vendors, such as building maintenance people, enter the secure area, are they required to sign a logbook indicating what time and date they entered and exited the claims department?
At 2:50 p.m. on Monday, April 15, two bombs went off at the finish line of the 117th annual Boston Marathon. Three people were killed, hundreds were injured, and local case managers needed to help deal with the crisis.
When two bombs went off eight seconds apart at the finish line of the Boston Marathon, there were many emergency plans in place. "There's an emergency disaster plan in place for both the city and the marathon itself," says Peter Moran, RN, BSN, MSN, CCM, emergency room case manager at Massachusetts General Hospital (MGH) in Boston. In addition, each hospital has its own emergency process in place.
Who would have thought that buying gas with a credit card or wearing a pacemaker could leave a person's information exposed? Yet highly sophisticated credit card skimming devices at gas stations are stealing from consumers, and healthcare organizations are concerned about the potential for malicious tampering or the theft of PHI from wireless medical devices such as pacemakers. Hidden vulnerabilities lie in everyday activities like these, and some of those vulnerabilities can expose PHI and put healthcare organizations at risk.
The HIPAA omnibus rule provides greater protection for PHI by imposing more stringent requirements and limits on a covered entity's (CE) use and disclosure of that information when it comes to functions such as marketing, sales, and fundraising.
