HHS Announces FINAL Rule for ICD-10 Compliance Date and HPID

Health and Human Services has announced a Final Rule that confirms the proposed extension of the ICD-10 compliance date to October 1, 2014.

The Final Rule also establishes a unique health plan identifier (HPID), as well as a unique identifier for other entities (OEID), and modifies the NPI Rule to include pharmacy prescribers.

The Final Rule establishes these important dates:
• Health plans, with the exception of small plans, must obtain an HPID by November 5, 2014
• Small health plans must obtain an HPID by November 5, 2015
• Covered entities must use HPIDs in the standard transactions on or after November 7, 2016

The changes to the NPI rule become effective May 6, 2013.

HIPAA Simplified Expanded to Include ICD-10, other upcoming HIPAA and ACA Regulations

Emdeon’s HIPAA Simplified website (www.hipaasimplified.com) has been expanded to address ICD-10, as well as other upcoming regulations enacted by HIPAA and the Patient Protection and Affordable Care Act of 2010 (ACA).

New Section added for ICD-10:
We have added a new section for ICD-10 that includes Emdeon Clearinghouse FAQ’s. Emdeon’s ICD-10 Program Playbook will also be published in the near future, offering our customers an in-depth look at Emdeon’s ICD-10 strategy. The playbook will include:

• An overview of ICD-10, important facts and key changes between ICD-9 and ICD-10
• Guiding principles and governance of our ICD-10 program
• Emdeon’s ICD-10 implementation timeline
• Plans for customer messaging and communications
• Information on trading partner testing

To access the ICD-10 page, click the ICD-10 link from the HIPAA Simplified home page. Alternately, you can go directly to the ICD-10 page using the URL http://www.emdeon.com/5010/icd10.php.

Operating Rules:
The Patient Protection and Affordable Care Act (ACA) of 2010 requires The Department of Health and Human Services (HHS) to adopt operating rules for the HIPAA transactions. The first of these regulations, concerning the health plan Eligibility/Benefit and Claim Status transactions was issued in July 2011, with a compliance date of January 1, 2013.

The Operating Rules page of HIPAA Simplified presents frequently asked questions about the regulation and Emdeon’s readiness to keep you updated regarding this important milestone.

As an industry leader, we are committed to helping our trading partners successfully navigate the HIPAA and ACA regulatory timeline. Emdeon intends for HIPAA Simplified to be an evolving site and valuable resource for our customers.
Bookmark HIPAA Simplified and check back often!

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Medicare Payment Reduction on Tap for Physicians Who Don’t ePrescribe

Providers who have yet to participate in Medicare’s Electronic Prescribing (eRx) Incentive Program better get moving.

The program (authorized under the Medicare Improvements for Patients and Providers Act of 2008) provides for payments to eligible professionals, including physicians and group practices, equal to one percent of their total estimated Medicare Part B Physician Fee Schedule-allowed charges. However, it also called for a payment adjustment for covered providers who are not yet successful ePrescribers.

It’s not just the incentives and payment reductions that should propel providers into action (see chart). ePrescribing provides a host of benefits, such as driving greater efficiency by reducing paperwork and increasing medication dispensing accuracy. ePrescribing also provides additional patient safety measures missing from manual processes. The Journal of the American Medical Informatics Association reported in a 2007 article that more than one million serious drug errors occur in U.S. hospitals annually. Many ePrescribing technologies include medication reconciliation modules that allow providers to see prescription histories and reconcile medications at the point of care. Enabled ePrescribing systems can capture up to 95 percent of patient medication information, far more than what is revealed during patient interviews.

As a side note, CMS does realize that while a majority of physicians will easily comply with the incentive program, some will find it more difficult to ePrescribe. As a result, CMS will exempt individual eligible professionals and group practices participating in the ePrescribing program from the 2014 payment adjustments if requirements for becoming a successful electronic prescriber would result in a significant hardship. Providers will qualify for the exemption if they:

• are unable to submit electronic prescriptions due to local, state or federal law, or regulation;
• will prescribe fewer than 100 total prescriptions during the January-to-June reporting period;
• practice in a rural area without sufficient high-speed Internet access; or
• practice in an area without sufficient available pharmacies for electronic prescribing.

To request the hardship, individual eligible professionals and group practices must submit their significant exemption requests through the CMS Quality Reporting Communication Support webpage (https://www.qualitynet.org/portal/server.pt/community/communications_support_system/234). CMS will review the requests on a case-by-case basis.

Fortunately, eligible providers considering their next steps towards becoming ePrescribing compliant have access to many enabling tools such as Emdeon Clinical Exchange EHR Lite, a component of Emdeon’s Office Suite. As a certified EHR Lite, this solution combines routine administrative health information exchange with consolidated ePrescribing as well as electronic lab ordering and results distribution.

These tools are specifically designed not only to help providers qualify for Meaningful Use and the eRx incentive, but to drive clinician efficiency and improve patient safety—two of the most important and compelling objectives healthcare has been challenged to address.

To learn more about tools for achieving eRx compliance, please review information about Emdeon Clinical Exchange EHR Lite on the Emdeon website.

1 “Evaluation of Outpatient Computerized Physician Medication Order Entry Systems: A Systematic Review,” Journal of the Medical Informatics Association (JAMIA), July 2007.

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Look What’s New in Emdeon Office Suite!

Reporting & Analytics Update
Emdeon has added four new updates in Reporting & Analytics to help you better manage and evaluate your practice’s analytics data.

1. Improved Exporting of Large Reports—When pulling reports over 20,000 rows in Reporting & Analytics, you can export the report based upon the segment of the report you want. A pop up box will appear that allows you to click which segment you would like to export. To export multiple segments, click on each segment.

The following reports include this new functionality:
• Claim Summary
• File Summary
• Insured Detail
• Summary By Payer
• Summary By Payer By Day

Please note that the standard download save/print process for reports with less than 20,000 rows remains available.

2. Column Sorting—A new column sorting functionality is available in Reporting & Analytics reports. By clicking on the column header, you can sort columns in ascending and descending order. Similar to Microsoft’s Excel®, the report is sorted on the column in which the sort arrows appear in the column header. The new sorting functionality is available on most Reporting & Analytics reports.

3. File Status on Landing Page—An Acceptance/Rejection status column has been added to the Landing Page File Summary Status Report in Reporting & Analytics. If the file is rejected, you can click on the File ID link to view the Reject File report.

4. File Level Rejection Alerts on Landing Page—A new alert with File Status information is displayed on the Reporting & Analytics Landing page. This alert shows the number of rejected files for your user account for the specified date range. You are able to click the link to view the File Summary Report in more detail.

Learn more about these new features and more in one of our Emdeon Office Reporting & Analytics Informational Webinars held every Tuesday at 11am EDT/10am CDT.

Webinar Details:
Every Tuesday: 10am Central / 11am Eastern
Web access: www.emdeon.com/office-webinar
Audio access: 877.345.2580
Meeting number: 62791804

New Payers Added to Workers’ Compensation and Automobile Medical Bill Network
Emdeon Office Suite now has access to over 400+ Workers’ Compensation and Automobile Medical insurance payers. This increased access allows you to submit more Workers’ Comp and Auto Medical bills and attachments electronically, further reducing the need for paper attachment handling while improving the accuracy in your claims process.

Electronic submission of Workers’ Compensation and Automobile Medical claims helps you comply with applicable state mandates as well. Texas and Minnesota have already adopted legislation that requires electronic Workers’ Compensation and Automobile Medical claims submissions; other states are considering similar legislation. Emdeon Office Suite also enables electronic submission of required attachments to simplify the process even further.

Start processing your Workers’ Compensation and Automobile Medical claims electronically today and see how you can simplify your claims process.

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Five Top Tips for Improving Payment Collections

A Small Practice Whitepaper

Are you struggling with keeping your practice financially sound? It’s no wonder. Practices today are facing financial burdens never seen before in the healthcare industry. Medicare payments have decreased in favor of incentive-based programs and commercial payers are gradually shifting financial responsibilities to the patient, making it harder for you to collect on what you are owed.

Get the information you need to increase your collections in our latest Emdeon whitepaper, “Time-tested and practice-proven: Top tips for collecting payments”. We share our five best tips to keep your practice running successfully, encompassing all aspects of your patient’s visit from the first scheduled appointment to the final patient payment. We also offer insight into how to utilize today’s technology to measure and analyze your practice to keep you on track and your cash flow healthy.

The “Time-tested and practice-proven: Top tips for collecting payments” whitepaper is available now. Download it today!

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New Payer Transactions Added Recently

New payers on board with Emdeon. Take a look at the new list
We have recently added the following payers:
• Arbor Health Plan – Claims
• Arbor Health Plan – ERA
• Centene LA Healthcare Connection - ERA
• CNA - Claims and ERA
• Dallas Independent School District – Claims
• Dallas Independent School District - ERA
• Greater Covina Medical Group - Claims
• Harris County - Claims
• Harris County - ERA
• Innovative Healthware Systems – Claims
• Integrated Medical Solutions, LLC – Claims
• Martins Point Health Care - Claims
• Meadowbrook Insurance Group - Claims
• Meadowbrook Insurance Group - ERA
• Medical Associates Health Plan - Claims
• Mediview, Inc. – Claims
• Michigan Medicaid – ERA
• Network Health Plan of Wisconsin, Inc. - Claims
• Resolve Health Plan Administrators, LLC - Claims
• Security Health Plan - ERA
• Summit Administration Services, Inc. - Claims
• Wyman-Gordon Companies – ERA
• Xchanging, Inc – ERA
• Xl Environmental, Inc. – ERA
• Zachry Construction - ERA

For a complete list of the payers in our network, visit our website at www.emdeon.com/payerlists/

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See the full list >>