Health Information Technology

The American Recovery and Reinvestment Act of 2009 (ARRA) included incentives for health care providers to adopt Health Information Technology, most notably Electronic Health Records (EHRs). There are incentive funds for both Medicare and Medicaid providers.  Health Information Technology (HIT) makes it possible for health care providers to better manage patient care through secure use and sharing of health information. HIT includes the use of electronic health records (EHRs) instead of paper medical records to maintain people’s health information. Health care providers will have accurate and complete information about a patient’s health and a way to securely share information with patients and their family caregivers.  Community Health Centers have been leaders in the use of health information technology (HIT) for improved documentation, communications and clinical decision. With the increased emphasis on Meaningful Use and Quality Improvement metrics, CHCs have expanded their use of Electronic Medical Records, Patient Portals and Data Reporting Tools.  MPHCA has committed to programs and staff to assist CHCs with the implementation and use of HIT and information exchange.

Helpful Links: 

HealthIT.gov - Information and resources from HHS’ Office of the National Coordinator for Health Information Technology (ONC)

HRSA Health IT and Quality - Part of HHS, the Health Resources and Services Administration provides assistance directly to Federally Qualified Health Centers. 

NACHC Health Information Technology - This site provides tools and resources to assist health centers in the selection, implementation, and meaningful use of various health information technologies (HIT) from the National Association of Community Health Centers. 

Significant Guidance Released Regarding HIPAA Compliance The Office of the National Coordinator for Health Information Technology Guide to Privacy and Security of Electronic Health Information - BAKER DONELSON April 2015

Medical practices can expect an increase in medical claim denials after Oct. 1, 2015. But that doesn't have to mean that revenue will be lost. The Centers for Medicare and Medicaid Services (CMS) predicts denials could increase from 100 percent to 200 percent and lengthen accounts receivable cycles an extra 40 percent. The easy answer is to stockpile savings or get a line of credit so medical practices can last a couple months without reimbursements. Who can afford that? This is going to require attention and investment. Managing claim denials after Oct. 1 will require more than a response from a medical coders — especially if the denials could call into question medical necessity. Then physicians will need to spend time justifying the reimbursements. This is going to be the kind of query that bogs down productivity more than documenting the encounter will. Healthcare providers will need a denials manager who can track denials and communicate with healthcare payers. This is where early communication with payers becomes an investment. If staff have a contact person now, it's more likely they can reach someone who can deal with denials after Oct. 1. Denials managers need to be able to grasp the medical billing process and medical concepts. They need to understand why claims are denied so they can help correct deficiencies in clinical documentation or medical coding accuracy. End-to-end testing will be vital. It's a chance to identify problems and solve them before they hinder reimbursements. Testing will reduce surprises after Oct. 1. There also needs to be an effort to look for trends in denials. Trends can help healthcare providers understand how to submit medical claims properly. This is also why it's a good time to track denials and rejections.

You need to know if there's a problem first so track:

      • Days in accounts receivable by healthcare payer
      • Denial rates
      • Amount of reimbursements denied
      • If reimbursements match the contracted rates

As with productivity, you need to know what's "normal." That means now. Otherwise if you wait for Oct. 1, 2014, you won't know if the numbers reveal problems or business as usual. Bradley also suggests crunching these numbers weekly to keep small problems from becoming big ones at the end of the month. And who knows. Maybe tracking these metrics will reveal problems unrelated to ICD-10 coding that you can solve sooner than later. ICD-10 denial management starts now. Medical practices need to understand what triggers denials now and what could cause problems with ICD-10 claims. This will help prevent crippling reimbursement delays.

HHS OIG to Study Meaningful Use Payments and EHR Security

Two New Updates from HHS on the Meaningful Use of Health Information Technology

1) CMS Opens Electronic Health Record Incentive Program Registration

Effective January 3, 2011, registration is available to eligible health care professionals and hospitals who wish to participate in Medicare and Medicaid electronic health record (EHR) incentive programs.

Through Medicare, eligible professionals can receive up to $44,000 over a five-year period, and as much as $63,750 over six years under Medicaid. Under both programs, eligible hospitals may receive millions of dollars for implementing and meaningfully using certified EHR technology.

Registration in the Medicaid program is available in Alaska, Iowa, Kentucky, Louisiana, Oklahoma, Michigan, Mississippi, North Carolina, South Carolina, Tennessee and Texas.

Interested providers should visit CMS’ Official Web Site for the Medicare and Medicaid EHR Incentive Programs. The site provides general and detailed information on the programs, including tabs on the path to payment, eligibility, meaningful use, certified EHR technology, and frequently asked questions.

Eligible providers seeking to participate in the Medicaid programs must initiate registration at CMS’ registration site but complete the process through an eligibility verification site maintained by their state Medicaid agency. Questions about state launch dates should be directed to state Medicaid agencies. 

Those who meet eligibility requirements for both Medicare and Medicaid programs must select one program when they register. After receiving payment, they may change their program selection once before 2015. Hospitals that are eligible for both programs can receive payments from both Medicare and Medicaid.

2) ONC Issues Final Rule for Permanent Certification Program for Health Information Technology

The Office of the National Coordinator for Health Information Technology (ONC) has issued a final rule to establish the permanent certification program for health information technology (HIT). The permanent certification program provides new features that will enhance the certification of HIT, including increasing the comprehensiveness, transparency, reliability, and efficiency of the current processes used for the certification of electronic health record (EHR) technology. Meaningful use of “Certified EHR Technology” is a core requirement for eligible health care providers who seek to qualify to receive incentive payments under the Medicare and Medicaid Electronic Health Record Incentive Programs.

The temporary certification program, established through a final rule published on June 24, 2010, will continue to be in effect until it sunsets on December 31, 2011, or at a later date when the processes necessary for the permanent certification program to operate are completed. ONC expects to stand-up the programmatic activities necessary to implement the permanent certification program throughout 2011. 

2016 CMS EHR Incentive Program Requirements