Winter 2018 Newsletter

In this end-of year edition of UHIN’s bi-monthly newsletter you’ll find 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 communications@uhin.org. 

The Year in Review

UHIN had a busy 2018 and we’re very proud of the important advancements that we achieved during the year. As you know, we’re constantly striving to positively impact healthcare through reduced costs, improved quality, and better results driven by innovative healthcare technology solutions. Here are just a few of the accomplishments UHIN achieved during the year.

  • Celebrated our 25th anniversary of serving the healthcare community.
  • Expanded Patient Centered Data Home (PCDH) to exchange appropriate patient data with HIEs in Alabama, Arkansas, California, Indiana, Michigan, Missouri, Ohio, Oklahoma, Oregon, Tennessee, Texas, and Washington.UHIN is now connected to 18 states across the country – and growing!
  • UHIN’s chief information officer participated in the CIO Forum at the National Committee on Vital and Health Statistics (NCVHS), the public advisory body that advises the Health and Human Services Secretary and reports to Congress on HIPAA implementation.
  • We partnered with the Minnesota Department of Health to provide clearinghouse services.
  • UHIN hosted the annual HIT Conference centered on patient information technology. The conference featured a panel of experts actively working on the opioid crisis, as well as industry leaders discussing the importance of patient-directed exchange, interoperability on a state and national level, and other interesting topics.
  • Several of UHIN’s IT team participated in the HL7 FHIR connection “connect-a-thon” with developers from around the country.
  • Refocused our staff around product teams to enable even greater concentrated efforts to address the needs of our members.
  • Successfully recertified with EHNAC.
  • Provided a new telephonic call-back feature for customers contacting Customer Service.

Of course, we are also all very proud that Teresa Rivera, our president and CEO, was selected as a Utah Business Magazine Healthcare Hero this year as well.

Everyone at UHIN is excited about the prospects for 2019 and we look forward to continuing working closely with the healthcare community to improve the lives of patients and ease the administrative burdens of providers.

THE TRAINING TIP

One of the most rewarding aspects of working in the healthcare field is the consistent opportunity to learn new skills. But let’s face it, sometimes learning something new can be a challenge! The good news is that learning is a skill in and of itself, and you can hone that important skill by employing some good habits. So next time you’re faced with learning a new skill, use these learning strategies:

  • Take notes: Studies show that people who passively listen to new information will only remember a fraction of the content. To increase your ability to remember the important information later, take notes. You don’t need to write everything down, just what you believe is the most important information. It’s also more beneficial to take hand-written notes – the process of actually writing information down by hand makes it easier for your brain to remember it later.
  • Translate: No, we don’t mean into a different language (hey, unless that helps you)! We mean translate the new information into familiar terms and situations. This process benefits both memory and understanding of the context. It’s enhancing your learning process by leaning on your existing experience and knowledge. For example, if you already know how a heart works and you’re learning about automotive fuel pumps, you might make a mental analogy that fuel pumps are like hearts because both pump essential fluids to areas where they’re needed.
  • Practice: We wouldn’t expect anyone to learn a musical instrument in one sitting, right? Of course not, we know that it takes practice. The same is true for learning something new in a professional setting – it can’t happen instantly. When you’re learning a new skill, set aside some practice time to go over the new information and behaviors, run through the new process a few times to ensure you’re finishing all the required steps, etc. Don’t put off practicing – a delay of even a day may result in forgetting important information or steps.
  • Teach: Often, teachers discover that they gain greater understanding and insight of new material during the process of determining how to explain it to their students. Therefore, if you’d like to reach an even higher level of proficiency, try teaching what you’ve learned to someone else!

SECURITY TIP

You’ve probably heard the term “phishing” and know that avoiding it is an important part of keeping protected health information (PHI) and personally identifiable information (PII) safe. But what exactly is phishing, and how do you avoid it?

Phishing, of course, is an alternate spelling of “fishing” and was first used by hackers over 20 years ago when they “lured” AOL users to divulge passwords. It’s spelled with a “ph” in honor of the first form of hacking, “Phone Preaking,” from the 1970s!

You’ve probably received an email from a prince seeking help depositing a large amount of money, that’s phishing. But hackers seeking PHI and PII are much more sophisticated…and much more successful. Every year 11 million Americans are affected by a loss of PII and $2.3 billionhave been lost to CEO email scams!

So, what’s the best way to guard against phishing emails?

  • Stop to reassess the email and employ the acronym FAKE:
  • F– Feeling: does it trigger an emotion
  • – Action: you’re asked to do something
  • – Know: do you know the sender
  • – Expect: were you expecting the email
  • Don’t click any unfamiliar links or urls. Numbers, hyphens and strange country codes (i.e. .za or.ru) are signs that the email was generated from an untrustworthy source. You can hover over links to see the url.
  • Don’t trust any attachment that you aren’t already expecting. And question archive files like .zip, .rar and .7z – these are a prime vehicle for hackers to hide malicious files.
  • Don’t open Office files – like Word or Excel – with Macros because they can contain embedded code. You can identify these files as .docm, xlsm or .pptm.
  • Be wary of files with double extensions like file.gif.exe.

Most importantly, verify the email. Just because an email came from the CEO or another executive doesn’t mean they actually sent it. If the language in the body of the email doesn’t sound like your boss, or if the email contains a request to transfer cash or any other information, take a minute to verify. It’s better to ask than to explain you’ve helped a hacker!

NEW IN THE CHIE

The CHIE data is growing every day. We’re pleased to announce two very important additions:

  • St. Mark’s Family Practice is now sending Advanced Directives and POLSTs to the CHIE. These important end-of-life documents can be found both in the Care Management tab in the patient summary section, and in the Advanced Directive tab under the More Information section.
  • Need to know at which of Granger Medical Clinics nearly 20 locations your patient experienced a medical encounter? Now you’ll find that important information both in Granger’s ADT notifications and its transcription feeds!

 

STANDARDS: NCVHS PREDICTABILITY ROADMAP

At times, national standards have seemed to struggle to keep up with the fast-paced healthcare industry. The National Committee on Vital and Health Statistics (NCVHS), which serves as an advisory body to HHS and reports to Congress on HIPAA implementation, has long been looking to mitigate the issue. To address the situation, NCVHS has published a draft Predictability Roadmap, which aims to identify actions that will result in more timely and predictable industry updates. The current draft proposal includes several bold changes that would significantly alter how the healthcare industry creates, approves and implements updates to our standards.

UHIN’s Standards Committee submitted comments to NCVHS on the proposed Predictability Roadmap. You can learn more about NCVHS and view the proposal here.

SAVE THE DATE – STANDARDS WEBINAR

Save the date January 16, 2019for the webinar “The Gold Standard…of Standards,” which will discuss the role of standards and how they are developed. You’ll be able to register for the webinar soon – check the UHIN events page for all of our upcoming webinars. https://uhin.org/events/.

WHAT’S ON YOUR CORRESPONDENT’S MIND? A NEW YEAR.

For the past few weeks, your intrepid correspondent has been receiving many emails predicting what 2019 holds for healthcare. More rollback of the ACA? Even greater focus on the opioid crisis? Medicaid expansion in more and more states? The only clear vision he sees in his crystal ball is the continued growth of data sources for the CHIE, expanded connectivity, and greater interoperability for patients, providers and payers alike. If you’d like to share your prediction, you can reach him at communications@uhin.org.

Fall 2018 Newsletter

In this edition of UHIN’s bi-monthly newsletter, you’ll find helpful tips, the latest from Standards, what’s happening around the community, 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 communications@uhin.org.

 

Join Us at The Annual UHIN HIT Conference!

 

UHIN’S ANNUAL HIT CONFERENCE –PATIENT INFORMATION TECHNOLOGY

WHEN: OCTOBER 11, 2018

START TIME: 7:30 a.m. – Registration and Light Breakfast

END TIME: 12:30 p.m.

WHERE: SLCC – Miller Campus in Sandy

FEATURING:

  • -Governor Spencer Cox
  • -Ryan Howells, CARIN Alliance
  • -Joe Miner, Executive Director, UDOH
  • -Expert panel on opioid crisis
  • -The future of HIE and Utah
  • -And much more!

For more information and to register visit:

https://www.eventbrite.com/e/2018-annual-uhin-hit-conference-tickets-48897201847

 

The Training Tip

Patient Account Numbers are an often-underutilized resource for keeping track of claims and responses. UHIN’s Corporate Trainer will pull from over 9 years of experience working with Patient Account Numbers to help you improve your workflow.

Each claim includes a Patient Account Number, which is a required field used for tracking (it is in box 26 for Professional claims, box 3 for Institutional claims). If you don’t have software that automatically sets this value, you will be asked to set the Patient Account Number when you enter the claim. As you decide on a format, consider the following:

  • -You can change the format and the specific numbers/letters at any time. You don’t have to continue with a format or number if something else would work better.
  • -You can use any combination of numbers and letters; just avoid spaces and punctuation of all kinds.
  • -If you have few patients and only a few claims for those patients, you might be able to proceed with a static number for each patient. This means the same patient would always have the same Patient Account Number. However, if your volume of patients or claims increases, you may have trouble distinguishing between different claims for the same patient.
  • -If your volume is too high to use a static number, look for ways to make the number different for each claim. This will allow you more flexibility and precision when tracking your claims. It will also make troubleshooting faster and easier if you call into a clearinghouse or payer for help. Some examples of claim-specific formats are below:
  • -Patient “Smith,” for dates of service in May 2018: SMITH0518
  • -Patient “Smith,” who has been assigned the number 001, for dates of service in May 2018: 0010518
  • -Patient “Smith,” for the 12thclaim of the year: SMITH12
  • -Patient “Smith,” for a correction to claim number 12: SMITH12CR

Having good tracking numbers will make your life easier when you are looking for claim statuses when you need to troubleshoot a transaction, and when (or if) you need to distinguish between original and resubmitted claims.

 

UHIN Continues to Add Connections

Locally:

The four clinics within the Utah Navajo Health System are now sending transcription notes to the CHIE. These newest data sources are community health clinics, providing comprehensive healthcare services to the individuals they serve.

With support from the various native organization and governmental entities, the Utah Navajo Health System was created in 2000 to serve the medical and dental needs for rural communities in southeastern Utah. The four clinics include Blanding Family Practice, Montezuma Creek Community Health Center, Monument Valley Community Health Center, and Navajo Mountain Community Health Center.

Regionally:

St. James Healthcare and Holy Rosary Healthcare in Montana are both sending Admission / Discharge / Transfer (ADT) notifications to the CHIE.

St. James Hospital System – Located in Butte, Montana, St. James was founded in 1881 by the Sisters of Charity of Leavenworth (SCL Health). Along with a 67-bed hospital, St. James also offers a variety of other services, including 24-hour emergency services, a labor, and delivery unit, cardiac services, oncology services, and an orthopedic center.

Holy Rosary – Serving an 11-county region of eastern Montana, Holy Rosary is located in Miles City. The hospital, founded in 1910, also offers cancer care, critical care and emergency/trauma services, family wellness, a Level II neonatal care unit, orthopedics, radiology, sports medicine, therapy and rehab services, women’s health services and more. It is also part of SCL Health.

Nationally:

Reliance eHealth Collaborative, the health information exchange (HIE) in Oregon, and UHIN are now connected. This is the newest connection advancing Patient-Centered Data Home (PCDH), the ongoing effort to allow HIEs across the nation to exchange important patient data. PCDH is an initiative of the Strategic Health Information Exchange Collaborative (SHIEC)  aiming to provide seamless delivery of patient health information across state lines and across health systems. Through PCDH, when a patient in any of the participating HIEs’ databases experiences a medical encounter in any of the other participating HIEs’ areas of operation, the patient’s participating primary care provider receives an ADT notification.

Therefore, the Reliance-UHIN connection allows Utahns experiencing a medical encounter in one of the areas Reliance serves to have their primary care physician alerted with an ADT notification. The reverse is also true for Oregonians – and those California and Washington patients living in Reliance’s coverage area – who experience medical encounters in Utah or any of the other participating HIEs.

Located in Medford, Oregon, Reliance was founded in 2011 as a community collaboration between healthcare providers, hospitals, public health agencies, clinics, and other healthcare stakeholders. Today Reliance serves the people of Oregon, as well as counties in southern Washington and northern California.

With the addition of Reliance, UHIN is now connected to HIEs or hospital systems in 18 additional states across the country either directly or through PCDH implementation hubs. UHIN is connected to HIEs serving the people of Alabama, Arizona, Arkansas, California, Colorado, Idaho, Indiana, Kentucky, Michigan, Nebraska, Nevada, Ohio, Oklahoma, Oregon, Tennessee, and Washington, as well as hospital systems in Montana and Wyoming which do not yet have HIEs. Additionally, UHIN is in the process of connecting with several other states, including Alaska, Iowa, Louisiana, North Dakota, and Texas.

Along with these connections, over 500 hospitals, clinics, labs, long-term post-acute care facilities, and emergency services also contribute data to the CHIE – including all the hospitals in the four largest systems in Utah. For a full listing of the CHIE’s data sources, visit https://uhin.org/the-chies-data-sources/.

You can learn more about SHIEC’s PCDH initiative here.

 

Security Tip

Did you know that according to a survey conducted by The Harris Poll just about half of Americans (49%) are extremely or very concerned about the security of their healthcare data? And there’s a good reason for that concern. A study by the Ponemon Institute and IBM discovered that, on average, a healthcare data breach is worth $408 per record! That’s almost twice the $206 per record cost of a financial data breach. Moreover, companies lost $4.2 million annually on lost business after a breach.

One important step that organizations can take to help protect healthcare information is to encrypt data when it is at rest and in transit. “In transit” is when data is moving from one location to another, such as from one network to another network, or from a local storage device to a cloud device. “At rest” is when data is not actively moving.

When data is encrypted it is far more difficult – hopefully impossible – for it to be deciphered by attackers. All of the data at UHIN is always encrypted – in transit and at rest. Additionally, when data is sent to UHIN it is also always encrypted in transit and at rest!

If you’re looking for a data encryption service, there are many available offering the most up-to-date algorithms. When considering an encryption vendor ask if they:

  • -Can encrypt text, folders, and files
  • -Will automatically encrypt files that are attached to emails and other times during transit
  • -Include encrypted storage
  • -Use multiple numbers of algorithms
  • -Have healthcare-specific experience

Additionally, data security experts suggest encryption be supplemented with other security measures such as:

  • -Two-factor authentication for logging into systems
  • -Frequent security training for employees
  • -Regular audits of who is accessing the data
  • -Remote removal of data from mobile devices capabilities

To learn more, visit https://digitalguardian.com/blog/data-protection-data-in-transit-vs-data-at-rest.

 

New to the CHIE Clinical Portal? Just Need Some Helpful Hints?

UHIN has added a great resource for those members starting off with the CHIE Clinical Portal or those who just need some helpful hints – a new training video. The video covers a wide range of topics including how to access the CHIE Clinical Portal, and how to search for a patient’s records.

You can view the video at https://docs.uhin.org/chie-clinical-portal-training-video/. You’ll also find more UHIN training videos, on a plethora of topics, at https://docs.uhin.org/.

News from the Community – Call for Nominations

Applications for the 2018 Outpatient Practice Quality Awards are now open. Sponsored by HealthInsight Utah, the awards aim to promote excellence in health care. You can learn more about the award or nominate someone here.

What’s New at UHIN? More Easy-to-Use Features!

MORE CONVENIENT ELIGIBILITY PATIENT SNAPSHOT

UHIN’s time-saving and cost-effective electronic eligibility tool is more convenient than ever! Our enhanced Patient Snapshot is now found in a dual pane screen – conveniently allowing you to view important patient information without needing to scroll down the page. Along with subscriber and plan information, you can now easily see Co-Pay Information.

ENVIRONMENT SWITCH in the DESKTOP VERSION OF UHIN’S FILE TOOL

The desktop version of UHIN’s File Tool now allows you to switch between the test environment (UAT) and Production environment. This means you can now conveniently test changes in your system with payers as needed. You can find the Environment Switch on the top left corner of your screen.

For more information about the Eligibility or File tools, please contact UHIN’s Customer Service at customerservice@uhin.org.

 

In the News

UHIN’s Chief Medical Informatics Officer, Dr. Matt Hoffman, and our Director of Operations, Cody Johansen, recently published a paper focusing on workflow changes that help with patient matching in poison control. It was published with our partners from Intermountain Healthcare and the University of Utah in Applied Clinical Informatics. You can read the paper here.

In other news, HIEs can play an important role in accelerating interoperability. You can read more about it in HIT Data Management.

Standards – The Latest from X12

Earlier this summer, members of UHIN’s staff joined hundreds of other experts from around the country at the X12 workgroup meeting. Here are some of the key takeaways important to you.

  • -X12 has been developing a new streamlined process for creating and approving content for the standards and implementation guides. This new process is now in effect for new work.

Additionally, they will be moving to annual TR publications, which are updates to the currently implemented versions. Although the decision has been made, it will take a while to implement the change and will not take effect until after the 7030 version is completed.

  • -The National Committee on Vital Health Statistics (NCVHS) is working on a predictability roadmap to help determine how the industry can move forward with a faster and more streamlined process for developing, voting, and implementing updates and standards.

Other news from the NCVHS:

  • -During the NCVHS CIO Forum update, the discussion highlighted one way to potentially increase the speed of version releases: moving the transactions into the new versions in phases rather than waiting for all the versions to be approved.
  • -A healthy debate ensued about how much faster and more flexible the workgroup should be when the industry may struggle to keep up with a faster pace. The workgroup clearly still needs a degree of certainty that the proposed solutions will actually address the current problems.
  • -The 835 group is working on guidance for the industry regarding how to use CARCs and RARCs together appropriately. More information will follow as the guidance is formalized.
  • -National Uniform Billing Committee / National Uniform Claim Committee (NUBC/NUCC )
  • -Next release of the taxonomy code was set for July 1.
  • -Medicare prospective payment final rule resulted in some coding changes.
  • -The 270 / 271 (eligibility transactions) public comment period began July 16 and will run for 120 days. UHIN has convened a work group to review the proposed changes. If you have comments you would like to submit or are interested in joining the workgroup, please contact Sara Vandermolen at education@uhin.org. Please note, all comments must be submitted to the workgroup by November 1st.
  • -In 7030 (837), there will most likely be a change in the usage for the D8 and RD8 qualifiers. In 5010, it was allowed to have a date range with the RD8 qualifier but have the same date in both the “to” and “from” fields. This will be clarified so that the RD8 qualifier can only be used if the fields contain different dates. Otherwise, the single date should be listed as a single date with a D8 qualifier.
  • -The CN1 segment was originally added to the HIPAA guides because there wasn’t the bandwidth at the time to create a separate guide/standard just for post-adjudicated claims. Now that the PACDR guides are fully developed, they are removing the CN1 transaction from the HIPAA guides and advising that those sending encounter claims base their usage on the PACDR guides.

It’s important to remember that the above 837 and CN1 information is based on the current iteration of the 7030 implementation guides. Until these implementations are finalized, additional changes can still occur. More information will follow as the 7030 guides are finalized.

Another CHIE Success Story

By Amber Mackay

“Alliance House, Inc., helps adults with severe and persistent mental illness complete their educational goals, develop important work skills in order to return to productive employment and, when needed, find secure and affordable housing. Our funding is based on how well we assist our members by reducing hospitalizations. CHIE Alerts provide the important details we need to proactively work to prevent hospitalizations and readmissions. Additionally, CHIE Alerts provide the much-needed support in grant writing by supplying the numbers necessary for tracking.

We also have a large wellness focus, and CHIE Alerts offer the details needed to track success – whether it is for mental or physical wellness – and they provide the necessary information to assist in the education of our patient base.

Alliance House is a nonprofit that has existed for 31 years. An important part of why our business model is successful is the information the CHIE Alerts provide us. The CHIE Alerts were our first way to benchmark progress by offering essential data. Our board of directors loves seeing the success CHIE Alerts have brought to our group. “

UHIN Honored with SHIEC Achievement Award

Earlier this month at the Strategic Health Information Exchange Collaborative (SHIEC) Annual Conference, UHIN received the first-ever SHIEC Achievement Award for Advocacy and Governmental Relations. The award recognized UHIN’s successful completion of its 2015-2017 Office of the National Coordinator for Health Information Technology (ONC) grant to advance interoperability. As part of the ONC grant, UHIN and its various community partners worked to increase interoperability to previously underserved populations including rural communities, poison control, long-term post-acute care facilities, emergency services, children and youth with special healthcare needs, and patients through an aggregated patient portal.

What’s on Your Correspondent’s Mind? Patient Engagement.

According to Medical Economics, patient engagement is a top priority of 70% of providers. But your intrepid correspondent’s experience hasn’t been very engaging. With a mixture of an A-type personality and a charming penchant for self-preservation, he has always been remarkably good at making and keeping routine medical appointments. The same is not true for scheduling follow-up tests three months later – even when his primary care physician sends a reminder letter. As we quickly approach 2019, a letter may be quaint communication, but clearly ineffective. Yet according to a Healthcare IT News, patients connected with their provider offices via an online portal – like UHIN’s MYONECHART – are significantly more likely to get preventative tests and screenings. Your correspondent is far more likely to act on an email or text than he is a letter. And Health IT Outcomes says more than 50% of Americans agree with him. If you want to engage with him, you can reach him at communications@uhin.org.

May-June Newsletter

Want to know more about Standards? Looking for tips about using Direct? Interested in the newest product offering from UHIN? It’s all here in the latest edition of UHIN’s bi-monthly newsletter! 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 communications@uhin.org.

The Training Tip

Sometimes, the best workflows come from a little trial-and-error. However, that experimenting can take some time to deliver results. To help expedite those results, over the next few issues of this newsletter, UHIN’s Corporate Trainer will pull from over 9 years of trial-and-error experience to provide a variety of workflow tips.

Here are some of the best ways to improve your workflow when it comes to new payers:

  • -Adding a new payer, new connection, or new software is the time in your workflow that you are most likely to see problems. When any one of these changes occurs, keep an extra close eye on your transactions until you have received your first payment. Some specific suggestions for this include:
  • -Keep your first submissions to a handful of claims (or fewer). That way, if something goes wrong, it will be easier to track, fix, and resubmit a smaller number of claims.
  • -Note down the patient name, account number, and submission date for those first submissions. If you need to contact anyone to troubleshoot these claims, having this information will expedite the process.
  • -Remember, you should receive an initial payer response within a matter of minutes (although in some cases it may take up to 24 hours) and a detailed report, called a 277CA, within 2 days of submission. If you have not received these acknowledgements within the expected timeframe, contact your clearinghouse.
  • -Many payers require enrollment for some or all of their electronic transactions. Before you send to a new payer for the first time, check with your clearinghouse to see if you need to enroll. UHIN is happy to help our members with the enrollment process should it become necessary.
  • -After you have submitted your request to your clearinghouse, make sure to read any confirmation emails carefully. They may contain confirmation numbers you can use to track your request, and/or they may contain instructions for additional steps.
  • -If you have requested electronic remittances (835s) or if you are enrolling for a government payer, it’s more likely that you will need to take some sort of additional action. UHIN members in this situation will receive an email from our Enrollment Specialist with a copy of any required forms as well as submission instructions. Following those instructions will set you up for a smooth and timely transition.

For providers submitting to Utah Medicaid:

The window for claims processing at Medicaid closes every Thursday evening; therefore, if possible, aim to submit your claims on a Monday or Tuesday. Submitting early in the week will allow you to see the initial acknowledgements from Medicaid, fix and resubmit any claims with errors, and see the initial acknowledgements for the new submissions, all before that Thursday cutoff.

 

UHIN Continues EHNAC Accreditation

UHIN recently completed a thorough audit by the Electronic Healthcare Network Accreditation Commission (EHNAC) to continue its accreditation with this federally-recognized standards development and accrediting organization. This third-party review provides the assurance that UHIN is keeping your data safe through our systems, processes and procedures. EHNAC is just one of several accreditations UHIN maintains in our ongoing pursuit of adhering to the best industry practices and offering the highest levels of security. You can learn more about EHNAC at the organization’s website.

Webinars and Training Information Now Online

 

Looking for a great resource to help you learn about UHIN’s Dashboards, CHIE Alerts or any number of other topics? Did you miss one of our free webinars? Good news! You can now access these great training videos and the recorded webinars online. They’re all available on the UHIN website or on the UHIN Education YouTube channel.

Speaking of webinars, UHIN has a year-long series of free webinars on a wide-range of topics from EDI to LACE scores, from electronic eligibility to decreasing workplace drama. You can register for these webinars on the events page of our website.

 

Security Tip

HeathIT Security, an online publication, recently highlighted a survey conducted by Kickstand Communications, which showed an astonishing 87% of healthcare workers admitted they send personal health information (PHI) and other confidential information through non-secure email. When asked why, nearly three quarters of respondents said they believed regular email was a secure way to send PHI and other confidential information. But regular email and text messages aren’t HIPAA compliant – leaving practices violating the law, and putting their patients’ PHI at risk.

There are, however, alternatives to unsecure email, such as Direct, which offer the convenience of regular email while providing HIPAA-compliant security. Secure Exchange Solutions (SES), which provides secure communications to a wide-range of healthcare stakeholders, cites several advantages to using options like Direct.

  • -Most EHRs have Direct built into their systems, so doctors and staff can use Direct to communicate within their already-existing workflows
  • -It is just as intuitive and easy to use as non-secure email
  • -It facilitates paperless communication, lowering the chances of an unintentional disclosure of PHI
  • -It is a particularly good choice for behavioral health organizations since it is person-to-person communication, eliminating the need to revert to paper, and thus keeping the patient’s information private

Security Tip: In order to prevent unintentional exposure of PHI, any device using Direct should be treated in the same manner as other devices handling PHI – don’t share log in information, and always remember to log out.

If you’re interested in learning more about Direct, please contact sales@uhin.org.

You can read the full HealthIT Security story here.

 

What’s New at UHIN?  Easy-to-use new features in MYUHIN!

Self-service password reset

At UHIN, security is always top of mind. That’s why we introduced a new feature that allows members to reset their own passwords for UHINt and UTRANSEND! The new feature is found in MYUHIN and it is easy-to-use, self-explanatory, and gives you peace of mind. For more information see our MYUHIN User Guide.

Environment Toggle

Need to switch between the UAT and Production environments in the MYUHIN Dashboard? We’ve added a simple environment toggle in the lower left corner of the screen!

For more information about resetting passwords or using the environment toggle, please contact Customer Service at customerservice@uhin.org.

What’s MYUHIN?

MYUHIN is a single-sign on portal for multiple UHIN products and services, including:

·      File tool – Easily upload and download ANSI X12 transactions

·      Eligibility Tool – Electronically check benefits and coverage

·      Password Reset – Reset passwords for UHINt and UTRANSEND

UHIN Adds Blue Mountain Hospital as Data Source

UHIN is closer than ever to being connected to 100% of Utah’s hospitals! Blue Mountain Hospital serving the 15,000 residents and thousands of visitors of San Juan County, is now sending ADT notifications and lab reports to the CHIE. If you’re subscribing to notifications of hospital admissions, you will now receive them on any of your patients receiving care at Blue Mountain Hospital. If you are not yet taking advantage of this CHIE Alerts service, contact sales@uhin.orgtoday!

Located in Blanding, Blue Mountain Hospital offers a wide variety of services, including emergency care, surgical services, obstetrics, radiology, inpatient care, and many others. It is the latest independent hospital to connect with UHIN. All the hospitals in the four largest health systems are connected to UHIN, as are most independent hospitals – the last handful of which are scheduled to come on line within the year.

As the newest data source, Blue Mountain joins over 500 clinics and hospitals in Utah, as well as health information exchanges and hospital systems in several additional states, contributing data to the CHIE! For a full list of facilities sharing data through the CHIE, visit https://uhin.org/the-chies-data-sources/.

VA Moving to “Opt-Out” on Consent

President Trump recently signed the VA MISSION Act of 2018, which includes language removing the requirement that the VA be required to obtain written consent from veterans before sharing health records. Implementation of the new procedure is still being determined; more information will follow as soon as it is available.

Currently, veterans are required to provide signed consent through the VLER Health Authorization Form if they wish to have their records electronically exchanged between the VA and other providers with whom they have a treatment relationship. The Form requires re-authorization every ten years. The new law eliminates the need for providers to encourage veterans to sign the authorization form and keep it updated, increases interoperability, and allows providers the opportunity to better serve the brave men and women who have so selflessly served our country. You can read more about the new law in EHR Intelligence.

In the News

As you may remember from our last newsletter, Gold Cross Ambulance is using the CHIE to help its EMTs understand the final diagnosis and outcome of the patients they transport. You can read more about this unique usage of the CHIE in The Journal of Emergency Services.

 

Standards – UHIN is Your Voice

What are EDI Standards, and why do you need to know about them? Simply put, standards are a baseline set of expectations for how people perform certain tasks. Standards improve efficiency by allowing us to use the same process and format for multiple uses; saving everyone time and money. When it comes to healthcare, Electronic Data Interchange (EDI) Standards bring consistency in how organizations create, submit, process, and pay claims. For providers, these standards allow you to use the same software to create, send, and receive transactions to and from multiple payers.

Standards are always evolving. Accredited Standards Organizations, like UHIN, convene groups of stakeholders from the healthcare community to discuss where the remaining problems, inconsistencies, and inefficiencies lie. These groups then work together to find a way to standardize solutions to these issues. Some issues are addressed with local standards, while others may get escalated to the appropriate national committee.

Community members play a vital role in developing local and national standards. When a provider’s workflow requires customization at any point in the process in order to accommodate different receivers, there may be an opportunity to improve the situation through a standard. If you’re experiencing these types of issues, please reach out to education@uhin.org to get the discussion started – who knows, it could result in a new standard! Remember, you’re always welcome to participate in the process to create a new solution.

 

UHIN Now Working with Minnesota Department of Health

We are excited to announce that UHIN was recently selected by the Minnesota Department of Health (MDH) to help transmit claims and remits for providers working on the MDH’s Cancer Control Safe Programs.  These Centers for Disease Control and Prevention-funded programs aim to strengthen efforts around cancer prevention, detection, treatment, survivorship and health equity. UHIN is honored to be a part of these efforts.

CHIE Data Keeps on Growing

Did you know that the CHIE now has over 59 million health records for over 5 million unique patients? Along with over 90% of all the hospitals in Utah, many clinics, labs, pharmacies, emergency services, and long-term care facilities, UHIN is also connected to seven other HIEs outside of Utah, and hospital systems located in Wyoming and Montana.

When a Utah patient has a medical encounter in one of the other participating HIEs or hospital systems, primary care providers who subscribe to CHIE Alerts receive an ADT notification. UHIN is connected to HIEs in Arizona, California (San Diego and Santa Cruz), Colorado, Idaho, Nebraska and Nevada. Over 3000,000 ADT notifications have been exchanged between UHIN and the other participants since 2014.

What’s on Your Correspondent’s Mind? Telemedicine.

Having had his own recent experience with telemedicine thanks to an itchy brush with poison sumac, your intrepid correspondent noticed that he received at least one email referencing telehealth medicine every day this week. It’s clearly a hot topic. A recent poll by the Associated Press-NORC Center for Public Affairs Research indicated a whopping 90% of Americans over the age of 40 are willing to use telemedicine, providing the quality is equal to what they receive at an in-person visit, and that their PHI is kept confidential. Your correspondent’s experience was overall positive, his PHI was kept private, but he refuses to admit he is among those Americans over the age of 40. You can reach him at communications@uhin.org.

Spring 2018 Newsletter

In this edition of UHIN’s bi-monthly newsletter, you’ll learn about the latest in security and training, what’s new at 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 communications@uhin.org.

 

The Training Tip

Policies and procedures are a vital aspect for any successful practice, but they’re only useful when they are implemented. How can an office trying to improve compliance for a policy and/or procedure encourage staff to make behavior changes?

Humans are creatures of habit, which can make it a real challenge when you’re asking for behavior changes. It also can be extra challenging when you’re trying to motivate people about compliance. There are, however, some practical steps you can take to stack the odds in your favor.

  • -Get buy-in from your leadership – Companies truly take direction from the top; if your leadership isn’t visibly on board with your compliance effort, it sends the message that the effort isn’t important to the organization. Ensure your leaders are visibly and vocally supporting your message by setting a good example with their actions.
  • -Reward positive behavior – When you see staff members adhering to or promoting the new policies / procedures, find some way to recognize them in a positive way. This could include anything from gift cards and giveaways to a special “shout out” at the next staff meeting. Not only will this spread positivity around compliance, it helps reinforce specific, positive actions.
  • -Hold people accountable – If staff members continue to be out of compliance on policies and procedures, ensure you have organizational support to hold them accountable. This will accomplish two results: first, it will help nip problem behaviors in the bud; and secondly, it will also communicate to the entire staff the importance of compliance. If the importance of compliance isn’t stressed, you run the risk of communicating the idea that policy / procedure compliance is a nice idea but is not really required.
  • -Focus on what’s important – As you teach staff about the requirements, stay focused on aspects of the policy / procedure that are most important to them. It’s human nature to tune out whatever points we perceive are irrelevant to us. If you’re flooding them with seemingly unnecessary information, they are less likely to tune in to the information that actually is relevant to them and their job. This may require splitting up your trainings to emphasize different areas for each job role.
  • -Switch it up – To get the maximum benefit, provide important information multiple times but in a variety of formats, lengths, and via different senses. For example, you might do a large, hour-long training once, but then send a short email follow-up a week later. Later on, perhaps you distribute a relevant video. Also, consider placing infographic posters in areas people congregate or visit frequently.
  • -Give them opportunities to practice – Many people learn best through experience, so provide your staff opportunities to try out the new behaviors in a learning environment. This might mean giving them a scenario to play out during a staff meeting, while you offer hints if they get stuck on a process. Play games or set up an office competition that involves modeling the desired behaviors. If you notice that a particular behavior is commonly troublesome, find a way to focus on an alternate behavior for that situation. Just make sure people know mistakes happen: if they’re genuinely trying, an error during one of these exercises won’t put their job in jeopardy. People need to feel safe to make the most of new information!

For questions or additional ideas, feel free to contact us at education@uhin.org.

 

Overhaul of Meaningful Use

CMS has announced it is rebranding Meaningful Use and removing “redundant and unnecessary” reporting measures. The new rules will go into effect on Oct. 1, 2018. You can read more about the changes in Healthcare Informatics.

 

Join Us for Free Webinars

Throughout the year, UHIN is hosting a series of free webinars. With a wide-range of topics and industry experts, you’re sure to find a webinar right for you. Upcoming webinars include:

  • -Care Coordination – May 23, 12:00 – 1:00
  • -Troubleshooting EDI with Kirstin Burdge of SelectHealth – May 30, 12:00 – 1:00
  • -Medicare Updates with Lori Weber of Noridian – June 13, time 10:00 – 11:00
  • -Dealing with Difficult Customers –June 20, 12:00 – 1:00
  • -Advanced EDI – Reading X12 – July 18, 12:00 – 1:00
  • -Advanced EDI – Reading X12: 999 and 277CA –Aug 22, 12:00 – 1:00
  • -LACE Scores with Dr. Matt Hoffman, UHIN – Sept. 12, 12:00 – 1:00
  • -HIPAA, Privacy, & Security – Oct 17, 12:00 – 1:00
  • -ABCs of Electronic Eligibility – Nov 14, time TBD
  • -Decrease the Drama to Increase the Income – Dec 19, 12:00 – 1:00

You can register for these webinars on the events page of our website https://uhin.org/events/.

 

Security Tip

Fishing can be relaxing and fun (well, maybe not for the fish!), but phishing can be dangerous to your business! Phishing is when you receive an email from what appears to be a trusted source but is actually an attempt to gain access to your personal data like passwords or credit cards, or to spread dangerous malware. According to the Anti-Phishing Working Group, over 100,000 new phishing attacks are reported every month!

Worse still is Spear Phishing where the email looks like it comes from a friend, a coworker, a vendor, or someone at a familiar company. After all, you are more likely to click a link in an email from Bob in accounting than you are a Nigerian Prince.

Thankfully, there are some simple precautions you can take to protect yourself and your company from getting hooked.

  • -Trust your gut – if the email seems out of character for the sender, something is likely amiss
  • -Look at the URL carefully – company.com is close to company.org and copmany.com
  • -Does the text seem legitimate – are the spelling and grammar correct
  • -Don’t download attachments – this is a primary method for spreading malware
  • -Don’t click on links – they can lead to false websites created to gather your personal data
  • -Increase email security – regularly scheduled anti-phishing trainings and reinforcing strong email passwords are an important first defense against phishing
  • -Make use of other safety tools – there are many options out there
  • -Anti-phishing toolbars quickly ferret out potential phishing sites you may try visiting
  • -Anti-virus software can help prevent malware and other malicious files from accessing your computer
  • -When all else fails ask – call Bob in accounting to see if he really is the source of the email

Remember: being vigilant will help keep you from being phished – hook, line and sinker!

*Sources: Wired and Phishing.org

Source: Information Technology Services Center

 

What’s New at UHIN?

Call Back Feature

UHIN’s famously short Customer Service wait times just got shorter! We recently added another customer-friendly option that allows our Customer Service team to offer even more convenient service to our clients – a new call back feature! Now customers who call for help only to find the Customer Service team on the phones assisting other people, no longer need to wait on hold. Instead, you can now choose to have your call returned! Customers opting for a call back won’t lose their place in line, and you can even choose to have the call returned to a different number for greater convenience. It’s just another way that UHIN is putting our customers first!

UHIN’s File Tool

 

Did you know that UHIN offer an easy-to-use web-based File Tool allowing UHIN’s members to process American National Standards Institute (ANSI) X12 transactions in a more convenient, time-saving manner? The upload / download file tool is included with all clearinghouse memberships, and is compatible with all operating systems, including Linux and Mac.

The File Tool allows users to upload claims and patient eligibility requests to insurance payers electronically. In return, the users can download and receive important claim acknowledgment reports and remittance reports, providing information on which claims have been paid, for which patients, and outlining any associated deductibles.

In addition to the web-based application, UHIN also has a desktop application. The desktop version features all the advantages provided by the web-based application, but also includes a “set-it-and-forget-it” listener monitor that continuously uploads and downloads files.

The new File Tool is found in the MYUHIN suite, the growing dashboard that will eventually house all UHIN’s product offerings. To learn more about UHIN’s File Tool, please contact Customer Service at customerservice@uhin.org.

 

In the News

 

UHIN’s members use the CHIE to check health records outside of their system or to be notified of a patient’s hospital admission / discharge / transfer. But Gold Cross Ambulance is using the CHIE to help its EMTs understand the final diagnosis and outcome of the patients they transport, and use that information to improve quality and training. You can read all about it in this Modern Healthcare story!

 

Patient Portal White Paper

Are you interested in learning more about the power of patient portals? Well, Secure Exchange Solutions recently published a white paper featuring UHIN’s patient portal, MYONECHART. The white paper explains how patient portals not only improve patient care, but help advance patient-centered care. You can read the white paper at the below link.

https://uhin.org/wp-content/uploads/2018/03/Advancing-Patient-Centered-Care.pdf

 

OpenNotes

OpenNotes, an international, nonprofit movement advocating for greater openness and access to provider notes. They believe that greater available access to notes helps to empower patients, families and caregivers to have greater control of their healthcare decisions.  That’s why UHIN proudly joined OpenNotes.

Nearly 22 million patients now have easy access to their health providers’ notes because of OpenNotes’ efforts. All 50 U.S. states and the province of Ontario, Canada have organizations dedicated to sharing notes with patients. UHIN is one of five Utah members of OpenNotes.

As you may remember, recently UHIN established a patient portal, allowing individuals access to their aggregated health records. MYONECHART offers patients the ability to review their records from all their providers in one convenient location, read notes, check lab results and medications, and securely contact their providers through HIPAA-compliant email.

To find out more about the OpenNotes movement, please visithttps://www.opennotes.org/.

 

ADTs Help Lower Readmission Rates

Receiving an alert / discharge / transfer (ADT) notification can help reduce hospital readmission rates, but by just how much? For the six-month period starting in April 2017 through November 2017, one national insurance payer discovered that their hospital readmission rates dropped by an impressive 2% thanks to discharge alerts generated by the CHIE! Want to learn more about how ADTs can help sales@uhin.org.

 

Meet Your Correspondent

Your intrepid correspondent is always open to topic suggestions for inclusion in the newsletter – feel free to send ideas his way. He is also an Aries, his favorite color is green, and he once rode a camel in the Gobi Desert – neither he nor the camel particularly enjoyed the experience. You can reach him at communications@uhin.org.

Jan-Feb Newsletter

Keep up-to-date on all the latest in security, training, standards, the community and much more in this edition of UHIN’s bi-monthly newsletter! 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 communications@uhin.org.

The Training Tip

Coordinating benefits for patients with multiple coverage is vitally important to ensure you are properly reimbursed. Following these helpful guidelines can help make submitting Coordination of Benefits (COB)/secondary claims go smoothly.

First, remember that the secondary payer needs to understand the entire history of the claim up to the point where you sent it to them for processing. Double check to ensure your COB claim includes all service lines and billed amounts from the primary claim, as well as all payments and adjustments (non-payments) adjudicated by the primary payer. The secondary payer will need all this information during processing.

Remember to wait a full 30 days between receiving the primary payment and sending the COB claim since the primary payer may actually send your COB claim for you. Medicare, after adjudicating a claim as primary, may automatically send your claim on to the secondary insurance. This is called an automatic crossover.

In fact, some payers are beginning to reject COB claims that are sent in too quickly; they want to wait to determine whether an automatic crossover will happen before they process a COB claim directly from the provider. Therefore, if you send your COB claim within 30 days of receiving the primary payment, some payers may reject your claim for being sent too soon.

It’s also important that you make sure your claim balances. In other words, ensure all the amounts on your primary claim are accounted for. For example, if you billed the primary insurance $100, then all of the paid amounts and adjustments (non-payments) that you list in the COB claim should add up to that $100 amount.

For questions or additional COB training, contact us at education@uhin.org.

Security Tip

Increasingly, mobile devices are becoming an important tool for health care providers. According to Research2Guidance, 80% of physicians use smart phones and medical apps. More than one in four employ some sort of mobile technology in the treatment of patients. Indeed, according to an infographic created by Wolters Kluwer Health:

  • -72% of physicians use a smartphone to access pharmaceutical information, such as dosage, calculations, and side effects
  • -44% communicate with staff via a smartphone
  • -63% use a tablet to access medical research

With the increasing role that mobile devices play in delivering healthcare, what are some of the best practices for keeping health care data secure?

Becker’s Health IT and CIO Review shared these 5 simple steps to ensure PHI is kept safe on mobile devices.

  1. Activate the screen locking option – Requiring a password to access the device prevents unauthorized access. Today’s cell phone technology allows for a variety of authentication tools – from personal identification numbers (PINs) and “swipe pattern” passwords to finger prints and even facial recognition.
  2. Regularly update your security software – Having the most up-to-date security software and operating systems on your mobile device can help prevent unauthorized access.
  3. Avoid public WiFi – Only use a secure Virtual Private Network (VPN) connection to send or receive HIPAA-protected information. VPNs are encrypted, which prevents data from being readable if it is intercepted.
  4. Enable encryption – Encryption keeps information on mobile devices safer by making that information more difficult to read if it’s accessed without authorization. Many of today’s mobile devices have built-in encryption, but you can also buy and install the necessary tool.
  5. Install remote wiping and/or disabling options – This option allows you to clear a phone of all data remotely if your mobile device ever gets lost or stolen. In some cases, you even have the ability to selectively remove data.

As mobile devices continue to play an increasingly important role in the treatment of patients, the security of the personal health data on them will become even more paramount. These few simple steps can help keep the data on them safe.

The Latest on HIPAA Transaction Standards

The UHIN Standards Committee recently approved four new or amended standards, which are in varying stages of being adopted into rule:

  • -Applied Behavioral Analysis (ABA): standardizes the use of certain procedure codes, modifiers, and units for ABA treatments, commonly used to treat autism spectrum disorder. Standardizing this billing helps to avoid confusion especially when submitting claims to secondary or tertiary payers. The goal is to eliminate the need for translation between payers.
  • -Telehealth: standardizes the billing of claims and encounters for telehealth, including valid options to use for place of service modifiers.
  • -Transparency Administrative Reporting: annually, most payers are required to report a variety of administrative statistics such as telephone wait times to the Utah Insurance Department (UID). This standard sets the expectation for what specifically needs to be reported and any associated deadlines.
  • -Transparency Denial Reporting: each year, most payers are required to report which payments they denied and the reasoning behind the denial to the Utah Insurance Department (UID). This standard sets the expectation for what statistics needs to be reported and any associated deadlines.

What’s new in X12

Three times a year, X12 subject matter experts from across the industry convene at the X12 Standing Meeting to develop new standards and implementation guides. Typically, attendees will choose one or two workgroups to attend for the duration of the event. It’s in these workgroups that change request are created, public comments are reviewed, and changes necessary to meet the industry’s needs are recommended and discussed.

UHIN’s Standards Committee gives the Utah community an opportunity to present requests for future X12 developratice managementent, which are then carried to X12 and advocated for by UHIN and Standards representatives.

Below are updates from the most recent X12 Standing Meeting:

  • -The group is working to clarify the CTX segment in the 999. Although no changes to the actual segment are planned, how the segment should be used will be clearer.
  • -In the 277CA, the STC12 data element position is being completely removed. This is where payers have been adding free text information. A proposal has been made for an additional STC01 code to be created with any free text to be entered in a PWK segment instead. For this implementation to proceed, the new code and PWK alternative must still be approved.
  • -In the 837, the committee is considering adding an “Original Claim Creation Date” in the 2300 loop. This would reflect the date the claim was created out of the PRATICE MANAGEMENT system, and will remain untouched even if dates in the header are changed by clearinghouses as files pass through. The intention is for this to assist tracking.
  • -The unified agenda for 2018 includes attachments. The committee is optimistic for either a Notice of Proposed Rule (NPR) or Interim Final Rule (IFR) to be announced in August. With an NPR, a comment period is required, however with an IFR a comment period is allowed but not required.
  • -Additionally, the currently recommended attachment version remains 6020, however as it is not a HIPAA guide there’s no regulation for it. The 277 transaction (which is separate from the 277CA) is the solicited response to a 276.
  • -With 277 and 277CA in 7030, payers will be required to report status on the line level, except when the entire 837 file is rejected for an overarching reason on the claim level.
  • -Public comment is being solicited for the proposed amendments to 270, 835, 829 and 276.

Comments can be submitted at http://forums.x12.org/.

 

Join us for the Provider Education Summits

It’s time for the annual Provider Education Summits! The 4-city Summits are scheduled for:

Salt Lake City – March 21

Ogden – March 27

Provo – March 28

St. George – April 11

These ever-popular events are always free and provide an opportunity for billers, coders, front desk and support staff, medical assistants, and other office personnel to learn about a variety of topics from industry experts.

Among this year’s wide-ranging topics are sessions focusing on trouble shooting EDI claims, credentialing, HIPAA and privacy, tips and guidelines about common coding errors, dealing with difficult clients, and the always-popular payer panel – extended this year to allow for more questions to be answered!

To learn more about the upcoming Provider Education Summits or to register for one of these free education events, visit https://uhin.org/events/provider-education-summit-2018/.

Free Webinar

Engaging patients and employees is key to positively impacting your bottom line. Christopher Katis, UHIN’s Director of Corporate Communications, will help you gain ideas to create a positive patient experience, and learn the communication methods needed for a great work environment!

Wednesday, February 21 at 12:30 p.m. Register at https://uhin.org/events/event/webinar-positively-impacting-your-bottom-line/

In the Community

February is American Heart Month: Talk to Your Patients about Heart Health

Heart disease is the leading cause of death for both men and women in the United States. This year cardiovascular disease will take the lives of more than 800,000 Americans.

American Heart Month honors health professionals, researchers and heart health ambassadors whose dedication to fighting heart disease enables countless Americans to live full and active lives. The observance aims to reduce the burden of heart disease by raising awareness, taking steps to improve individual heart health, and encouraging colleagues, friends and family to do the same.

Clinicians are reminded to have conversations with their patients about heart health. Million Hearts® offers a number of resources for clinicians to aid them in identifying patients with undiagnosed hypertension, including a clinical video, an interactive hypertension prevalence estimator tool, as well as additional references, resources and case studies.

The American Heart Association’s National Wear Red Day® encourages individuals, groups and companies to show their support in the fight against heart disease. Each year, on the first Friday in February, millions of women and men come together to wear red, take action and commit to fighting heart disease. National Wear Red Day this year is Friday, Feb. 2. You can also spread the word by posting #HeartMonth and #HeartDisease on social media.

HealthInsight is working with health care professionals and community stakeholders in Nevada, New Mexico, Oregon and Utah to lower cardiac risk and improve cardiac health. For more information on HealthInsight’s efforts around cardiovascular health and Million Hearts, visit healthinsight.org/cardiovascular-health.

Nov-Dec Newsletter

In this edition of the bi-monthly UHIN Newsletter, you’ll find training and security tips, information from the community, 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 communications@uhin.org.

The Training Tip

We all make mistakes, right? After all, to err is human. But what happens if you realize you had an error in your claim after-the-fact? Is there anything that can be done? Yes! UHIN’s corporate trainer suggests the following to correct your claim without causing further confusion.

Although you may be tempted to resubmit the corrected claim immediately, your first step should be to do nothing at all, just wait. Re-sending the claim right away could cause the resubmission to be rejected as a duplicate.

Watch for reports. Make a note of all the germain information from the claim such as the billed amount, service date, and/or patient account number to easily track the related reports.

If the claim gets rejected by a clearinghouse or payer, you can send the corrected claim again as an original claim. Once a claim is rejected, new copies are no longer marked as duplicates. However, if the original claim is accepted for processing and passed through adjudication for payment, although there is no official industry standard, typically a correction / replacement or cancellation will be required.

You should send a correction or replacement when the patient and provider identities are correct but other claim details are incorrect. For example, you might need to correct the number of units reported or the amount billed. Your software may call this setting, “Correction of Prior Claim” or “Replacement of Prior Claim.”

If the incorrect information affects the patient or provided identity, you must cancel the claim. Your software may call this setting, “Cancel of Prior Claim.” This cancelation is required to avoid benefit or tax implications being applied to the wrong member or provider.

At this point, you will know if you need to send a correction or cancellation or not. When sending these corrections/cancellations, remember the following:

  1. Make sure to mark the claim as a correction/replacement/cancellation. There should be an option for this in your claim software. Once you find the correct menu, select the appropriate option based on the criteria above.
  2. On a report from the payer, such as a 277CA, 835, or EOB, find and write down the number assigned by the payer for this claim. It may be labeled an ICN, TCN, or Payer Claim Control Number.
  3. In your claim software, find the “Original Reference Number” field, or similarly-named field. (For UHINt users, this is box 22.) Place the payer-assigned number in this field.
  4. Ensure the rest of the claim form contains the necessary details.
  5. For corrections/replacements: enter the details for the entire claim, including any corrections needed. Remember, the previous copy will be removed from the payer’s system, any money paid on the incorrect claim will be taken back, and this new claim will replace it.
  6. For cancellations: enter the details for the original, incorrect claim and send. This will remove the incorrect claim from the payer’s system. Once this is completed, you can send an original claim with the correct information.

 

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Security Tip

When you think about protecting personal health information (PHI), you may think of firewalls and other forms of technology that help keep hackers at bay. Those certainly play an invaluable role. However, for all the media coverage hackers and ransomware receive, human error still plays an alarming role in breaches. According to the U.S. Department of Health and Human Services, Office of Civil Rights, hacking accounts for less than half of the breaches that occurred between January 1 – October 31, 2017. More than 1/3 (36%) were the result of employee error via unauthorized access or disclosure. Another 16% were caused by the theft of laptops, computers or other devices, and 3% were caused by the loss of a device or improper disposal of paper records. [1]  Thankfully, there are steps that can be taken to help reduce the risk of human error to increase security.

  1. Create a culture of security at your organization. Keeping the PHI with which your organization has been entrusted safe isn’t just the job of the security. It’s not something only IT needs to handle. Security is every employee’s responsibility. Schedule regular security trainings, periodically review your policies to ensure everyone understands them, and offer “rewards” to staff “caught” keeping PHI secure. Creating an atmosphere in which security is always top of mind for every team member helps to foster a unified effort to keep PHI safe.
  2. Educate your staff about the importance of security. Helping staff understand the severe consequences of a breach can prove invaluable. Just one record being compromised can cost your organization up to $50,000. Multiple HIPAA violations can run in the millions of dollars and lead to incarceration. The negative publicity associated with even a “minor” breach can end careers, and more importantly, a PHI violation can irreversibly damage the lives of those individuals whose privacy has been violated.
  3. Assess your weaknesses. Doing a risk assessment provides your organization with a clearer understanding of where potential threats and vulnerabilities lie. This will provide you with insights into the areas your organization needs to improve, and can spark meaningful conversations between employees about the importance of security, leading to new ideas and initiatives.
  4. Reinforce that simplicity can be meaningful. Being diligent doesn’t have to be burdensome. Consistent reminders that everyday tasks such as keeping workspaces clear of any PHI, being cautious of potential “phishing” emails, locking computers, changing passwords, using complex passwords, and locking drawers all play vital role in protecting PHI. Your IT department can even develop fake phishing emails to educate your staff about the threats emails can play.
  5. Remember that security efforts never end. Whatever your current efforts are today, they may not be sufficient tomorrow. Stay abreast of new tools available, understand new threats being posed, and keep challenging employees to stay vigilant.

Human error – intentional or not – remains a primary cause for data breaches. Thankfully, there are simple measures any organization can take to help prevent a simple mistake from becoming a costly one.

 

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Falls Prevention

Every year 2.8 million older Americans suffer a fall, and injuries related to falls are one of the primary reasons people lose their independence. The Centers for Disease Control has a new campaign to keep seniors from falling, stay active and live independent lives.

Older people can reduce their chances of falling through:

  1. Regular exercise – keeping active helps improve balance and builds strength.
  2. Reviewing medications – talking to doctors and/or pharmacists about prescribe and over-the-counter medications, supplements and vitamins helps make sure that dosages or side-effects are not increasing the risks of falling.
  3. Annual eye and hearing exams – updating eyeglasses and ensuring there are no inner ear issues are important parts of preventing falls.
  4. Safe homes – floors that are free of clutter, throw rugs with non-slip backing, well-lit stairs, tubs with handrails, and lamps or lights close to beds are just some of the easy steps that can help prevent falls.
  5. Being assessed for fall risk – a simple 12-question assessment can offer healthcare providers with important insights into a patient’s risk for falling.

To learn more about the CDC’s Live fall prevention efforts, visit www.cdc.gov/steadi/. You can view a patient brochure with the Risk for Falling Assessment here.

 

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UHIN’s Third Annual HIT Conference – Interoperability in Times of Crisis

More than 125 healthcare professionals attended the Third Annual UHIN HIT Conference this year where they learned of the invaluable role interoperability plays during times of crisis. An impressive lineup of speakers provided both national and local perspectives addressing crises as wide ranging as rising healthcare costs to natural disasters.

Genevieve Morris, the Principal Deputy National Coordinator for Health Information Technology offered the keynote, providing insights into the current interoperability landscape. She explained how the ONC is successfully expanding interoperability nationwide thanks to the dual efforts of improving usability while decreasing the regulatory burdens on providers. She also outlined the ONC’s 2018 interoperability targets:

  • Technical – focusing on patient/provider data matching, data quality and standards
  • Trust – looking at privacy / HIPPA, intellectual property and permitted purposes
  • Financial – making the business model to share data and creating incentives
  • Workforce – encouraging provider IT staff and clinical informatics careers

Ms. Morris also stressed that the technical and trust targets on interoperability align well with the 21st Century Cures Act as the law looks to provide uniform conditions of certification (Technical), while increasing common exchange frameworks and agreements, and decreasing information blocking (Trust).

Discussing interoperability during Hurricane Harvey, Gijs van Oort, PhD and Phil Beckett, PhD, the CEO and CIO of Health Access San Antonio (HASA) were joined by Nick Bonvino, CEO of Greater Houston Healthcare. The three HIE leaders shared how after two days of rain, an unprecedented 52” of additional rain water battered Houston, forcing thousands of citizens to evacuate. Staff from the two HIEs joined medical teams at shelters to provide access to medical records and medication information for evacuees. A full 70% of records requested were found. Proving irrefutably that interoperability can save lives.

Dr. Karen DeSalvo, former acting Assistant Secretary for Health and Human Services, and formerly National Coordinator for HIT, shared her belief that the nation is making impressive progress on the interoperability roadmap, which was developed during her tenure at the ONC. Taking audience questions, she argued that patient expectations that their records are shared is driving demand for interoperability. She also stated that interoperability can play a vital role in public health, helping states to avert disease outbreaks and the costs associated with epidemics.

Sen. Brian Shiozawa, M.D., a member of the Utah state Senate, and a practicing emergency room physician, provided insights on the use of interoperability in every day hospital settings. Addressing the advantages of having information from various sources available, Sen. Shiozawa spoke of the cost savings realized by eliminating redundant tests. Moreover, he stressed the invaluable role interoperability plays in battling the opioid crisis.

UHIN’s Chief Medical Informatics Officer, Matt Hoffman, M.D. was the final speaker of the conference. He offered attendees a glimpse into Utah’s HIE, UHIN’s cHIE. He highlighted ADT notifications, which alert providers when a patient is admitted or discharged from a hospital, and provided a demonstration of dashboards used to help prevent costly hospital readmissions.

We’re already busy planning next year’s conference. It’s sure to be an event you won’t want to miss!

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New Medicaid Card with Unique ID Number Coming Next Year

New Medicare cards will be arriving in mailboxes beginning in April 2018. These cards will have a new Medicare-generated number that is unique to the person, rather than their Social Security Number. The purpose of the new cards is to help to protect privacy and patient identity. You can find more information about the new Medicare cards at CMS.gov.

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In the Community

Influenza takes a considerable toll on Americans each year, causing millions of illnesses and medical visits, hundreds of thousands of hospitalizations and thousands of deaths. Here are important updates for encouraging your patients to protect themselves and their families this year by updating their shots.

2017–2018 Recommendation Highlights. The Advisory Committee on Immunization Practices (ACIP) and The Centers for Disease Control and Prevention (CDC) continue to recommend an annual influenza vaccination with an injectable influenza vaccine for everyone 6 months and older, including pregnant women. The recommendation not to use live attenuated influenza vaccine (LAIV) was extended for the 2017–2018 season. The inactivated influenza vaccine information statement (VIS) will be used again this season. Full recommendations for the 2017–2018 influenza season are online at https://www.cdc.gov/mmwr/indrr_2017.html.

Vaccine Supply. Manufacturers have projected they will produce between 151 million and 166 million doses of injectable influenza vaccine for the 2017–2018 influenza season, which should ensure sufficient supply of vaccine.

When to Vaccinate. Optimally, vaccination should occur before onset of influenza activity in the community. We recommend vaccination by the end of November, if possible. To avoid missed opportunities for vaccination, providers should offer vaccination during routine health care visits and hospitalizations when vaccine is available. Vaccination efforts should continue throughout the season because the duration of the influenza season varies and influenza activity might not occur in certain communities until February or March. Vaccine administered in December or later is still likely to be beneficial even if given after the influenza season has begun.

Safe Vaccine Administration. When you “know the site and get it right,” you can help prevent shoulder injuries such as deltoid bursitis—generally caused when vaccines are injected high on the shoulder and the needle enters a shoulder bursa. This error occurs mostly among adults. The CDC provides comprehensive vaccine administration resources at: https://www.cdc.gov/vaccines/hcp/admin/admin-protocols.html.

Below are some data that might inform your conversations with patients in the upcoming months:

Influenza vaccine can prevent flu illness and hospitalization. The CDC estimates that influenza vaccination prevented approximately 5.1 million influenza illnesses, 2.5 million influenza-associated medical visits, and 71,000 influenza associated hospitalizations during the 2015-2016 season, with an overall vaccine effectiveness of 48 percent.

Influenza vaccination was found to reduce deaths in children. A study in Pediatrics showed that influenza vaccination is effective in preventing influenza-associated deaths among children.

Influenza vaccination may make illness milder. While some people who get vaccinated may develop influenza, vaccination may make their illness milder. A 2017 study in Clinical Infectious Diseases (CID)  showed that influenza vaccination reduced deaths, intensive care unit (ICU) admissions, ICU length of stay, and overall duration of hospitalization among hospitalized influenza patients.

Tools and resources to make your conversation with patients easier. HealthInsight has developed a toolkit with multiple resources for helping providers educate their patients and improve their vaccination rates. Included in that toolkit is a document on motivating patients to get vaccinatedthat can help you start the conversation. The Adult Immunizations Toolkit is available for clinicians and physician offices and home health agencies.

Updated influenza vaccine information for providers and patients is available at http://www.cdc.gov/flu.

Thank you for all you do every year to help protect your patients, families, and communities against influenza.

UHIN’s New Look

You may have seen UHIN’s new look. We feel that the bold colors and new logo better reflect who UHIN is and where we are headed as a company. As part of our re-branding, we also updated our mission to: “Positively impact healthcare through reduced costs, improved quality, and better results driven by innovative healthcare technology solutions.” We’re excited about our company and it shows!

 

[1] https://ocrportal.hhs.gov/ocr/breach/breach_report.jsf

September Newsletter

We are pleased to announce the return of the UHIN Newsletter. We strive to make this bi-monthly communication informative and timely. Each issue will offer tips, industry insights, the latest from UHIN, and important industry news. 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 communications@uhin.org.

 

The Training Tip

UHIN’s corporate trainer answers a myriad of questions about claims. After all, sending clean claims the first time is an important step to getting paid for the care you’ve provided. Although every training session is different, there are some commonly-asked questions, which can provide insights that benefit everyone.

One of these commonly-asked questions is: What steps should I take to ensure that sending electronic claims to a new insurance company will goes as smoothly as possible?

ANSWER: There are some easy steps you can take to help make sure that your initial claims to a new insurance company go well.

  1. First, check with UHIN to see if the payer requires EDI enrollment. If the payer does require enrollment, UHIN will be happy to assist you with submitting the correct paperwork to enroll for electronic transactions. Also, remember to keep copies of all enrollment and
  2. contracting paperwork. If any follow-up is required, it’s very handy to have that information ready.
  3. When you send the first claim(s), watch carefully for the proper payer responses. Some types of enrollment issues can cause claims to go unprocessed without any error or rejection messages. If you don’t receive your 999 and 277CA reports within 48 hours, this could be a red flag. Contact UHIN for help.
  4. If possible, start with a small number of claims. If there are any issues with your submission, a larger number of claims can complicate the situation, causing a resolution to take longer, and increasing the time before you can resubmit your claims. Wait until you have received payment on your first set of claims before billing the rest.

 

If you have a question about how to improve your claims submission, contact UHIN’s customer service to make an appointment with our corporate trainer.

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Security Tip

Let’s face it: healthcare providers have access to a great deal of personal information, data that must be kept secure both legally and ethically. Yet, according to Norton, a well-known online security software company, unsecure emails pose the greatest threat to protecting that data. There are, however, ways to both protect your password and to strengthen it.

First and foremost, never share your password. Nor should you keep it written down on a slip of paper or a “sticky note.” The more people with access to a password, the greater opportunity for it to be misused. And be sure to change passwords regularly – the UHIN standard requires changing of passwords every 90 days.

Some important steps to strengthen your password include:

  1. Avoid obvious passwords. Norton lists 123456, 111111, monkey, and qwerty as the most commonly-used passwords. Also, avoid the names of children or pets. An anonymous hacker won’t know your dog’s name, but a disgruntled former coworker likely will.
  2. Use a combination of both upper and lower case letters randomly throughout the password.
  3. Include both numbers and symbols. If your system allows, add a space between words or letters.
  4. Ensure your password meets the UHIN standard, and contains at least 8 characters
  5. Do not use a single word as your password, even in a foreign language. Hackers have programs that include dictionaries in hundreds of languages.

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Getting the Most Out of ADT Alert Notifications

The cHIE has more than 45 million clinical messages pertaining to over 5 million unique patients. Data comes from all four major Utah hospital systems, most independent hospitals, many labs, and long-term care facilities. The cHIE even has data on patients from five surrounding western states! Every day, in excess of 2,000 Admit / Discharge / Transfer (ADT) alert notifications are sent from the cHIE. But what are some of the best practices provider offices can employ to obtain the most value from these alerts? We sat down with Dr. Matt Hoffman, UHIN’s Chief Medical Informatics Office to find out.

Question: What type of information is found in an Alert?

HOFFMAN: Alerts offer a great deal of information. They include the patient demographic information –including name, gender, date-of-birth, address, etc. – whether the ADT is for an inpatient or emergency encounter, the associated ICD-10 codes, diagnosis information, emergency and inpatient history, primary care physician and much more.

 

Q: Where do most clinicians see the greatest value in receiving Alerts?

MH: Most importantly is knowing where their patient is and what is happening with their patient. Other valuable uses of Alerts:

  1. Being aware of any changes to medications or additional medications that may have been given as part of the visit that may interact with those currently being taken.
  2. Outreach to the patient for a follow-up visit to check on medications, check on status of any chronic illness, and verify that the reason for the admission has been appropriately addressed. Have they improved?
  3. For patient being managed by a case manager, alerts are a great opportunity to gather any pertinent information from the visit that applies to a specific illness, and reach out to the patient to check current status.

 

Q: What are some of the best practices clinicians should follow when utilizing Alerts?

 

MH: The most important thing to do is to use the alert as a trigger to reach out to the patient and schedule a follow up visit. As part of that visit it’s important not only to check on the health of the patient but a nurse, or another member of the team, can attempt to capture a back story to what lead up to the admission and see if there are any existing factors, such as job loss, homelessness, divorce, etc. that could be addressed and would lower the risk of readmission.

 

Editor’s Note: Remember for Medicare, there is an opportunity to bill for transitional care management services.

 

Q: Can Alerts be customized for clinicians?

MH: There are many ways Alerts can be customized, including breaking down the patient list into subpopulations based off of disease cohorts or specific physicians within a clinic. The method of delivery is also customizable; Alerts can be received via a spreadsheet, via HL7 messages directly into the physicians EHR, or Alert Dashboards which are now available and provide tools to help manage that patient population.

 

Q: What’s coming down the pipeline?

MH: We are excited about some of the new tools we will be rolling out in the next few months, including the ability to rank Alerts based on the calculated LACE score to identify the patients at risk for re-admission, or the option to receive a list of medications given to the patient at discharge.

 

The Latest on HIPAA Transaction Standards

 

The UHIN Standards Committee, comprised of community members, worked diligently over the past year on the Public Comments for the HIPAA Transactions. These transactions will be put forward for inclusion into the HIPAA rule within the next year or so. The review was conducted in cycles focusing on groups of transactions.

The preliminary verdict is a total of 3,488 changes in the guides were reviewed and discussed.

 

Significant Changes

The most significant changes across all guides include new functionality such as:

  • -Acknowledging each claim individually in the Claim Status Transaction
  • -Pre-Determination for Professional and Instructional Claim Transactions
  • -New Payment methodologies in the ERA

 

Other general changes consisted of deletion and addition of segments, new value codes, consolidation of codes, redefinition of codes, and the deletion of codes.

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Join Us for the Third Annual UHIN HIT Conference

 

Join us September 26th as we discuss Interoperability in Times of Crisis. This year’s speakers include:

 

  • Genevieve Morris, Principal Deputy National Coordinator at the ONC
  • Karen DeSalvo, former Assistant Secretary of Health and Human Services
  • Gijs Van Oort, PhD, CEO and Executive Director, HASA – Texas-based HIE
  • Nick Bonvino, CEO, Greater Houston Healthconnect, HIE
  • Brian Shiozawa, M.D. – Member of Utah Legislature and ER physician

 

Lunch will be provided.

 

For more information or to register for the free conference, please visit:

https://www.eventbrite.com/e/2017-uhin-annual-hit-conference-tickets-37011520454

 

HealthInsight’s Quality Conference

It’s time for HealthInsight’s Third Annual Quality Conference. To learn more or to register, please visit:

https://healthinsight.org/changeagents/details

Patient Summaries From Foothill Family Clinic Available in the CHIE

UHIN is pleased to announce that Continuity of Care Documents, CCDs, from Foothill Family Clinic are available in the cHIE Clinical Portal as of July 14, 2016! Foothill Family Clinic is a 38-physician, three-location multispecialty practice that treats an average of 8,000 patients each month. They will automatically send CCDs, also called patient summaries, to the CHIE for all of their patients.

The data will be automatically added to the correct section in the Clinical Portal’s Patient Summary view, and will remain available in the Patient Summary view. Additional details, such as the text of provider notes, may also be available under the “Documents” tab. To view these details, click on the CCD you’d like to view and choose the HTML option.

The Patient Summary view will also display available information from hospitals participating with Quality Health Network in western Colorado and the Arizona Health-e Connection, as well as from Utah Gastroenterology (formerly called Mountain West Gastroenterology). CCDs from Intermountain Healthcare, Lone Peak Hospital, St. Mark’s Hospital, and the Veterans’ Affairs Health Care System can be accessed by clicking on the External Documents tab. We are actively testing with more data sources, and expect to include CCDs from a range of providers in the near future.

CCDs are a user-friendly way to get the latest information on your patients’ health, including problems, medications, allergies, lab results, care plans, procedures, and more. This “snapshot” format makes it easy to see the information you need, when you need it. CCD inclusion is one more way we’re making the CHIE more valuable for you.

All Intermountain Healthcare Facilities Now Sending ADT Alerts

UHIN is excited to announce that all Intermountain Healthcare facilities are now sending ADT notifications to participating providers. The ADTs alert providers when a patient has been admitted, discharged or transferred at any of the 22 Intermountain hospitals and more than 180 clinics. This information provides invaluable information to foster better care coordination, improved outcomes, and reduced costs.

Currently, the Intermountain facilities are identified by a numbered code. UHIN is working closely with Intermountain to provide the actual facility name. In the meantime, if you need help in identifying the facility at which your patient sought treatment, please contact UHIN customer service at 877-693-3071 or customerservice@uhin.org.

UHIN sends more than 2,000 ADT notifications every day from all four major Utah hospital systems, most independent hospitals, many long-term care facilities and five other western states.

UHIN Connects With Central Valley Medical Center, Kane County Hospital and Pacific Mobile Diagnostics

UHIN continues to grow the number of data sources to the CHIE! The latest additions to the CHIE are Central Valley Medical Center, Kane County Hospital, and Pacific Mobile Diagnostics.

Located in Nephi, Central Valley Medical Center is a 25-bed critical access hospital serving the people of Juab County. CVMC provides emergency services, cardiopulmonary, orthopedic surgery, labor and a delivery services, and a host of other medical services.

Kane County Hospital in Kanab serves the rural communities of southern Utah and northern Arizona. Along with a 24/7 emergency department, the 25-bed hospital offers a wide-range of services from family medicine and in-house lab services to maternity care and radiology services.

Pacific Mobile diagnostics is a mobile imaging company serving long-term care facilities with offices in Utah, Colorado and Arizona. Celebrating its 30th anniversary this year, PMD provides mobile X-ray, ultrasound, EKG and other imaging services.

The continual growth that the CHIE is experiencing is certainly exciting. The Clinical Portal now includes data from over 500 clinics and hospitals in Utah and the surrounding states! For a full list of facilities sharing data through the cHIE, visit https://uhin.org/the-chies-data-sources/.