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Quest for Managing Cyberthreats in Healthcare

Author: Carey, Susan

Source: Journal of AHIMA

Publication Date: May 2017



So far 2017 is shaping up to be the year of fear in the realm of healthcare cybersecurity. There was a 61 percent increase in healthcare cyberattacks in 2016. This followed two years of steadily increasing cyberthreats in healthcare, including 93 major cyberattacks in 2016 resulting in com....

Are You Ready for a HIPAA Audit?

Author: Wiedemann, Lou Ann

Source: Journal of AHIMA

Publication Date: April 2017



Editor’s Note: The following is an excerpt from the new “External HIPAA Audit Readiness Toolkit” developed by AHIMA. The full toolkit is free for AHIMA members.


THE HITECH OMNIBUS Rule mandated that the US Department of Health and Human Services (HHS) condu....

How Small Organizations Handle HIPAA Compliance

Author: Primeau, Debra

Source: Journal of AHIMA

Publication Date: April 2017



Smaller healthcare facilities typically lack the resources and expertise to address the constant flow of competing priorities, forcing leadership to wear many hats in a fragmented environment. Few have a designated privacy, security, or compliance officer, let alone the corporate support s....

RAC Audit Underpayments: Does CMS Owe You Money?

Author: Eramo, Lisa A

Source: Journal of AHIMA

Publication Date: February 2017



Anxiety—it’s the emotion that looms over most patient financial services (PFS) directors and those working in health information management (HIM) when they discover that their organization’s claims are subject to a Centers for Medicare and Medicaid Services (CMS) Recovery....

Role of Coding and Documentation in the Quality Payment Program

Author: DeVault, Kathryn; Easterling, Sharon; Huey, Kim

Source: Journal of AHIMA - Coding Notes | Journal of AHIMA

Publication Date: January 2017



In the current era of healthcare transformation, the continuing importance of documentation and coding cannot be overstated. With the multitude of acronyms being added to the healthcare vocabulary, one may wonder where documentation and coding fits in. It’s important to remember that....

Provider’s Condensed Resource for Revenue Cycle, Coding Tools, and More

Author: Clack, Crystal; Freeman, Rae; Lewis, Laquette

Source: AHIMA practice brief | Journal of AHIMA

Publication Date: January 2017


A cyclone of regulatory requirements for providers has officially touched down in the United States. The Affordable Care Act (ACA), Medicare Access and CHIP Reauthorization Act (MACRA), patient-centered medical home (PCMH), and value-based purchasing (VBP) initiatives are contributing to dramat....

Clinical Validation: the Next Level of CDI (December 2016 update)

Author: Denton, Debra Beisel; Endicott, Melanie; Ericson, Cheryl E; Love, Tammy R.; McDonald, Lori; Willis, Daphne

Source: AHIMA practice brief

Publication Date: December 2016


One of the more challenging tasks for both coding and clinical documentation improvement (CDI) professionals is clinical validation. This is a relatively new responsibility that has evolved as CDI programs mature and CDI and coding professionals advance their knowledge and collaboration on clin....

Hospice Coding Left Out?

Author: Zastoupil, Shawna

Source: AHIMA newsletter article | CodeWrite

Publication Date: October 2016




Like many other healthcare settings, hospices are starting their journey into coding compliance. Before the first Federal Regulation (FY 2013), which addressed diagnosis coding clarification, hospices typically reported one code on their claims. Since that time, the Department of Heal....

What to Expect When Phase 2 HIPAA Audits Begin

Author: Rose, Angela Dinh

Source: Journal of AHIMA

Publication Date: June 2016



The HITECH Omnibus Rule mandated that the US Department of Health and Human Services (HHS) conduct periodic audits on the privacy and security compliance of covered entities and business associates. It was during the Office for Civil Rights (OCR) update session on March 21, 2016 at the 20....

Analyzing Eight Months of ICD-10

Author: Butler, Mary

Source: Journal of AHIMA

Publication Date: June 2016



Teachers know there are two kinds of students. Student A studies and does their assigned reading throughout the whole semester, earning extra credit where they can. When the final exam rolls up, they’re anxious but prepared—they did their homework. Student B, on the other hand, has the sa....

Nothing Lasts Forever: How Physicians Can Prepare for the End of the One-Year Amnesty from Post Payment Reviews Due to Unspecified Codes

Author: Lee, Christine

Source: ICD-TEN Top Emerging News | AHIMA newsletter article

Publication Date: May 2016




Just as ocean tides shift with the earth's gravitational pull, physician practice administrators align staff and focus resources to address their organizations' most pressing concerns. This year, the tsunami grabbing administrators' attention is the conclusion of a one-year grace peri....

Information Governance for Offsite Data Security

Author: Saharia, Devendra

Source: Journal of AHIMA

Publication Date: April 2016



Disruptive technology can turn any industry on its head—virtually overnight. Just five years ago, summoning a taxi was an inefficient, time-consuming effort that often involved dialing up a dispatcher, who contacted a driver, who would then make their way to your location, perhaps in an h....

Bringing Physician Practices into the HIM Fold: Guidance on Making a Smooth Transition and Ensuring the MD/Hospital/HIM Relationship Remains Mutually Beneficial

Author: Lee, Christine

Source: Journal of AHIMA

Publication Date: April 2016



According to the American Medical Association (AMA), physician practices continued a slow but steady transition toward hospital ownership in 2015. In their July 2015 study, the AMA reported a decrease in physician-owned practices alongside a continual increase in physicians working direct....

OCR Clarifies Policy on Medical Record Request Fees

Author: Greene, Adam H

Source: Journal of AHIMA

Publication Date: April 2016



In 2009, CONGRESS passed the Health Information Technology for Economic and Clinical Health (HITECH) Act, which granted individuals a right to have a copy of their records sent to a third party, according to 42 U.S.C. § 17935(e) of the regulation.


Unfortunately, many attorn....

Revisiting Unrelated Surgical Procedures (MS-DRGs 981-989)

Author: Wilson, Donna D

Source: CodeWrite

Publication Date: February 2016



Make a fresh start in the new year by revamping coding compliance plans to include a second level review of all claims that group into MS-DRGs 981-989 (Operating Room Procedure/Unrelated to Principal Diagnosis). Historically, MS-DRGs 981-989 have been "low hanging fruit" for outside audito....

Shifting from Reactive to Proactive HIPAA Audits

Author: Brinda, Danika

Source: Journal of AHIMA

Publication Date: January 2016



Stories about workforce members inappropriately accessing health information continue to plague the Department of Health and Human Services’ Data Breach Portal—which lists US provider data breaches that affect more than 500 individuals. Recently two data breaches reported on th....

What Lies Ahead in 2016?

Author: Hedges, Ron

Source: AHIMA blog post | Journal of AHIMA - website

Publication Date: December 18, 2015





This is the last Legal e-Speaking post of 2015. I thought I would use it to predict what 2016 might bring in litigation and beyond. When looking ahead to the next year, there are many possible things that HIM professionals should keep an eye out for, but five stand out to m....

DIY Privacy Risk Assessments

Author: Butler, Mary

Source: Journal of AHIMA - website

Publication Date: November 2015


The HIM Problem


Completing regular privacy risk assessments is one of the most proactive ways of preventing healthcare privacy breaches. However, finding helpful tools for these assessments is hard to come by.


The HIM Problem Solver: Sharon Lewis, MBA, RHIA, CHPS, CP....

Cybersecurity 101

Author: Lucci, Susan; Walsh, Tom

Source: Journal of AHIMA

Publication Date: November 2015



One of the most alarming statistics in the news, which is growing with intent and severity, is the prevalence of cyber-attacks, particularly in healthcare. It is an alarming trend that has gained a good deal of attention. For example, in July 2015, UCLA reported that up to 4.5 million pati....

Employee Confidentiality Training for the Electronic Health Record: A Systematic Review of Literature

Author: VanderMolen, Julia; Prince, Alesha; Neu, Emily; DeKraker, Rachael

Source: Educational Perspectives in Health Informatics and Information Management

Publication Date: October 2015


Abstract


Introduction: The healthcare industry is an ever-changing field, and in recent years, the introduction of the electronic health record (EHR) has enabled hospitals to store and retrieve detailed patient information for use by healthcare providers, and sometimes patients, d....

Evaluating the Information Governance Principles for Healthcare: Retention and Disposition

Author: Datskovsky, Galina; Hedges, Ron; Empel, Sofia; Washington, Lydia

Source: Journal of AHIMA

Publication Date: September 2015



Editor’s Note: This is the final installment in a series of four articles that discuss the eight Information Governance Principles for Healthcare™.


AHIMA’s Information Governance Principles for Healthcare™ (IGPHC) provide a framework for healthcare organizations to enhance....

Evaluating the Information Governance Principles for Healthcare: Compliance and Availability

Author: Datskovsky, Galina; Hedges, Ron; Empel, Sofia; Washington, Lydia

Source: Journal of AHIMA

Publication Date: June 2015



Editor’s Note: This is the third in a series of four articles that discuss the eight Information Governance Principles for Healthcare.


AHIMA’s new Information Governance Principles for Healthcare (IGPHC) provide a framework for healthcare organizations to leverage informati....

Privacy Holes in the 'Hidden Healthcare System': Students' PHI-laden Education Records that are Stored and Shared Electronically Don’t Have the Same Safeguards as most EHRs

Author: DuBravec, Daniel A; Daigle, Matt

Source: Journal of AHIMA

Publication Date: June 2015



With student safety and privacy an increasing parental concern, school administrators nationwide are sitting on a powder keg of potential backlash because of a gray area of student privacy protections that Julia Lear, senior advisor for the Center of Health and Health Care in Schools at G....

Clearing the HIPAA Cobwebs: New ONC Chief Privacy Officer Lucia Savage Focuses on Balancing Privacy and Security with Expanding Interoperable EHR Exchange

Author: Dimick, Chris

Source: Journal of AHIMA

Publication Date: April 2015



The spiders of time have been hard at work on the US healthcare privacy and security rules, to the point that their place in health IT interoperability has become fogged and is inhibiting their proper role in the meaningful exchange of health information, according to Lucia Savage, JD, th....

Evaluating the Information Governance Principles for Healthcare: Integrity and Protection

Author: Datskovsky, Galina; Hedges, Ron; Empel, Sofia; Washington, Lydia

Source: Journal of AHIMA

Publication Date: April 2015



Editor’s note: This is the second in a series of four articles that discuss the eight Information Governance Principles for Healthcare.


AHIMA’s new Information Governance Principles for Healthcare (IGPHC) provides a framework for healthcare organizations to enhance their ab....

OIG Reveals Top Oversight Priorities for 2015

Author: AHIMA Advocacy and Policy Team

Source: Journal of AHIMA

Publication Date: March 2015

OIG's 90-page work plan for fiscal year 2015 (FY15) offers a high-level view of the office's continued monitoring of various HHS programs and initiatives, particularly those designed to ensure the appropriateness of Medicare and Medicaid payments. The work plan also outlines many of the government's activities in FY15 designed to ensure care quality and safety in hospitals and other healthcare settings.

ABCs of Health Plan Audits

Author: Crump, Dawn; Hennum, Jeannie

Source: Journal of AHIMA - website

Publication Date: March 2015



The Affordable Care Act (ACA) has a dramatic ripple effect on the healthcare industry—and will continue to create seismic shifts for many years to come. One important change for health information management (HIM) professionals to understand is the impact of ACA on health plan audits. Alre....

Recovery Audit Program Changes

Author: Wilson, Donna D

Source: CodeWrite

Publication Date: February 2015



Editor's note: The Centers for Medicare and Medicaid Services (CMS) has delayed the commencement of work under the Recovery Audit contract for durable medical equipment (DME), home health (HH), and hospice reviews. For more information and further updates on this new development, please s....

Evaluation of PHI Hunter in Natural Language Processing Research

Author: Redd, Andrew; Pickard, Steve; Meystre, Stephane; Scehnet, Jeffrey; Bolton, Dan; Heavirland, Julia; Weaver, Allison Lynn ; Hope, Carol; Garvin, Jennifer Hornung

Source: Perspectives in Health Information Management

Publication Date: January 2015


Abstract


Objectives: We introduce and evaluate a new, easily accessible tool using a common statistical analysis and business analytics software suite, SAS, which can be programmed to remove specific protected health information (PHI) from a text document. Removal of PHI is import....

Industry Awaits Phase 2 of HIPAA Audit Program

Author: Asmonga, Donald D.

Source: Journal of AHIMA

Publication Date: January 2015



The wait for the second round of mandated privacy and security audits from the Department of Health and Human Services’ (HHS) Office for Civil Rights (OCR) continues. OCR is currently working through final details for the revised audit plan as they await finalization of new technolog....

Work Plan Fiscal Year 2015

Author: U.S. Department of Health and Human Services. Office of the Inspector General

Source: Government (U.S.)

Publication Date: October 2014

This report forecasts areas of OIG focus based on the results of OIG’s risk assessments and have been identified as significant management and performance challenges facing HHS. In FY 2015 and beyond, we will continue to focus on emerging payment, eligibility, management, and IT systems security vulnerabilities in health care reform programs, such as the health insurance marketplaces.

Coping with Government Audits

Author: Butler, Mary

Source: Journal of AHIMA - website

Publication Date: August 2014





The HIM Problem: Medicare Auditor Scrutiny of Inpatient Claims


This spring, the Centers for Medicare and Medicaid Services (CMS) issued its “two midnight rule” which was intended to define and clarify what Medicare considers to be criteria justifying an inpatient st....

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