AMA resource: Electronic transaction responsibilities, enforcement

The health care industry increasingly has moved from paper and telephone communications toward electronic interactions for information exchange. Designed to eliminate idiosyncratic electronic communication methods by health insurers and reduce administrative burdens and financial waste in the industry, standard electronic transactions for exchanging information between physicians and health insurers were mandated under the Health Insurance Portability and Accountability Act (HIPAA).

Physicians can truly realize the intended efficiencies and savings of the HIPAA standard transactions only if health insurers become and remain compliant with the regulations. Because the enforcement process is based on complaints, physician practices need to understand health insurers' responsibilities and the enforcement avenues created by the regulations.

Click here (log-in required) to access an AMA resource that will help physicians understand and maximize the effectiveness of the standard transactions. This resource details the physician rights and health insurer responsibilities created by the HIPAA standard electronic transactions. It also advises physicians on how to respond when health insurers aren't properly adhering to the regulations. Additionally, the AMA offers an archived webinar discussing the specific rights created under the HIPAA regulation.

Click here to visit the AMA's electronic transaction compliance and enforcement webpage to access these resources and related information.

It's time to start testing with ICD-10; get started today

To help small physician practices prepare for the ICD-9 to ICD-10 transition, the Centers for Medicare and Medicaid Services are providing several testing opportunities. More information about End-to-End testing and Acknowledgement testing is below.

• Road to 10 Testing Information
• Medicare Fee-For-Service (FFS)-Testing Approach
• FAQs about End-to-End Testing

ICD-10 clinical documentation improvement webinar recording available

The Centers for Medicare and Medicaid Services recently collaborated with the American Health Information Management Association (AHIMA) to present a webinar on clinical documentation improvement. Watch the recording to learn about:

• Why detailed clinical documentation is important for the ICD-10 transition
• Steps for training your staff
• Additional resources and information

To access the recording, please click here to register for the webinar. Click here to view the webinar presentation and here to view ICD-10 FAQs on the AHIMA website. Click here to visit the federal CMS ICD-10 website for the latest news and resources to help you prepare.

AMA: Weigh in on new Practice Management System Accreditation Program

A new vendor accreditation program for practice management systems aims to reduce administrative burdens for physician practices by increasing vendor compliance with the standard electronic transactions and operating rules mandated by the Health Insurance Portability and Accountability Act (HIPAA).

The program was developed for organizations that electronically exchange health care data by the Electronic Healthcare Network Accreditation Commission (EHNAC), a non-profit standards development organization and accrediting body, alongside other industry stakeholders. The goal of the program is to establish a baseline set of functionalities and features for practice management system software and allow vendors to demonstrate their adherence to quality, privacy, and transactional and security standards.

Comments are due Feb. 10, when the public review and comment period for the draft Practice Management System Accreditation Program criteria will close. The AMA strongly encourages physician analysis and input from medical associations. Click here to visit the EHNAC website to review the program's draft criteria and submit feedback.

Medicare news: 2015 Part B fee schedules available

Novitas Solutions encourages physicians and their staffs to download the new 2015 fee schedules. Click here to access their new Fee Search and Download Tool for a quick, convenient way to download the files or search by a single code.

HCPF: Healthcare Common Procedure Coding System (HCPCS) procedure code updates for 2015

Colorado Medicaid implemented the annual 2015 Healthcare Common Procedure Coding System (HCPCS) deletions, changes, and additions effective for dates of service on or after Jan. 1, 2015.

Click here to view a bulletin from the Colorado Department of Health Care Policy and Financing (HCPF). Note that the bulletin is intended to notify providers of coding changes related to the 2015 HCPCS and Current Procedural Terminology (CPT) updates. Code descriptions are not contained in the bulletin.

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