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Editor's e-Note
Are you confused by the rules governing privacy and data protection? Who isn’t, right? If you’re not sure where HIPAA ends and the Federal Trade Commission regulations take over, you may want to check out this month’s E-News Exclusive, which gives a succinct explanation of why consumers should be paying attention to the health data they’re downloading to apps and similar tools.

This edition of the newsletter also includes a brief wrap-up of the recently completed AHIMA20 Virtual Conference.

Lee DeOrio, editor
e-News Exclusive
Three Reasons Tougher FTC Breach Notification Rules Make Sense
By Charles Stellar

Much can change in a decade, which is why the Federal Trade Commission (FTC) earlier this year put out a request for comments regarding the Health Breach Notification Rule.

Not many people outside health care likely are aware of the FTC breach notification rule, which sets parameters for data breaches in areas not regulated by HIPAA, including personal health records (PHRs), PHR-related entities, and third-party service providers.

Since the rule went into effect in 2009, just three companies have submitted FTC health breach notifications that affected a total of 570,000 records. Compare that with the HIPAA breach portal maintained by the Office of Civil Rights within Health and Human Services. During September 2020 alone, 81 reports were listed that affect 9.2 million patient records.

But protecting both patient health data through HIPAA and consumer health care through the FTC are critical considerations to keep data private.

Full story »
AHIMA Adapts With Aplomb
By Lee DeOrio

Only days ago, AHIMA wrapped up what could be reasonably called its most unique annual conference ever. Instead of a crowded exhibit hall, chatrooms were filled with attendees who wanted to share stories. In fact, the ability to communicate as presenters were, well, presenting was a neat feature that offered insight as well as a bit of humor. It even afforded presenters who taped their session the chance to “mingle” while speaking.

If someone were to take a crack at describing the conference’s theme, their thought process could very well land on “data accuracy.” No matter whether it’s coding, documentation, or patient identifiers, accurate medical records hold great power in the quest to provide quality patient care. Perhaps nothing exemplifies this overarching emphasis than the inclusion of a session titled “Making Data Accuracy Fun.” Amy Richardson of Haugen Consulting Group spoke about her efforts to get an organization to overcome the dread of all-day webinars to actually enjoy the process of making data more accurate.

Read more »
Products & Services
WENO Exchange Launches HIPAA Tool for Small Practices
WENO Exchange announces the availability of HIPPA Simplified, a condensed cyber security privacy and security manual to address HIPAA for small businesses that have access to protected health information. It focuses on how to manage compliance without having to read thousands of pages or multiple manuals with confusing information or esoteric theories. HIPPA Simplified incorporates all of the policies and procedures for employees and business associates in a condensed, easy-to-follow manual that is less than 30 pages. Chapters are organized by HIPAA regulations and includes forms that can be used or improved upon. WENO Exchange’s HIPPA Simplified can be purchased online for $350. It comes with an online orientation meeting and six months of e-mail support. Learn more »

Hayes Launches Revenue Optimizer
Hayes has launched Revenue Optimizer to equip health care organizations with actionable insights that help eliminate barriers to revenue integrity and manage overall financial performance. Integrated with MDaudit Enterprise, Hayes’ revenue integrity software platform, Revenue Optimizer leverages natural language processing and augmented intelligence technologies to improve management of a health care organization’s overall financial performance. It tracks the case mix index, elective surgery trends, and average lag days from denial resubmission to adjudication, year-over-year, and year-to-date trends for Medicare and commercial payers, detecting data anomalies and outliers that are barriers to revenue integrity. It also monitors and predicts denial trends by various functional areas, such as patient access, coding, compliance, and patient financial services, over multiple years to enable better management of revenue risks. Revenue Optimizer tracks hierarchical conditional category– and COVID-19–related denials to maximize value-based reimbursements and integrates with audit workflows so corrective action can be taken to accelerate cash flow. Learn more »

AHDPG Debuts New Online Training Program
The American Healthcare Documentation Professionals Group announces the availability of its newest online training program, Medical Practice Administrator. The program is designed for individuals seeking to launch a career in health care or individuals currently working in health care who are interested in taking their next career step. This Medical Practice Administrator Online Training Program teaches fundamental skills for managing a physician’s practice. This course will discuss the requirements of managing the revenue cycle, compliance regulations, human resources, health information, and general business processes that make practice management a challenging yet rewarding profession. This program is delivered completely online with Instructor support. Students can complete coursework in as little as three to four months. Learn more »

WEDI Delivers a Pair of Industry White Papers
WEDI announces the release of two industry white papers, each focusing on key issues impacting the current health care climate: “Incorrectly Routed Payments and Remittance Advice” and “Value-Based Payment Models.” Authored by the WEDI Remittance Advice and Payment Subworkgroup, “Incorrectly Routed Payments and Remittance Advice“ offers guidance for payers and providers on situations that occur when electronic health care claim payments and/or remittance advice are routed to a receiver incorrectly, potential causes, and best practices to remedy the situation.

The WEDI Payment Models Workgroup released the first in an ongoing “Did You Know?” series with “Volume One – ‘Value Based’ Payment Models.” The 16-page document addresses a variety of topics, including the difference between value-based care and value-based purchasing or value-based payment, why value-based payment trending is accelerating, why the economic model must change, whether there’s an industry standard framework to gauge value-based payment characteristics and common models, whether interoperability plays into value-based payment, and “shared savings” and “bundled payments” examples of value-based payment models.
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In this e-Newsletter
Recently in For The Record
A Tangled Mess
Tasked with learning on the fly, coders have run into road bumps in an attempt to fully capture COVID-19 conditions. Read more »

The ICD-11 Clock Is Ticking
The next version of coding’s bible is lined up and ready to make its presence felt in the not-too-distant future. Read more »

Eliminating the Problems From Problem Lists
Improperly maintained problem lists can become cluttered with outdated or redundant information of little clinical value. Read more »

Strategies for Filling the CISO Role
How should organizations approach the Security Personnel standard, which requires every covered entity to identify one person who is operationally responsible for ensuring that the organization complies with the Security Rule? Read more »
Other News
New York State Widow Accuses Hospital of Withholding Husband’s Medical Records
A woman has filed a lawsuit against HealthAlliance Hospital and Ciox Health, accusing them of withholding the records she needs for a separate malpractice lawsuit against the hospital, reports the Times Herald-Record.

Can EHR Natural Language Processing Detect Opioid Misuse Codes?
When assessing probable opioid use disorder using EHR documentation, human reviewers were able to identify more patients than a natural language processing algorithm, according to EHRIntelligence.
Industry Insight
AMA Announces New CPT Codes for Multivirus Tests to Detect COVID-19 and Flu

The American Medical Association (AMA) recently published an update to the CPT code set that includes new code additions and editorial revisions for reporting medical services sparked by the public health response to the COVID-19 pandemic.

The update to the CPT code set was approved by the CPT Editorial Panel, the independent body convened by the AMA with authority to review and approve proposed additions and revisions to the CPT code set. The new additions and revisions to the CPT code set have been approved for immediate use.

“Two of the newly approved codes report nucleic acid assays that allow a single test to simultaneously detect the novel coronavirus and a combination of common viral infectious agents, including influenza A/B and respiratory syncytial virus,” says AMA President Susan R. Bailey, MD. “Concurrent detection promises to conserve important testing resources, allowing for ongoing surveillance of influenza while testing for the novel coronavirus.”

Read more »
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