Everyone I have spoken to recently are implementing, upgrading, or changing billing software. Here are some of the reasons why I believe this is a significant trend in the health care industry:
New system features provide more flexibility;
Additional data needs to be captured;
Additional code table interface is needed;
Better interoperability is desired;
Security safeguards are required;
Greater productivity needed in maintaining and processing data;
Regulatory requirements playing greater role in business decisions.
You may want to ask the new system vendor if they have performed a similar conversion recently. If so, what are the gaps in the data between the new and the current system? [You may want to start thinking about how you can populate these new data fields for your existing records. Could your clearinghouse provide this information to electronically populate the new fields?] Does the vendor have a crosswalk or data mapping available? If you have access to a user group of your current system, you may want to ask if any have looked at this new system, are in the process of converting, or have converted, and what are the gotchas.
If you haven't yet, you may want to consider what procedures will need to be modified to integrate the new technology into the day-to-day actions of the system users.
Also, you may want to filter this system conversion through FISMA, or HIPAA privacy, security, and TCS. Changing a billing system will undoubtedly be affected by the HIPAA TCS Rule, a.k.a. General Administrative Requirements and Modifications to Transactions and Code Set Standards for Electronic Transactions (http://aspe.hhs.gov/admnsimp/final/txfinal.pdf). The TCS Rule defines a standard transaction by purpose, sender, and receiver. When the sender and receiver are covered entities, the electronic transaction must be a standard transaction formatted in accordance with the IGs. To enhance processing, any companion guides should be referenced. I have attached a matrix of standard transaction types by purpose, sender, and receiver. To see if my interpretation is the same as yours, go to the url provided above and do a search for "subpart K" or whatever transaction type interests you. Understanding the definition of the standard transaction types is a necessary first step in jump starting TCS compliance.
Through research and participation in test groups, I have found that in order for a covered entity to achieve TCS compliance, the covered entity must manage by transaction type the relationship between application, billing service/BA clearinghouse (where appropriate) and trading partner(s). Even if the technical solution is totally out-sourced to vendors and business associates, a covered entity should have and be diligently executing a TCS compliance plan and invoking contingencies where needed to avoid enforcement actions, and prevent a disruption in cash flow.
Integrating requirements, standards, and specifications of HIPAA privacy, security, and TCS into current and future business decisions, and the day-to-day actions of your workforce is not easy to do.
There is an audio/video presentation that I put together to show how NIST guidance may be used to assist in achieving HIPAA security compliance. It is called "DeMystify Security -- NISTify IT!" You can access the presentation by clicking on the link below 24/7, and it is provided freely to all by Blass Consulting, LLC.
David A. Feinberg, C.D.P., put together an audio/video recording on the HIPAA TCS Rule, ASCA, and the alphabet soup of regulatory, advisory, and enforcement of HIPAA EDI. It is called "Avoid Penalties and Get Compliant!" David said, "This is definitely an experiment in reaching, informing, and assisting with HIPAA TCS compliance activities; although my biggest hope is that it will allow small providers -- as characterized in the presentation -- to expeditiously move forward." You can access the presentation by clicking on the link below 24/7, and it is provided freely to all by Blass Consulting, LLC.
Requires Name, No password, then email address and Company Name. (49 min).
For high-speed and broadband connections choose the 2nd file option. It is called "Microsoft Office Live Meeting Replay: Windows MediaTM - formatted streamed audio & video". When the windows media window opens you can right click on the window, then click on zoom, and then click on full screen.
For 56K modems, your bandwidth will not support video. You can choose the 1st file option. It is called "Basic recording with Windows Media TM formatted streamed audio". You can listen to the recording . This may not be very helpful. If you can get to a PC with high-speed internet access, I would recommend viewing it this way.
HIPAA ComplyAssistant (HCA) www.complyassistant.com is the leading tool in providing NIST functions and features for HIPAA privacy and security compliance management, and HCA provides the only tool to help you manage your TCS compliance plan.
How does HCA automate your compliance? By providing functions to document and manage surveys, issues, incidents, complaints, gap assessment, and mitigation work plan and budget development. The software provides work plans and budget reports, trending snapshot graphs and reports, links to valuable websites, and policy management. In addition, HCA includes a function to document and manage PHI (protected health information) data exchange./! SPAN>
The end result is a central database of project management and due diligence documentation
One of HCA’s user-friendly functions is the flexible and easy to customize question master. Because of this function, HCA may now be delivered with its standard HIPAA content or with the NCHICA HIPAA EarlyView™ Privacy and Security content.
Announcement!! The following audio/video recordings are available and freely accessible. Just click “Presentations” at www.complyassitant.com
DeMystify Security – NISTify IT!
HIPAA TCS – Become Compliant and Avoid Fines
Providers’ Current Realities of HIPAA Privacy, Security, and TCS
Payers’ Current Realities of HIPAA Privacy, Security, and TCS
Seeing is believing!!!! Request a live demo anytime at: www.complyassistant.com/online_meeting_req.htm
Thank you,
Barbara McGowin, CPC
Executive Recruiting
HIT Recruiting
(843) 824-8537
mcgowins@...
Connecting Healthcare Organizations with People,
Products and Services to Achieve HIPAA Compliance.
|
"Barbara McGowin" <mcgowin@...>
hitrecruiting
 Offline
 Send Email
|
Having problems with message search?
