A typical standard operating procedure in many practices when adding a new physician is to phase in his/her schedule as s/he becomes credentialed by each payer. Traditionally, new physicians have been able to see Medicare patients immediately due to the Medicare guideline that allowed for a practice to retro-bill for Medicare patients seen before (up to 27 months, actually) the doctor was officially credentialed.
Now all that has changed, and starting April 1, 2009, practices can only retro-bill for Medicare patients seen 30 days prior to the date the credentialing form was filed (if it was ultimately approved.) What are the implications of this? (more…)
The Medical Home, also called the Patient-Centered Medical Home, and the Personal Medical Home, is a movement to solve the problem of fragmented care (one hand doesn’t know what the other is doing) by having a primary care physician or practitioner act as the center of all care information for the patient. Fragmented care is dangerous (lack of coordination of care causes mistakes and mistreatments), costly (repetition of diagnostic tests and regimens), and wasteful of healthcare resources. The Medical Home plan goals are to provide care for all individuals, improve care, and decrease healthcare costs.
“Crossing the Quality Chasm: A New Health System for the 21st Century” was published in 2001 by the Institute of Medicine. In this landmark book, the patient’s role and responsibility for navigating the healthcare system and acting as the information hub around which the spokes of primary, specialty and tertiary care providers revolve was denounced (more…)
What a wonderful, crazy time this is, both in healthcare and in my life. I can hardy keep up with either!
First, some changes to my website/blog. I’ve added a few new pages to house special resources, but I don’t have them connected to RSS or email yet, so for the time being readers will need to check out these pages on the bar at the top of the page to see what’s new:
- The Library will house links and documents. Right now it houses links, but documents are coming soon. If you have documents you’d like to share, or some you’d like to see posted on this page let me know.
- Dictionary (will be available soon) is a collection of definitions of words used on this site and is a quick reference for readers. It works two ways. You can go to the page to look up a word alphabetically, and my wonderful tech guy has set it up so the definition of any word in the Lexicon shows up any time you roll over the word anywhere on the blog.
- Down the road I plan to…well, why ruin the surprise – stay tuned!
Second, yesterday my husband and I embarked on a cross-country trip from Seattle to Raleigh. We are relocating back to North Carolina as I continue my job search. If you’d like to hear about our travels, click on the last new page, Road Trip.
And third, Manage My Practice.com is closing in one year of blogging, 100 posts, more than 100 subscribers via email and RSS, and close to 100 visitors daily. I sincerely thank each of you for taking the time to visit my blog.
Selected by President Obama as his choice for National Coordinator for Health Information Technology Dr. Blumenthal will lead the implementation of a nationwide interoperable, privacy-protected health information technology infrastructure as called for in the American Recovery and Reinvestment Act.
An electronic, cumulative record of health-related information on an individual, drawn from multiple sources, that is created, gathered, and managed by the individual. The integrity of the data in the ePHR and control of access to that data is the responsibility of the individual.
Office of the National Coordinator for Health Information Technology. In 2004 the position was created by by Presidential Executive Order. In March 2009, President Obama appointed David Blumenthal, M.D., M.P.P. to the position. The primary purpose of this position is to aid the Secretary of HHS in achieving the President’s goal for most Americans to have access to an interoperable electronic medical record by 2014 (from the HHS.gov website.)
To qualify as a “meaningful user,” eligible providers must demonstrate use of a “qualified EHR” in a “meaningful manner.” ARRA defers to the secretary of Health and Human Services (HSS) to set specific guidelines for determining what constitutes a “qualified EHR”; however, it does specify that e-prescribing, electronic exchange of medical records, and interoperability of systems will be determining criteria. Starting in 2011, providers deemed to be “meaningful users” of EHR systems will be eligible to receive $40,000 – $60,000 in incentive payments paid out over five years in the form of increased Medicare and Medicaid payments.
(as defined by HIMSS- Health Information and Management Systems Society) -not yet defined for ambulatory care
The HIT components of the stimulus package ”” collectively labeled HITECH are:
- Funding to the Office of the National Coordinator of HIT (ONCHIT)
- HIT adoption incentives through Medicare and Medicaid reimbursement
- Comparative effectiveness research for the Agency for Healthcare Research and Quality (AHRQ)
- Funding for the Indian Health Service
- Construction funds for the Health Resources and Services Administration (HRSA) for community health centers
- Funds for the Social Security Administration to upgrade HIT systems
- Funding for the Veterans Administration
- The Department of Agriculture will receive telemedicine funding
- Funds to the National Telecommunications Administration for broadband to enable telemedicine.
The electronic record of health-related information on an individual that is created, gathered, managed, and consulted by licensed clinicians and staff from a single organization who are involved in the individual’s health and care (as defined by NAHIT, the National Alliance for Health Information Technology.)