The CHIE continues to add important data sources, providing healthcare professionals with vital medical information when it is needed most. Recently, several clinics and post-acute care facilities began contributing data to the CHIE.
Now sending both admission / discharge / transfer (ADT) information as well as transcriptions to the CHIE are:
Maliheh Free Clinic, which provides free quality medical care to low income and uninsured Utah families
Mountainlands Community Health Centers, focused on providing care to uninsured and underinsured individuals at their Provo, West Park, Payson, and Vernal locations
Joining Maliheh and Mountainlands are post-acute care and home health facilities, providing invaluable ADT messages. Primary care physicians wishing to be notified when a patient has been admitted or discharged from a post-acute care facility or when home health care is being provided can now subscribe to these notifications. The new data sources include:
Millcreek Home Health, part of Signature Healthcare at Home, promotes independence and recovery for patients in the comfort of their own home
“Sister facilities” City Creek Post-Acute and Heritage Park Healthcare both provide in-house therapy programs customized to each patient’s needs
Sun Tree Home Health, with locations in Cedar City and St. George, provides home health, hospice, palliative and senior care
Legacy Village of Taylorsville provides both memory care and home health and hospice
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.”
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.
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.
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 email@example.com.
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
Logan Regional Hospital
Orem Community Hospital
Park City Hospital
Primary Children’s 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
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:
The new interoperability and information blocking rule is here…what should you do now?
With the announcement of CMS and ONC’s finalized rules on interoperability and information blocking, it is important to understand exactly what this will mean for your organization. UHIN is here to help navigate these new waters with you and we will be providing helpful resources such as webinars, podcast episodes, FHIR trainings and articles to deep dive into timelines, technology requirements, and more.
Not only is UHIN here to keep you updated and informed on the new rule, we have subject matter experts as well as a suite of products that can help! If you’re interested, reach out to us at firstname.lastname@example.org.
Upcoming Webinars, Podcasts, and more
We will be putting out content around this topic in the coming weeks, including high-level overviews of the new rule and detailed deep dives of individual requirements. To get notified when content is available, sign up for our email list: http://eepurl.com/dreC3P
Have questions now and want to reach out to our team?
You may have heard about the The Provider Education Summits (PES), but what are they and who are they for? Simply put, the PES is a series of healthcare education events for Utah’s provider community, specifically billers, coders, and office managers.
Hosted by UHIN, the summits are a collaboration between multiple healthcare organizations and feature a wide range of engaging subjects, including the ever-popular Payer Panel. Sessions typically cover important topics, such as Medicaid/Medicare, audits, compliance, denials/rejections, payer reimbursements, appeals, EDI basics, and documentation improvements.
What started in 1998 as a single room of tables staffed by local payer and practice management teams answering questions from a few dozen provider staffs, has now grown to a four-location summit that attracts more than 450 attendees each year. A diverse range of provider settings are represented, allowing excellent collaboration and networking opportunities.
In 2020 there will be more than a dozen separate breakout sessions from experts throughout the community and the Payer Panel will feature as 15 payer representatives participating in an hour-long Q&A session. Vendors and payer organizations are also part of a separate vendor hall where they can engage with attendees throughout the day.
As a non-profit organization, UHIN is dedicated to inspiring, educating, and connecting Utah’s healthcare community. The annual PES events will continue to play a vital role in that vision.
It has been a whirlwind year at UHIN and we want to update you on everything happening in our neck of the woods. What you can expect in our Fall 2019 Newsletter:
2019 Annual HIT Conference
SDoH: Poised to Care for the Complete Patient
UHIN Leadership Update
CHIE Alerts Case Study with Granger Clinic
Risk Stratification in your CHIE Alerts
We’re excited to announce that registration is now open for the 2019 HIT Conference. This year’s event is focused on Social Determinants of Health: The Invisible Health Story.
Date: November 19, 2019
Time: 7:30 a.m. – 5:00 p.m. MST
Location: Viridian Event Center, West Jordan, UT
Full day of conference access with breakfast, lunch, and all-day snacks provided
“I must confess that I chose to go to medical school because I had a little bit of a hero complex that drove me into the field…the self-delusional nature of this dream quickly faded during my third year of medical school…”
UHIN CMIO, Dr. Matt Hoffman, wrote the cover story for the most recent issue of Population Health magazine. Read it here.
It was recently announced that Teresa Rivera has stepped down from her role as Chief Executive Officer. The UHIN Board of Directors has appointed Brian Chin, formerly UHIN’s Chief Financial Officer, as Interim CEO until a replacement chief executive is appointed. Read more…
Without knowing if and when their patients were admitted, transferred, or discharged from a hospital or emergency department (ED), and without reliable admissions data, Granger’s team found itself missing pieces necessary to manage their patients’ care. Read more…
Need to know which patients to prioritize for care coordination and interventions? The new LACE score enhancement assigns a readmission risk score to your CHIE Alerts list, allowing your Care Coordination team to quickly and accurately identify low-, medium- and high-risk patients.
The calculation of the LACE Score is based on vital information necessary to prioritize patient outreach, including the length of stay in a hospital, acuity of the admission, any comorbidities, and the number of emergency department visits.
LACE Scores provided in CHIE Alerts utilized “problem lists” and ED visits from the entire community rather than a single hospital system, offering potentially greater accuracy. To get started with LACE scores in your CHIE Alerts, contact the CHIE Team at email@example.com.
New Call Center Hours
We’ve recently changed our Call Center office hours!
New hours are Mondary – Friday from 8:00 a.m. – 5:00 p.m. MST.
We are closed 12:00 -1:00 p.m. MST each day for lunch
We are also closed each Tues 8:00 – 9:00 a.m. MST for training
Would you be prepared for a CMS-sponsored HIPPA compliance review audit? Beginning this year, as part of the Compliance Review Program, nine randomly selected HIPAA-covered health plans and/or clearinghouses, regardless of whether they work with Medicaid or Medicare, will participate in these annual CMS audits.
Fortunately, UHIN helps our payer members meet federal standards through our multiple solutions. For example, with our hosted eligibility, payers provide UHIN with coverage and benefit information which is utilized to create a compliant response to providers seeking eligibility information on patients. UHIN also provides claims validation at various SNIP levels. If errors occur on a submitted claim or report, UHIN can reject the claim or file on the front end, and work with the provider to correctly resubmit their claims. Both examples dramatically increase interoperability and reduce administrative burden for payers, while promoting the timely submission of accurate claims files.
As a federally-recognized standards development organization, UHIN convenes the community to help draft local standards and review national standards. These ongoing community efforts further refine HIPAA transaction standards. The Standards Committee also works to educate our community on the latest information in both local and federal standards.
If you would like more information on our EDI validation editing, or would like to learn more about the Standards Committee, please do not hesitate to contact UHIN’s Customer Service at firstname.lastname@example.org.
Are you checking eligibility for Medicare? Studies show $3.00 can be saved in administrative costs per patient simply by checking eligibility electronically. Utilizing eligibility transactions for all payers provides insight into everything from co-pays and out-of-pocket amounts to deductibles and limits. This information can help reduce rejected claims and decrease administrative costs, while increasing efficiency and improving cash flow.
Eligibility and coverage information is available for over 4000 payers, including Medicare, through UHIN. Your UHIN membership includes access to the eligibility tool, through MYUHIN, a one-stop source for UHIN’s offerings.
UHIN’s Eligibility and Coverage connection can be an invaluable tool in helping you save time and money. The direct connection provides 24x7x365 access to thousands of payers including Medicare eligibility information. Medicare’s information includes entitlement and termination dates, Medicare Advantage plan information, Medicare secondary payer information, home health episode information, hospice benefit periods, and preventive benefit information. Commercial payer information includes information on amounts met towards deductible and out of pocket maximums.
To learn more about electronic Eligibility, please contact UHIN Customer Service at email@example.com.
We’ve gone quarterly! Four times a year, UHIN will bring you helpful tips, the latest from Standards, the newest offerings from UHIN, and much more! If you have a comment or if there is a topic you would like to see us cover in an upcoming issue, please email us at firstname.lastname@example.org.
It’s Time for the Provider Education Summits (PES)
Registration is now open for the ever-popular Provider Education Summits (PES)! This free event is just around the corner. A collaboration between multiple healthcare organizations, it features a wide-range of engaging breakout sessions, the always-helpful Payer Panel, interesting vendors, and great prizes.
Last year’s summits attracted more than 400 billers, coders, office managers and other professionals. Register today!
To register, please click on the city that’s best for you.
Attendees who pre-register will be entered into a prize drawing.
The Training Tip
If something goes wrong with the claims billing/reimbursement process, you may need to reach out to someone for help. But whom do you contact? Well, the correct contact will depend on the problem; so, the best strategy is to identify where the process or timeline the problem occurred. You can usually verify this by looking for reports.
Electronic claims trigger a report at each stage, allowing you to track your claim’s progress. Depending on your connections and setup, you may get a confirmation from your claim creation software, an upload/send confirmation, a report from one or more clearinghouses (999/277CA), and up to three reports from the payer (999, 277CA, 835). Most of these confirmations should be available within 24-48 hours of submitting the claim.
Here are some examples of problems that could occur at different stages:
1. You never received a clearinghouse acknowledgement (999 or 277CA) for your claim. Since the clearinghouse never confirmed receipt of the claim, the problem is likely in the claim creation software or in the process of uploading/sending the claims to the clearinghouse. In this case, you should contact your clearinghouse and/or claim creation software vendor for assistance.
2. The claim was acknowledged by the clearinghouse on a 999 or 277CA, but you never got a payer 999 or 277CA. Since the clearinghouse confirmed receipt but the payer did not, the problem most likely occurred when the clearinghouse attempted to send the file to the payer. The best contact in this case is the clearinghouse.
3. The claim was acknowledged by the payer on a 999 and/or 277CA, but the claim has not been paid. Since the payer has confirmed receipt, the claim may be stuck in processing, it may have been pulled for manual review, or they may be waiting for supporting documentation. To find out more, contact the payer’s EDI department. The EDI department is a better choice than customer service since many payer customer service departments cannot see a claim until it has fully adjudicated (i.e. finalized and paid), whereas EDI departments can usually see claims as soon as they are received. If your claim has not adjudicated, make sure to ask for the EDI department.
4. The claim was paid, but you don’t have a remittance (EOB or 835) explaining the payment details. If you normally get paper Explanation of Benefit (EOB) documents in the mail, contact the payer’s customer service department to ensure the EOB was sent to the correct address. If you normally receive electronic 835s, those are passed from the payer back to your clearinghouse; in this case, contact either the payer or the clearinghouse to see if the 835 was generated or delivered, respectively.
Remember, the next time you come across a problem during billing, the first step is to identify where in the process the problem occurred. Did you get any reports? Was the claim rejected at any stage in the process? Which organization was the last one to acknowledge receipt? The answer will guide you to the organization best suited to help you find a solution.
Audits serve an important role in any healthcare organization’s security efforts. Formal audits, conducted by trusted third-party industry organizations, can provide important security accreditation like UHIN’s EHNAC and pending SOC and HITRUST accreditations. However, a self-audit can be the first step in ensuring your office is doing all it can to remain secure while helping to foster a culture of security.
Here are some tips to help you conduct a self-audit before a security issue arises.
Start with your employee handbook. These are the rules and regulations you’ve set in place to ensure that your company runs smoothly and securely. You want to verify that your staff is following the rules you’ve created.
Focus on the security section of your handbook. It’s a great idea to do audits on other sections as well, but for security it isn’t as important if your office has a set number of holidays.
After reviewing the rules you’ve created, have your IT department run a few simple reports that will help you verify that your regulations are being followed. Some of the areas you want to check to ensure the best security practices are being followed are:
· Passwords are being changed on a regular basis (UHIN and other industry experts recommend passwords be updated every 90 days)
· Access to emails and other tools with sensitive data was eliminated immediately after former employees left
· Websites are limited to those needed for employees to successfully do their jobs (thus reducing the chances of viruses)
· Medical records are accessed only by those who have a HIPAA-approved need to see them (UHIN can help you with a CHIE-access audit)
Next, do a physical audit. Some items to be conscious of:
· Computers that are still logged into when not in use
· Drawers and cabinets containing important information you find unlocked
· Doors leading to areas with sensitive information not properly secured
· Post-it notes with login and password information
All of these are a security hazard!
Once you’ve completed your internal security audit, use it as an opportunity to educate your staff about best practices. Barring a HIPAA violation, which would likely require a deeper investigation, and depending on your employee handbook, there’s probably no need for disciplinary action following the audit.
Remember, a self-audit is a great first step to improving security and helping to foster a culture centered around security!
Patient-Centered Data Home (PCDH) Keeps on Growing
The Strategic Health Information Exchange Collaborative’s (SHIEC) efforts to expand interoperability through nationwide connectivity continues to advance. Alabama’s HIE, One Health Record, is now sharing vital patient data with SHIEC’s PCDH Western Implementation, of which UHIN is a founding member.
With the inclusion of One Health Record, providers in any of the participating PCDH HIEs can now safely and securely coordinate care for over 2.5 million patients who may seek care in one of the other participating HIE’s jurisdictions. And Utahns who experience a medical encounter in one of 23 hospitals and over 70 other Alabama facilities can rest assured their Utah doctor will be notified via CHIE Alert.
The Cotton State is one of 22 states participating in the PCDH. More are in the process of joining every day.
New from UHIN
UHIN continually adds new features and offerings. We’re pleased to announce our latest additions:
UTRANSEND members can now conveniently upload attachments using a modern web implementation. The new feature allows payers and providers to communicate with one another to advance the claim attachment process and help expediate payments. Users can search, filter, print, accept, reject and even archive their claim attachments. Additionally, a graphical tracker helps users to visualize the current status of the claim attachment – keeping them in the loop every step of the way! Currently, Medicaid is the only payer actively accepting attachments, but more payers are expected to follow suit soon.
UHIN’s CHIE Alerts, notifying subscribers of ADT information have become even more helpful. Past encounter information for inpatient and emergency encounters over the last 90 days is now available. This information is invaluable to reducing hospital readmissions and improving patient care. If you’d like to have Past Encounter Information included in your ADT Alerts, please contact email@example.com.
Standards: What’s New in the Standards Committee?
There’s a new home for Standards Committee information on the UHIN website! The Standards Committee is open to the public; therefore, everyone is welcome to visit UHIN’s Knowledgebase section for Standards Committee Information to see minutes from the meetings, graphs of the standards process, and even the charter for the Standards Committee. If you have questions or would like to get involved, contact firstname.lastname@example.org.
On the national stage, important conversations have been brewing about how to improve the standards-development process. There have been concerns in the industry that the process to create and update standards is too cumbersome and slow to keep pace with the nation’s needs. To address this, NCVHS, an advisory body to Health & Human Services (HHS), has published a letter to the Secretary of HHS with a number of bold recommendations designed to provide solutions.
Other new developments include a new Utah standard to address the Applied Behavioral Analysis (ABA) code updates and their usage, a recent webinar by Dr. Mirella Petersen explaining the code updates and providing examples, and discussions on the national level about adding the ability to send a 277CA report with an acceptance and a warning. Stay tuned for future updates!
In the News
UHIN’s president and CEO, Teresa Rivera, was recently featured in Healthcare Finance in advance of her HIMSS 2019 presentation. You can read the news article here. Click here to download the slides from Teresa’s HIMSS 2019 presentation.
UHIN’s New Website
UHIN has launched a new, more user-friendly website! Check it out at www.uhin.org.
What’s on Your Correspondent’s Mind? Whose Records Are They Anyway?
Recently, your intrepid correspondent had his first exam with a new primary care physician. The flow of his records from his former physician to his new one was infinitely easier than when he changed doctors after moving from L.A. to Salt Lake. A call to his former California doctor’s office found him in an argument with the front desk person who told him she would only send the records to a new provider. This caused your mild-mannered correspondent to shout, “Whose records are they anyway?” Thanks to movements like OpenNotes, providers and payers alike are beginning to understand that those medical records belong to the patient. With UHIN’s beta patient portal, MYONECHART, patients can view all their aggregated records found in the CHIE – eliminating the need to log into multiple portals. If you want to share anything with your correspondent, he can be reached at email@example.com.
Join Teresa Rivera, President and CEO of UHIN, as she discusseshow the patient-provider connection is an increasingly critical component of patient care and consequently federal incentive and care quality programs. She will show UHIN’s patient application that assists in directed exchange and secure patient-provider communication supported by Secure Exchange Solutions and how it has proven to increase engagement and improve care management.
More details for the presentation can be found here: https://www.himssconference.org/session/new-horizons-patient-directed-exchange?mc_cid=5f3b5e24d1&mc_eid=4ec59c76d5