To Text or Not To Text Patients? The Message from HIPAA.

 

Most of the 1.9 trillion texts Americans sent from their smartphones to friends and family last year wouldn’t be secure enough for healthcare settings. It’s unfortunate, because texting is a quick, easy and effective way to communicate.
It’s probably also no surprise that texting is the most popular smartphone feature, according to a 2015 Pew Research Center survey,  and 97% of Americans use their phones to text.
But like most other things, different rules apply in the healthcare world.
The HIPAA/HITECH privacy and security rules cover any communication with electronic protected health information (ePHI), including e-mail, social media and text messages. In an actual case, providers at a nursing facility requested nurses text them patient information. Even without evidence that an unauthorized person saw the messages, CMS intervened with a 10-point remediation plan to retrain staff, appoint a HIPAA security officer and revise their HIPAA policies and procedures.

Remember that texting leaves a record, unlike telephone calls. Plus it’s easier to know you’re reaching the correct person on the phone. The risk of texting sensitive patient information to another person is not zero – in public surveys, about one-third of people say they’ve mistakenly sent a text to the wrong person.
In addition, HIPAA/HITECH privacy violations can carry hefty fines, up to $50,000. So avoiding the temptation to text a colleague for a quick patient consult could save you money as well.

HIPAA Compliant Texting
Even so, the Joint Commission did not rule out all texting, according to Andrew A. Brooks, MD, orthopaedic surgeon and Chief Medical Officer at Tigertext, a secure mobile messaging firm.  In a piece for the American Academy of Orthopaedic Surgeons, Dr. Brooks points out that minimum requirements for HIPAA compliance include:
* Secure data centers—Onsite or offsite (cloud) data centers must use a high level of physical security and policies to review controls and conduct ongoing risk assessments.
* Encryption—ePHI is encrypted both in transit and at rest.
* Recipient authentication—Confirmation that any communication containing ePHI only goes to its intended recipient.
* Audit controls—The ability to create and record an audit trail of all activity, including text messages containing ePHI.
The sheer volume of text messages indicates an overall preference for this form of communication. The 1.92 trillion texts last year is almost double the 1 trillion sent in 2008, so who knows how many texts Americans will send going forward.
Texting Appointment and Wellness Reminders
Your practice may already send patients text reminders for upcoming appointments. There’s evidence this strategy can reduce your patient no-show rate. HIPAA rules generally do not apply to communications without ePHI.
Text reminders also seem to help patients with medication, healthcare and lifestyle reminders. As examples, researchers show chronic disease text messaging can help patients manage their diabetes, remind African-Americans with high blood pressure to take their medication, and help people increase their exercise and physical activity levels, although some say more research on best practices is needed.
Healthcare vendors offer apps that promise secure texting and would allow physicians and medical professionals to communicate within a HIPAA-compliant platform. Verify information complies with HIPAA because government agencies do not vet many of these apps. Also, if you chose to use a third-party secure texting platform, keep in mind the three requirements for securing PHI: confidentiality, integrity, and availability. Any platform chosen must satisfy all three elements, according to Mellette PC Healthcare Provider Attorneys in Virginia.
Another option, now that more than 80% of physicians use electronic health record systems, is to communicate with patients by sending e-mails through a secure patient portal. As you probably know, secure portals can help eligible providers meet Meaningful Use.
Whatever strategy you use, remind your staff to never transfer ePHI through non-secure methods of communication. And while we congratulate you on moving to the world of quick and convenient electronic communication with patients, here at Power Your Practice we also don’t want to see you financially penalized.
Figured out a great way to reach patients – and hear back from them – without violating HIPAA? Share your tips with colleagues below.

Damian McNamara

Damian McNamara is a Content Marketing Writer & Editor. He brings his journalism experience covering 18 medical specialties to cover practice management, cloud technology and health IT best practices to Power Your Practice readers.

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What Disruptive Quality Means to Me & ClaimPay MD

"A disruptive quality about my opportunity is that right now is revolutionary timing for a rapidly changing Industry. The Healthcare  is now one of the top growing Industries, bringing in billions of revenue each year. With updates on Regulations & Laws, Electronic Data & Security Breeches, Insurance Policies & Payment Procedures, to ICD-9 Coding advancing into ICD-10, and electronic health records exchange and patient powered care-we all see in the news that there is a lot of change going on in Healthcare and this can be quiet an Head Ache & costly for Medical Providers.  In order to keep up with the consistently changing trends in this market, there is a lot of training to do.   Innovation in the Healthcare Industry is an  advancing evolution and outsourcing,  has become a new resource for the medical world. With headlines reading that outsourcing is the new choice many providers are making- to cut costs and get rid of their in-house billing department right now is the perfect time to start up ClaimPay MD.. This is a new and trendy innovation that helps create a new value and market in network with this ever growing Industry.  And this will eventually disrupts the existing market of in-house billing and replace the value network by displacing that earlier technology of using in house administration, and becoming a new technology outsource for the future."    

by *Toni Lauren Vossen October 7th, 2015 

Providers and clearinghouses will populate the database by providing information about 10 key metrics:

Providers and clearinghouses will populate the database by providing information about 10 key metrics:

1. Payer name/line of business.
2. Is the payer indicating that it will map from ICD-10 to ICD-9?
3. Is the payer indicating that it will dual code in ICD-9 and ICD-10?
4. Testing type/testing date/returning information/triggering ICD-10 edits/dates of service.
5. The URL from the payer’s website where information on their ICD-10 testing (including the testing plan) can be found.
6. Does the payer allow for the scheduling of future service testing dates?
7. Will a clearinghouse need to set up a new connection for ICD-10 testing?
8. Will the payer be rejecting or denying claims for unspecified diagnosis codes? 
9. Is provider and submitter registration required? 
10. With whom will the payer be supporting testing?

“As more and more payers’ testing information goes online, this will be the most dynamic tool for providers and clearinghouses to have as they plan and execute their testing strategies,” said CE Executive Director Tim McMullen.

2nd-cecosesola-washington-cooperative-exchange

Solution

Payers begin to offer incentives for user's digital health data

Validic, Sponsored

Health plans are helping increase the value of digital health data for providers and patients

September 29, 2015

Health plans need digital health data. That is a given.

With such massive, diverse member populations, payers have realized they can no longer rely on simply averaging data from their independent information systems to affect cost and quality of care. They need a more personalized approach to help their members and have found a way to do so with provider-and patient-reported digital health data. By incorporating this data into a centralized repository, payers can analyze and use this information to create and improve their various member services. For example, in addition to supporting patient-specific care-management models, integrated data could enable the creation of wellness programs, preventive or disease-management care initiatives or even health-coaching programs. This personalized data can go beyond incentivizing and motivating healthy lifestyles; it can also help payers increase member engagement, a critical objective for many health plan providers.

Some obstacles that may have prevented payers from using digital health data in the past have recently been broken down. For example, some technology companies now offer a "one-to-many" cloud-based data-integration platform that enables providers and patients to input digital health data through disparate wearables, applications and devices. This enables payers to then access and analyze the data via a singular, integrated platform. Legislative changes have also helped break down barriers. For example, the benefits of using digital health data in healthcare are explicitly highlighted in the Affordable Care Act and in recent updates to Medicare reimbursement rules.

However, despite these advancements, health plans have realized that they also need providers and patients to buy-in for the information to be robust enough to be analyzed and used for improved patient care.

So, just as providers have been financially incentivized to use various technologies in their practice, payers now are monetarily rewarding them for integrating digital health data. For example, financial incentives, such as bonuses, preferred pricing and tiered models are common health-plan tactics to help drive providers toward incorporating digital health data into their practice. Further, payers also are offering financial rewards to providers for utilizing such technologies as high-speed networks and large data repositories, as these would enable ease of digital data collection and sharing.

Health plans can now collaborate with providers to incorporate patient information into a central source of aggregateclinical data, biometric data and other data.  Such information can be used to not only improve care and lower costs, but also to create health information exchanges, and offer further clinical analytics.

Health plans also are using financial incentives to attract their members to joining digital health data programs. The carrot approach for members includes offers of cash, gift cards, premium reductions or other merchandise for using various devices, applications or other programs to record their health data. Such financial incentives can encourage members to take ownership of their healthcare by engaging in digital health data programs.

And in return, health plans offer their members a consumer/member-friendly dashboard that contains more robustanalytics and insights into their general and specific health trends over time, predictive analysis and other programs in the hopes that they will continue to be engaged in their care -- and in using digital health data technologies.

About Validic:

Validic is the healthcare industry's leading digital health platform. Validic provides convenient and quick access to patient data from mobile health and in-home clinical devices, wearables and applications. By connecting its growing base of customers -- that includes providers, pharmaceutical companies, payers, wellness companies and health IT companies -- to the continuously expanding list of digital health technologies, Validic enables organizations to better coordinate care across their communities, improve their patient engagement strategies and more efficiently manage their patient populations.

Topics: Analytics, Clinical, Patient Engagement, Affordable Care Act, Medicare, Clinical

Technologies With Positive Growth Potential

"While the EMR market itself is pretty saturated, and usage has really improved since the HITECH Act, the challenge for hospitals and health systems is, now that you have all this data, what do you do with it?" says Matt Schuchardt, director of market intelligence solutions sales at HIMSS Analytics.

There's no shortage of technologies out there to help hospitals improve operations. But it may surprise you to realize how relatively untapped they often still are.

Bed Management

Remaining first-time buyers: 49.7 percent

Business Intelligence

Remaining first-time buyers: 40.3 percent

Data Warehouse

Remaining first-time buyers: 39.7 percent

Dictation with Speech Recognition

Remaining first-time buyers: 44.4 percent

Enterprise Master Person Index

Remaining first-time buyers: 39.6 percent

Summary

" ClaimPay* is dedicated to the management of the revenue cycle of any medical specialty, office, or clinic looking to outsource billing to a third party company."

Company Summary

ClaimPay* brings a doctors most needed resources to the table. We set out to increase profitability, with 10% to 35% more claims paid. Bringing accounts receivable up while decreasing accounts payable, allowing growth within the company and community. By effectively managing the revenue cycle we get the Doc paid.

These procedures include: Working directly with the insurance company. healthcare providers, and patients to get a claim processed and paid with in the minimum time expected.

As well as, handling all aged and collection accounts to insure balance is paid in full, with little write off's and with analytical report, showing the differences ClaimPay* has on your bank account. This allows the Physician more time to preform the quality care needed and is less of a hassle for the HR department.

CAQH CORE Announces New National Healthcare Operating Rules

CAQH CORE Announces New 

National Healthcare Operating Rules

Health plans, healthcare providers, and the clearinghouses and vendors that support them, now have national operating rules to improve how they can work together as trading partners. The voluntary operating rules will help streamline the electronic data exchange of four more healthcare business transactions: healthcare claims; prior authorization; employee premium payment; and enrollment and disenrollment in a health plan.

CAQH CORE recently announced that the Phase IV CAQH CORE Operating Rules package has been approved and the industry should begin coordinating voluntary implementation. Reaching this milestone is the result of enormous effort by the multi-stakeholder CAQH CORE collaboration, which includes a wide range of public and private entities.

Continue reading..

Common Grants

• Agua Fund, Inc
• Herb Block Foundation
• The Morris & Gwendolyn Cafritz Foundation
• Carter & Melissa Cafritz Charitable Trust
• Naomi & Nehemiah Cohen Foundation
• Consumer Health Foundation
• Lois & Richard England Family Foundation (invited proposals only)
• Fight For Children
• Corina Higginson Trust
• The Jovid Foundation
• International Monetary Fund
• J. Willard & Alice S. Marriott Foundation
• The Claude Moore Charitable Foundation
• Morningstar Foundation
• The Curtis & Edith Munson Foundation
• Prince Charitable Trusts
• Washington Gas
• The World Bank

"Pitch Deck"

Management Team

I am going to get the business started, and secure clients for myself through marketing and word of mouth. As ClaimPay* becomes established, I will hire staff as needed. i will provide the proper training and equipment needed for each hired on to also start a home based office. This will open the doors to a variety of people to join today's working class and help boost the local economy. With the experience and knowledge I have gained from previous employment, I will be of great support to the struggles many see within the billing cycle. I will follow a complete step by step structured guide line that is set with in the binding laws and regulations of Washington State, Department Of Health, and HIPPA's Privacy Practices. 

Customer Problem

ClaimPay* is a resolution specialist providing services to Medical Doctors, Physical Therapists, and Doctors of Chiropractics, who are paying out more than they are bringing in. Our services solves any billing issues with CPT or ICD-10 coding, data entry, claim submissions, claim follow ups, and collection accounts and will quickly gets you paid. Guaranteed or the next month of services will be free.

Products & Services

ClaimPay* will provide end to end billing needs, such as, patient intake, scheduling, data entry, coding, insurance verification, claim submission, payment posting, collections, and analytical reporting. We will offer customized service options, allowing you to make the right fit for you company's needs. There will be constant contact and open communication with the providers administration and with the patients. Our dedicated and supportive staff will be their to assist in the fine details of the entire billing process. Reducing headaches and easing the tension within your office. Our job is to get you paid for the services provided as quickly as possible. Providers will benefit from our services from the notable growth rate in there services paid for, which brings their net worth up, and their ability to concentrate more attention to the patients needs, and their plan of care.

Target Market

ClaimPay* is a home based office that is located in Kelso, WA. Serving the greater part of Cowlitz County and surrounding areas. 
Our targeted market is any medical providers who wants to outsource their billing department to cut costs and increase profits considerably. 
Our goal is to contract with local providers to improve revenue with in our community.

Customers

Our customers will be smaller medical offices who are seeing a shortage in account receivables from payments from insurance company's due to error rejections, denials, and ineffective follow ups from the in house billing departments and have a high average of unpaid aged accounts. We will increase profitability within one month guaranteed.

Sales & Marketing Strategy

ClaimPay* will have prices that will beat all competition and services of today's going rate for outsourced billing companies. The services we provide will be top priority for every customer we contract with. I will advertise on social media, become affiliates with the local medical associations and attend chamber of commerce meeting to get the word out. You will be happy with our services and see a boost in profits by the end of the first month guaranteed or the next month of our services are free.

Business Model

First rate, top of the line communication between the clients and insurance agency, along with highly detailed, organized and effective management skills ClaimPay* will gain 100% of its clients trust with fast and timely responses and quick turn around time for payments. At a considerably lower cost than having an in-house billing department and all competitors locally.

Competitors

Locally there is only one outsourced Medical Billing Office, that I have found and other than that there are several up north. The biggest issue will be selling my services to offices that are already using in house billing department and getting them to be willing to switch to an outsourced billing company.

Competitive Advantage

With a highly detailed and efficient mind set ClaimPay*s goal is to preform top notch service with error-less claim submission allowing a fast turn around time for payments, at an extremely lower cost than all competitors. We want to gain the trust of our customers by showing them that outsourcing really is the best option for their billing needs. 
We use the best technology and the highest reviewed clearing houses found, as well as, actively research the going rates for services provided and adjust our prices, to lower than any of our competition. The point is to gain the trust of providers, so that they continue to outsource billing needs to us, which will allow ClaimPay* to thrive and grow into a more nationally known company. 
It is known that more than 50% of home workers are able to put 25% more time and effort in to the job to get it done, and that will be shown consistently by the improvements in your company bank accounts.

Healthcare Technology Vision 2015

That's according to a new Accenture report, Healthcare Technology Vision 2015, which lays out five key trends in the industry that show adaptation might be the best business model.

First, Accenture analysts are calling it the "platform revolution" – that is the ever-increasing ubiquity of mobile and cloud platforms that far surpass merely the ability to track in real-time a patient’s health. Rather, this is a platform that addresses interoperability, "that captures the data from disparate sources such as wearables, phones and glucometers, and pulls it all together to give a patient and caregiver a holistic and real-time view of the patient's health," they write.

[See also: Healthcare to enter 'third wave of digital'.]

The second trend, as the report emphasizes, is around the "outcome economy." In other words, "it's about delivering results." Hardware, nowadays, brings with it new intelligence. Better intelligence than ever before. And that's going to make patient data accessible with a mere click. It's going to give patients the convenience, and it’s ultimately going to lead to better outcomes, according to the report.

The third trend is around data, what's billed in the report as the "intelligent enterprise" – essentially a "data explosion" that will lead to tremendous clinical outcomes opportunities.

In fact, big data has gotten so big that some 41 percent of healthcare executives say the data volume their organization manages has increased by a whopping 50 percent just from a year ago.

Tomorrow, Accenture officials say, this trend will turn into an EMR including a "lifetime's worth of data"; it will be used regularly to predict ER visits. Consumers will be able to snap a photo of a skin rash and have a diagnosis shortly. Considering this trend, it may come as surprising that still only 28 percent of docs say they routinely use CPOE systems.

Coming it at No. 4 is the "Internet of me" trend – that is personalized medicine. And as more healthcare organizations invest in this technologies and system capabilities, they’re seeing positive results. In fact, an overwhelming 73 percent of health execs surveyed say they've seen ROI after investments in personalization technologies.

The last trend may make some feel a bit uneasy. And it's about the emergence of machines. It's the "workforce re-imagined." Think digital self-scheduling, sharing your own electronic medical record, training machines and connecting with physicians via social platforms.

According to Accenture data, 66 percent of health systems in the U.S. will have self-scheduling by the start of 2020. And nearly half of health execs strongly agree that within three years, they'll need to focus on training machines just as much as training employees. What does this mean exactly? Just think algorithms, machine learning and intelligent software.

"Patients can actually begin to care for themselves – relieve the burden of the delivery system and get a better result," says Kaveh Safavi, MD, global managing director of Accenture's healthcare business, in a video announcing the report. "That's truly workforce reimagined, because now you've made the patient part of their own care-giving team, and the technology makes it possible."