The Weakest Link: Identifying and Vanquishing Compliance Risks

The Presentation

The precipitous rise of cyber attacks, new privacy regulations, stricter enforcement, and private litigation are changing the compliance landscape right beneath our feet. At the same time, some of the best ways to keep your practice compliant are simple, inexpensive and straightforward. Together we will explore today’s threats to your practice and the uncomplicated, totally reasonable steps you can take to address them.

The Presenter

Robyn Johns is the Compliance Officer at Med USA, a medical billing and practice management provider. Robyn discovered the healthcare business as a college student with her first “real” job at the front desk. After graduating, she pursued her career in practice management. Robyn has worked with a variety of specialties and practice sizes in billing, denial management, payer audits, payer enrollment, and operations management. She has also focused on the area of ethics and compliance for over 20 years. Robyn is a relentless learner, and with new treatments, payment models, and regulations every day, she is never bored!

This webinar features content originally scheduled for the in-person Provider Education Summit (PES) events.

Executive Director of UDOH Issues Memorandum for All COVID-19 Lab Results

In an official Memorandum issued earlier this month, Dr. Joseph K. Miner, Executive Director at the Utah Department of Health (UDOH), asked all healthcare organizations to report all of their COVID-19 lab test results through UHIN.

This request, says Dr. Miner in the Memorandum, “is consistent with the reporting and data exchange of other healthcare information that is already done through UHIN.” 

The Memorandum reads as follows:

“To: All healthcare partners performing lab tests for COVID 19 

The reporting of lab test results in a timely fashion to the appropriate individuals and/or agencies has always been important. Every agency that performs laboratory testing has established reporting systems to assure that this is done. This includes the importance of entering the appropriate results into the State’s Epitrax system. 

Now that we are dealing with the COVID 19 pandemic, there is a need for a more comprehensive lab reporting system to assure that results for COVID 19 tests are received by all parties with a need to know. 

To this end, we would like to encourage the reporting of all COVID 19 lab test results through the Utah Health Information Network (UHIN) in addition to reporting to Epitrax. This request is consistent with the reporting and data exchange of other healthcare information that is already done through UHIN, in addition to billing information.” 

 

Medicaid Expansion in Utah

The Presentation

This presentation by RyLee Curtis and Michael Hales walks attendees through the recent implementation of Medicaid expansion in Utah. They will cover eligibility, approved waivers, and pending waivers that will shape the future of Medicaid in Utah.

The Presenters

RyLee Curtis received a dual degree in Communications and Political Science from the University of Utah, where she also received her master’s degree in Public Policy. She worked on Medicaid policy in Utah for many years, before joining University of Utah Health as the Director of Community Engagement. In this role, she is leading the Hospital’s Healthcare Anchor Institution work, engaging with community based organizations to address Social Determinants of Health, and building partnerships across University of Utah Campus, University of Utah Health Plans, and the University’s Hospital.

Michael Hales is the Senior Director for Government Healthcare Programs at U Health. He has 25 years of experience in the health care industry, ten were spent leading the State of Utah’s Medicaid and CHIP programs. At U Health, he provides strategic advice on federal and state government health programs. Prior to joining U Health, he worked at Intermountain Healthcare as a senior consultant and director of population health. Michael received a Master in Public Administration degree from Harvard University. He also has a Bachelor’s degree in Business Management from BYU.

This webinar features content originally scheduled for the in-person Provider Education Summit (PES) events.

PES Virtual Payer Panel 2020

COVID-19 may have put a damper on the 2020 Provider Education Summit, but that doesn’t mean we can’t deliver a great educational event to our amazing community! In collaboration with our local payers, we hosted the first-ever PES Virtual Payer Panel!

The payer panel is always a highlight of the PES events and features experts from more than a dozen payers. In 2020, we hosted the panel as an interactive live webinar with a Q&A format. 

Panelist Contact Information (additional contacts will be added as they are received):

Molina: The Molina email address for Provider Services requests/questions is MHUProviderServicesRequests@MolinaHealthCare.Com.

Aetna:
For Commercial Plans – 888-632-3862
For Government Plans – 800-624-0756
Workers Comp – 800-238-6288
ASA and Meritain – Number on back of member’s ID card

Click below to access the transcript of the event and answers to questions we didn’t cover during the event. Additional answers will be added as they become available. (Last Updated: 5/5/2020)

PES Virtual Payer Panel 2020 Transcript

Additional Panel Answers

YOUR PATIENTS’ COVID-19 LAB RESULT ALERTS IN REAL-TIME THROUGH THE CHIE

GET COVID-19 LAB RESULT ALERTS IN REAL-TIME WITH CHIE ALERTS

UHIN is sending COVID-19 lab result alerts directly from hospitals to healthcare providers, ACOs and care managers in and around the state of Utah.

Want access to COVID-19 Lab Result Alerts?

  • Already a CHIE member? Contact April Pace at apace@uhin.org to get set up
  • Not a CHIE member? Contact our team at enrollment@uhin.org

Results data directly from hospital labs

Utah hospitals are currently sending notifications of hospitalizations, ED visits, and COVID-19 lab orders and diagnoses through UHIN to other healthcare organizations. This real-time information allows care teams to coordinate interventions for their patients more effectively , especially those in greater need of physician oversight. 

About Lab Result Alerts

These lab alerts are available through UHIN’s Clinical Health Information Exchange (CHIE). Care teams will be able to see all SARS-CoV-2 test orders and results. Additionally, SARS-CoV-2 IgG/IgM Antibody tests are available in the data feeds and will be sent in the lab reports.

Care teams and physicians will be notified when one of their patients has been tested for SARS-CoV-2 and the result of those tests to ensure the patient is being cared for in the appropriate setting. Lab Result Alerts are also vital for an office’s infectious disease protocols. 

Delivery formats and timing

Alerts can be delivered batch or real-time in multiple formats, including HTML, HL7, SFTP, and Direct secure email. Alerts on non-COVID-19 lab results are also available.

Is there a cost for this?

Free for current CHIE Members: Lab Result Alerts are covered under CHIE membership costs. If your organization is already a CHIE member there will be no additional cost. 

Free for 60 days for new CHIE Members (ending June 22, 2020):

Because of the current healthcare crisis and the need to improve the exchange of health information, CHIE Alerts and Lab Result Alerts will be available at no cost to those physicians and care teams who are not currently CHIE members.  

Why is it free for only 60 days?

We are optimistic that the situation will stabilize in the next 60 days, at which time we will re-evaluate to determine the needs of the community based on the severity of the COVID-19 crisis.

What if I want to continue receiving Alerts after the 60 days?

Please contact us at enrollment@uhin.org if you would like to continue to receive either the CHIE Alerts (ADT) or Lab Result Alerts.

Who is sending COVID-19 lab data?

These are the hospitals, clinics and other organizations currently sending COVID-19 lab results to UHIN. We are currently in the process of connecting Intermountain hospital labs. Those locations will be available soon. If your organization is not on the list, but would like to help our community by sending your COVID-19 data, please reach out to our team at chiesupport@uhin.org.

Independent hospitals, clinics and medical centers, including:

Beaver Valley Hospital

Blue Mountain Hospital

Central Valley Medical Center

Gunnison Valley Hospital

Kane County Hospital

Memorial Hospital of Sweetwater County

Milford Valley Healthcare Services

Moab Regional Hospital 

St. Mark’s Family Medicine

Uinta Basin Medical Center

Intermountain Healthcare hospitals, clinics and medical centers, including:

Alta View Hospital

American Fork Hospital

Bear River Valley Hospital

Cassia Regional Hospital

Cedar City Hospital

Delta Community Hospital

Dixie Regional Medical Center

Fillmore Community Hospital

Garfield Memorial Hospital

Heber Valley Hospital

Intermountain Medical Center

Layton Hospital

LDS Hospital

Logan Regional Hospital

McKay-Dee Hospital

Orem Community Hospital

Park City Hospital

Primary Children’s Hospital

Riverton Hospital

Sanpete Valley Hospital

Sevier Valley Hospital

Utah Valley Hospital

HCA Healthcare hospitals, clinics and medical centers, including:

Brigham City Community Hospital

Cache Valley Hospital

Lakeview Hospital

Lone Peak Hospital

Mountain View Hospital

Ogden Regional Medical Center

St. Mark’s Hospital

Timpanogos Regional Hospital

Revere Health Clinics (includes all clinics)

Steward Healthcare hospitals and medical centers, including:

Davis Hospital and Medical Center

Jordan Valley Medical Center

Jordan Valley Medical Center West

Mountain Point Medical Center

Salt Lake Regional Medical Center

University of Utah hospitals and clinics, including:

Huntsman Cancer Institute

University of Utah Hospital

University of Utah In-Car Testing Sites

Includes all clinics 

UHIN ALERTING UTAH HEALTHCARE ORGANIZATIONS OF COVID-19 LAB RESULTS IN REAL-TIME

SALT LAKE CITY, UT, April 17, 2020 — In response to the need for increased sharing of time-sensitive health information during the ongoing COVID-19 crisis, The Utah Health Information Network (UHIN) is sending COVID-19 lab result alerts from hospitals directly to healthcare providers, ACOs and care managers in and around the state of Utah. These alerts will be available at no cost to physicians and care teams during the crisis and current CHIE users will incur no additional costs for Lab Result Alerts.

Utah hospitals, medical centers and labs are sending notifications of hospitalizations, ED visits, and COVID-19 lab orders and diagnoses through UHIN to other healthcare organizations. These alerts allow care teams to coordinate interventions more effectively for their patients, especially those in greater need of physician oversight. Care teams will also be able to see all observations and lab results that are part of a SARS-CoV-2 test order. 

“Care teams and physicians need to be notified immediately when one of their patients has tested positive for SARS-CoV-2 to ensure the patient is being cared for in the appropriate setting,” said Dr. Matt Hoffman, Chief Medical Informatics Officer at UHIN. “Lab results data is also vital for an office’s infectious disease protocols. A patient who tests positive for COVID-19 could unknowingly endanger a clinic or hospital if appropriate interventions are not taken.”

These lab alerts are being made available through UHIN’s Clinical Health Information Exchange (CHIE) and is part of the CHIE Alerts platform. The CHIE is the state-designated Health Information Exchange (HIE) for all of Utah and includes data from 95% of Utah’s hospitals and 90% of providers from Utah and the surrounding areas. Currently the CHIE encompasses clinical and hospital patient records for more than 6 million patients.

Providers, ACOs and care managers interested in receiving COVID-19 lab alerts access should contact the UHIN team by email at enrollment@uhin.org or customerservice@uhin.org

About UHIN: UHIN is a nonprofit coalition of healthcare providers, payers, state government and other stakeholders that have come together to reduce healthcare costs and improve quality and access for the community by enabling providers, payers and patients to exchange information electronically. UHIN focuses on creating electronic exchange solutions that work for the entire healthcare community, from single-provider practices to large integrated healthcare systems. For more information, visit www.uhin.org.

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Additional Resources:

Download the FAQ

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Data Sources List

Who is sending COVID-19 lab data?

These are the hospitals, clinics and other organizations currently sending COVID-19 lab results to UHIN. If an organization is not on the list but would like to help our community by sending COVID-19 data, please have them reach out to our team at chiesupport@uhin.org.

Independent hospitals, clinics and medical centers, including:

Beaver Valley Hospital

Blue Mountain Hospital

Central Valley Medical Center

Gunnison Valley Hospital

Kane County Hospital

Memorial Hospital of Sweetwater County

Milford Valley Healthcare Services

Moab Regional Hospital 

St. Mark’s Family Medicine

Uinta Basin Medical Center

Intermountain Healthcare hospitals, clinics and medical centers, including:

Alta View Hospital

American Fork Hospital

Bear River Valley Hospital

Cassia Regional Hospital

Cedar City Hospital

Delta Community Hospital

Dixie Regional Medical Center

Fillmore Community Hospital

Garfield Memorial Hospital

Heber Valley Hospital

Intermountain Medical Center

Layton Hospital

LDS Hospital

Logan Regional Hospital

McKay-Dee Hospital

Orem Community Hospital

Park City Hospital

Primary Children’s Hospital

Riverton Hospital

Sanpete Valley Hospital

Sevier Valley Hospital

Utah Valley Hospital

HCA Healthcare hospitals, clinics and medical centers, including:

Brigham City Community Hospital

Cache Valley Hospital

Lakeview Hospital

Lone Peak Hospital

Mountain View Hospital

Ogden Regional Medical Center

St. Mark’s Hospital

Timpanogos Regional Hospital

Revere Health Clinics (includes all clinics)

Steward Healthcare hospitals and medical centers, including:

Davis Hospital and Medical Center

Jordan Valley Medical Center

Jordan Valley Medical Center West

Mountain Point Medical Center

Salt Lake Regional Medical Center

University of Utah hospitals and clinics, including:

Huntsman Cancer Institute

University of Utah Hospital

University of Utah In-Car Testing Sites

Includes all clinics

Medicare B 2020 Updates

The Presentation

This Medicare Part B presentation encompasses 2020 updates, other important topics and valuable resources to assist your practice with successful Medicare billing.

The Presenter

Lori Weber is the current Oregon, Idaho and Utah Provider Outreach and Education (POE) representative with Noridian Healthcare Solutions, LLC. She joined Noridian Healthcare in 2006; the current Medicare Part B fee-for-service contractor for 13 states and 3 islands. She is a local chapter member of the American Academy of Professional Coders (AAPC), part of the CMS/Noridian Carrier Advisory Committee (CAC), part of the national Medicare Learning Network (MLN) committee, payer advisor to Carrington College and co-chairman of the Idaho HealthCare Conference (IHCC). She enjoys assisting and educating the provider community.

This webinar features content originally scheduled for the in-person Provider Education Summit (PES) events.