Strategic Planning for Compliance with New Electronic Billing Requirements

Proposal for More Detailed Health Information in Billing Has Implications For Other Compliance Areas, Including Privacy, Quality, Research and Fraud

HHS proposed a fundamental shift in the way in which healthcare billing will be conducted to get more specific information on diagnoses and treatments. The new rules will substantially change the depth and content of one of the most fundamental resources in healthcare – medical billing information.

The rules will create new opportunities; but they also will pose new challenges.

By proposing adoption of Version 5010 of the X12 transaction standards and the International Classification of Diseases Tenth Revision (ICD-10), HHS necessarily has required compliance professionals to start a new conversation over the effects of billing on a wide range of other issues, such as patient confidentiality, coverage, fraud detection and quality management.

HHS was not shy about its intentions either. It specifically said that its proposal for new electronic transaction and code set standards would address a number of issues, including compliance with the HIPAA privacy rule and the transition to electronic health records.

The proposal already has come under some criticism for being too ambitious in the compliance deadlines of April 1, 2010 for the 5010 conversion, and Oct 1, 2011 for the use of ICD-10. There are massive hidden changes that must occur for ICD-10 to be used effectively.

Regardless of the workability of the deadlines, these standards or some version of these standards are coming and should affect your short and mid-term planning.

The proposals should prompt healthcare executives and policymakers to start examining the many strategic policy and implementation issues raised by inevitable transition to greater detail in health claims billing.

To assist healthcare organizations, Melamedia, LLC, publishers of Health Information Privacy/Security Alert, is sponsoring:

Strategic Planning for Compliance with New Electronic Billing Requirements

Participants are briefed on:

• The key provisions of the two proposals to adopt new electronic formats and more detailed diagnostic and treatment descriptions;
• How the rules are related;
• The costs associated with the transition;
• Other compliance areas that will be affected, including privacy;
• What needs to be changed beside the technology;
• What to expect from electronic health records vendors;
• How these rules compare to previous HIPAA rules and implementations and where existing work can be used in the transition;
• Where to get necessary information to make decisions; and
• Much more.

Who Should Listen

The Faculty

Stanley Nachimson, Principal, Nachimson Advisors, is a former Senior Technical Advisor for CMS’s Office of Electronic Standards and Services where he led the development of HIPAA Security and Transaction Standard regulations and interpretations.

Dennis Melamed, Editor of Health Information Privacy/Security Alert, is an adjunct professor at the Drexel College of Medicine and the lead editor and writer of the three-volume HIPAA Handbook reference set.

Continuing Education Credits

• All seminar participants will receive a certificate of participation
• 1.5 IAPP Credits - Pending

CD Ordering

The CD recording with all course materials are excellent educational and briefing resources: $275

Download the form at http://www.melamedia.com/09_29_order.form.09.pdf and fax it to 703.619.4912