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Health Information Management

Health Information Management

Expert analysis, advice, and education for health information managers to improve processes for coding and reimbursement, medical records management, HIPAA, and clinical documentation improvement and ensure compliance with regulatory requirements for hospitals, clinics, and physician practices.

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Top Stories

  • CMS continues shift to value over volume in 2016 IPPS final rule

    CMS finalized changes to multiple quality measures in the fiscal year 2016 IPPS final rule, released July 31.

  • Two-Midnight Rule: Initial Reviews to Resume

    Having taken time out for retraining and internal audits, contractors may resume initial-phase reviews of Medicare reimbursement claims for short-stay inpatient hospital care, CMS says.

  • AHIMA: HHS must standardize minimum necessary definition

    HHS must provide a clearer definition of the HIPAA minimum necessary standard, AHIMA president Melissa Martin, RHIA, CCS, CHTS-IM, testified at a subcommittee hearing.

    The National Committee on Vital and Health Statistics’ subcommittee on privacy, confidentiality, and security held a hearing June 16 to determine how HHS can improve its guidance on the HIPAA minimum necessary standard. The minimum necessary standard requires covered entities (CE) to use, request, and disclose only the minimum amount of protected health information (PHI) necessary for a given transaction. CEs cannot use, request, or disclose an individual’s entire medical record unless it can justify that the whole record is reasonably needed for a specific purpose.

  • OIG Recovers More Than $2 Billion in Civil Monetary Penalties This Year

    The Office of Inspector General (OIG) recovered more than $2.77 billion in civil monetary penalties (CMP) during the first half of the year, according to the office’s Semiannual Report to Congress, released May 31. The OIG expects that figure to continue to rise through the second half of the year.

  • Patients unable to access medical records after clinics close

    A chain of health clinics in New Mexico closed after filing for bankruptcy and left patients without access to their medical records, KRQE News 13 reported.

    Atrinea Health operated urgent care and family practice clinics in Albuquerque, Rio Rancho, Santa Fe, Los Lunas, and Ruidoso. The company filed for bankruptcy in 2015 and in March a federal judge ordered the company to shut down all its clinics and sell its assets.

    A patient advocate was appointed by the court to coordinate patients’ transition to other clinics and physicians. However, many patients said they have not received their medical records. Their new physicians have had to reorder tests that were recently performed by Atrinea Health clinics and complete new exams to document pre-existing conditions. In some cases, patients were left without access to prescriptions. Other former Atrinea Health patients reported that they received little or no advance warning that the clinics were closing and that it’s difficult to find physicians who are accepting new patients.

  • OCR clarifies flat fee for electronic copies of PHI

    The Office for Civil Rights (OCR) released a new FAQ in May clarifying the fees an organization may charge for copies of an individual’s PHI.

    Earlier this year, OCR released a series of documents providing guidance and clarification on 45 CFR § 164.524, Individuals’ Right Under HIPAA to Access Their Health Information. This information included guidance on how to calculate actual and average costs for requests for electronic copies of PHI, and stated that organizations may choose to charge a flat rate of $6.50 for this service. The wording in the documents caused confusion and some organizations may have been led to believe that $6.50 was the maximum amount they were allowed to charge for copies of PHI.

Quick Poll

What part of the ICD-10 transition has been most difficult for your facility?

  • 47%: Documentation lacking necessary detail
  • 20%: Decline in coder productivity
  • 19%: We haven't had any major issues
  • 5%: MACs denying claims due to LCD mistranslations
  • 3%: Software issues related to EHRs
  • 1%: MACs holding claims for manual review
  • « Back

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Spotlight

  • JustCoding’s ICD-10-PCS Medical and Surgical Root Operations Training Handbook

    JustCoding’s ICD-10-PCS Medical and Surgical Root Operations Training Handbook

    This book divides the 31 root operations in the Medical and Surgical section into nine groups of related root operations to make it easier for coders to learn the nuances in the definitions.

    Purchase this book from our HCMarketplace.