Explosive Growth of Health Plan Requests Expected. Are you Prepared?
Planning and preparing for requests for clinical documentation from health plans can be extremely difficult from an operations perspective. While managing year-round requests to support denials, audit and second-level appeals, the arrival of the seasonal...
Confidentiality and the Battle against Substance Abuse
While HIPAA regulations allow health professionals to share health information regarding opioid abuse with a patient’s loved ones in emergency and dangerous situations, many HIM departments are still struggling with the release of information laws of such information...
Trump Halts Risk Adjustment Payments, Impacts Health Plans & Consumers
As if the complexities around healthcare affordability couldn’t get more convoluted, the latest news from the Trump administration to halt approximately $10.4 billion in risk adjustment payments has grave impacts to the healthcare industry. Risk adjustment, a...
Ciox Partners with Northwestern Memorial Healthcare
Ciox HealthSource to Advance Northwestern Memorial Healthcare’s ROI Process Ciox, a leading health technology company, announces today its partnership with Northwestern Memorial Healthcare, a health system comprised of more than 100 locations throughout the Chicago...
CC/MCC Analysis – What’s in Store?
Over the past few years, CMS has made known their intent to perform a comprehensive CC/MCC analysis to assess the appropriateness of each diagnosis codes ‘CC severity’. CC severity is the term used to describe a codes role as a DRG influencer in the inpatient...
Why Health Information Exchanges Are More Important Now Than Ever
The importance of Healthcare Information Exchange (HIE) is at an all-time high that is continually evolving to improve the quality and timeliness of care for patients.
Hurray – HEDIS® 2018 is over! Reflecting on this year’s season and preparing (already) for 2019
You can hear the shouts of joy when the HEDIS® season is drawing to a close! The countdown to the June 15th deadline to submit HEDIS 2018 data just wrapped up. Undoubtedly, there was no shortage of details to ensure submissions were accurate, locked on time, and...
Your Questions Answered: New HIPAA Laws Around Opioid Crisis
In a previous post, I wrote about HHS relaxing HIPAA to address the opioid abuse in the U.S., and in February I hosted a webinar where we discussed the new laws and how it will impact providers. In today’s post, I address several of the great questions we received...
Authorized Requests Under Bocage v. Acton Corporation
Healthcare providers and their release of information vendors continue trying to navigate the February 25, 2016 OCR guidance on patient access to medical records. One of the most common issues involves distinguishing a patient directed request from a patient attorney request.