No further delays for ICD 10. Please see article, Shows the House & Senate have both passed the SRG and ended the coninued Doc Fix. This was the bill that historically piggy backed the delay of ICD 10 implementation. Stay tuned for more posts explaining further...this "is" the livelyhood of your medical practice!

Another great webinar thanks to Dr Jose Puentes. Here is the recording:
http://youtu.be/W5wm1-xnn2M

Compelling webinar on allergies; must attend https://attendee.gotowebinar.com/register/2598007802452071425 …

9 Ancillary Services That Can Boost Practice Revenue

MedScape, August 7, 2014

In Medical Practices daily, we see and recognize the need for Ambulatory Care Facilities (small to medium size medical practices) to boost their revenue. We have been assisting with this for a long time now and felt the need to bring your attention to what works and what doesn’t work. Interestingly enough, the number 1 service that works well for patient & provider alike, has been keeping us very busy – thus, we have Joint Ventured with MDbizWORx through which we offer & service our clients. Here is a quick-read summary MedScape-Summary Table, and the link to the article MedScape Full Article .

Attention: ICD-10 is an Opportunity

ICD-10: The First Opportunity for Physicians to Take Back Control of Healthcare in 30 Years    

 Ever since 1969 when Richard M. Nixon signed the HMO Act, physicians’ and providers’ authority for care decisions and control over reimbursement has been steadily eroding, almost to the point of non-existence. The power of the insurance industry, which has taken over that mantle, notwithstanding, what has really allowed this to happen is the provider’s almost total lack of data with which to justify reimbursement levels or evaluate and prove effectiveness of care within specific disease categories or for specific conditions. ICD-10 and the use of EMR’s will give providers the ability to take back control of healthcare. The question is: Will they take it?

     There has never been a lack of data on procedures or care administered. The lack of data has been largely on the side of the diagnosis coding. The overwhelming use of unspecified and vague diagnoses from superbills and EMR pick lists, that are designed to allow for quick generation of codes for billing and the doctors aversion to the time it takes to document, has left a database that shows low acuity level patients that do not justify the levels of care being administered. In addition, vague diagnostic information makes it virtually impossible to discern in any large scope what treatment protocols work effectively with what specific conditions.

ICD-10 and EMR’s, if used properly, will give physicians their own database of information with which to justify what they have always known but could not demonstrate. Their patients are sicker! Continually submitting unspecified uncontrolled type II diabetes on the same patient for years after their condition had progressed to renal failure, neuropathy, and retinopathy has been the norm. Doctors that change those habits will have the means to justify proper reimbursement levels and will be able to see within their own data what specific disease categories, and conditions respond best to what treatments.

     Healthcare reimbursement for physicians is moving back toward diagnosed and performance based reimbursement. HMO’s are now being called ACO’s (more on this in my next blog). Physicians that do not fully utilize ICD-10 and document the true acuity levels of their patients are laying an undervalued foundation for their future reimbursement. Those that seize this opportunity, document well (which is actually easier in ICD-10, another blog) and report the true acuity level of the patients they see will be taking back control of their future and their industry as insurance companies transfer risk and care authority back to them in the ACO model. This is the first true opportunity I have seen in 30 years for providers to start taking back healthcare.

     Using ICD-10 effectively will help get us to real value and evidence based medicine faster. This is the realm of the Doctor not the insurance company. Physicians resisting ICD-10 do not see the big picture. It is akin to pushing away a life preserver when you are drowning because it is not the one you like.

     The real good news is that the patients will ultimately benefit more than anyone and that is what physicians are really all about.  Doctors get on board now. It is far easier than you have been lead to believe to take advantage of this great opportunity.

10 REASONS for HIPAA COMPLIANCE

Register: Webinar 1/14/2014 2:00 PM EST

            Physician practices that do not take proactive steps towards becoming HIPAA compliant do so at their peril. Here are our "Top Ten" reasons why you need to be compliant:

1. While the Meaningful Use Incentives are optional, HIPAA compliance is not

            If you manage Protected HIPAA Information (PHI), you must comply with federal HIPAA

regulations or face substantial penalties for non-compliance. It is as simple as that! Furthermore, if a Covered Entity chooses to accept Meaningful Use funding, a Security Risk Analysis is required and any funding will have to be returned if adequate documentation is not provided upon request.

2. The HITECH Act substantially increased civil penalties for non-compliance with HIPAA

Policies

            The penalty cap for HIPAA violations was increased from $25,000/year to $1,500,000/year per violation. And willfully ignoring or failing to be compliant means mandatory investigations and penalties that can be started by any complaint, breach or discovered violation. See the document published by the American Medical Association (AMA) http://www.ama-assn.org/resources/doc/washington/hipaa-omnibus-final-rule-summary.pdf  for further information.

3. The mandated deadline for the new HIPAA compliance rules has already passed

            All covered entities, including physician practices, clinics and hospitals and Business Associates must update their HIPAA policies, procedures, forms, Notices of Privacy Practices and otherwise implement the changes required by these regulations as soon as possible, if they were not in place by the September 23, 2013 compliance date.

4. New breach rules will increase the number of HIPAA violations that are determined to

be Breaches

            The recent federal Omnibus ruling expands the definition of a breach and failure to address it properly and provide proper notifications can trigger federal investigations and eventual fines and penalties.

5. Business Associates are now required to become HIPAA compliant

            With the recent Omnibus ruling, Business Associates must also be HIPAA Privacy and Security Compliant and Covered Entities are responsible for ensuring their BA's are compliant.

6. The Office of Civil Rights (OCR) is expanding its health information privacy

enforcement team

            As recent public announcement from the Office of Civil Rights indicates, they are stepping up hiring for HIPAA compliance activities:

"The Division of Health Information Privacy enforces the HIPAA Privacy and Security Rules and the confidentiality provisions of the Patient Safety and Quality Improvement Act. OCR is seeking experience in privacy and security compliance and enforcement as well as in the areas of policy, outreach, and health information technology systems. For more information on these positions, go to http://www.usajobs.gov/  and enter the corresponding job announcement number."

7. State Attorney’s General are getting involved in HIPAA Enforcement

            The Federal government has expanded the reach of HIPAA by enlisting State Attorney's General. See HIPAA training program agenda for state AG's offered by Health and Human Services - http://www.hhshipaasagtraining.com/agenda.php

8. All Covered Entities must have documented policies and procedures regarding HIPAA

compliance

            Recently, a dermatology practice learned this lesson the hard way by paying a $150,000 fine, plus implementing a corrective action plan "for not having policies and procedures in place to address the breach notification provisions of the Health Information Technology for Economic and Clinical Health (HITECH) Act, passed as part of American Recovery and Reinvestment Act of 2009 (ARRA).” For further details, see http://www.hhs.gov/news/press/2013pres/12/20131226a.html 

9. HIPAA Compliance Requires Staff Privacy and Security Training

            All clinicians and medical staff that access PHI must be trained on proper HIPAA procedures on a regular basis. Documentation of training that is provided is required to be kept for six years.

10. Protect Your Practice - Don't be another one of these

            Unfortunately, the list of healthcare organizations reporting major breaches and receiving substantial penalties is growing at an alarming rate. Keep your practice off the list of HIPAA Breach - http://www.hipaabreachlist.com/

As Promised, recorded allergy testing webinar, Deductibles Are Met

Phew…, what an exciting week, we’ve been inundated by follow-ups from the webinar about highly reimbursable allergy testing for the non-allergist.

Dr Jay Harvey (pediatrician) was great; he answered everyone’s questions and put all the non-allergist’s at ease about implementing this program in their offices.

As promised, here is the link to the full webinar from start to finish. VIDEO LINK

What’s more? Troy from AllergiEnd just committed to provide our clients a special offer to leverage this end of the year “deductable met” period. Please call me or email to discuss the details. No out of pocket to start the program right away and you still get the upside reimbursement as well as great patient care, as you’ll hear from Dr Harvey’s experience during the webinar.

As always, thank you for your trust and confidence; I look forward to your prompt reply as the window of opportunity is closing.

About the Panelists

Dr Jay Harvey is a board certified pediatrician with over 20 years of private practice experience currently practicing in Trinity Florida.

Troy Grogan, President and CEO of MedScience is originally from Sydney Australia and has a background in health promotion, public health and medical education. He was a co-founder and former secretariat head of the Australia Lifestyle Medicine Association which provides continuing medical education for thousands of primary care providers in areas of chronic disease prevention and management.