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 email@example.com.
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.
- 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
- contracting paperwork. If any follow-up is required, it’s very handy to have that information ready.
- 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.
- 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.
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:
- 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.
- Use a combination of both upper and lower case letters randomly throughout the password.
- Include both numbers and symbols. If your system allows, add a space between words or letters.
- Ensure your password meets the UHIN standard, and contains at least 8 characters
- Do not use a single word as your password, even in a foreign language. Hackers have programs that include dictionaries in hundreds of languages.
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:
- 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.
- 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?
- 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.
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.
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:
HealthInsight’s Quality Conference
It’s time for HealthInsight’s Third Annual Quality Conference. To learn more or to register, please visit: