GETTING READY FOR ICD-10

Transcription

1 GETTING READY FOR ICD-10 Karen Popa, RN, Director of Patient Financial Services Munson Medical Center Kelly Whittle, ICD-10 Program Lead Physician Network at Trinity Health A deadline that once seemed distant is now in sight: As of October 2014, health care providers will bill with ICD-10 codes versus ICD-9. To help physician offices in the five county region prepare, two surveys to assess education needs are in development and, based on the survey responses, a host of education and training materials will be made available in late 2013, said Karen Popa, RN, Director of Patient Financial Services for Munson Medical Center. What we are trying to do is make education readily available so offices and physicians don t have to spend a lot of time or money seeking education on their own, she said. The entire health care system is in the same place with respect to ICD-10. It is a monumental change and we all need help. The potentially over-whelming scope of the ICD-10 changeover has driven the need to assess exactly what educational materials physicians and their offices might need. Responses to the surveys one on medical necessity and the other on ICD-10 readiness will influence the education and training that will be developed over the next few months with Trinity Health, said Kelly Whittle, Interim ICD-10 Program Manager for Munson Medical Center, Cadillac, and Grayling. Through its partnership with Trinity Health, Munson has identified vendors such as Precyse Medical Management, which has a large catalog of role-based education that can easily transmit through HealthStream, she said. In addition to that, we will be creating webinars on demand, hosting regional meetings, and offering printed materials. Continued on page 3 FIRST STEPS GETS THE CONVERSATION GOING A program that is free to physician offices also has the bonus of helping physicians and providers meet Patient Centered Medical Home criteria. First Steps, part of Munson s Advance Care Planning (ACP) department, facilitates an uncomplicated approach to a complex conversation, said Jane Dinnen, RN, Advance Care Planning Program Coordinator for Munson Medical Center. When it comes to living well with or even without an illness, First Steps allows physicians to weave ACP discussions into the routine of good patient care, said Dinnen, who also trains health care professionals nationwide on behalf of the Michigan Coalition for Honoring Healthcare Choices. Once their goals are in place, subsequent treatment and therapy decisions make more sense to the patient. While ACP comes to mind during times of health crises often at life s end, First Steps is a resource for healthy adults age 50 and up and their health care agent(s), the person(s) they have named in their advance directive. Physicians simply refer their patients to ACP, and an outreach coordinator takes it from there, meeting with the family, ensuring legal paperwork is completed, and circling back with the physician s office. Susan Wischman, the Outreach Coordinator for ACP, said that the program s aim is to get the conversation going. Where physicians are concerned, our goal is to help with the heavy lifting, with no cost to offices or their patients, said Wischman. Wischman has counseled patients, their health care agent and families for more than 10 years on creating a robust power of attorney for health care. Our role, should the patient wish, is to craft a legally recognized advance directive, making sure the directive reaches all relevant parties and is updated appropriately. Continued on page 3 Page 1 Practice Pro March 2013

2 NEW HIPAA FINAL RULE STRENGTHENS PATIENT PRIVACY The Department of Health & Human Services (HHS) released its biggest set of changes to the HIPAA privacy and security rules with the recent unveiling of its long-awaited HIPAA Final Rule, also known as HIPAA Omnibus Rule and the HIPAA Mega Rule. The rule goes into effect March 26, 2013 and becomes enforceable for compliance on September 23, September is only six months away. In brief, the HIPAA Final Rule: broadens breach notification expands fundraising re-defines marketing expands research revises the Notice of Privacy Practices makes Business Associates directly liable for compliance expands a patient s Right to obtain a copy of their record in electronic format, in addition to other changes. POLICIES Rochelle Steimel Physician Practices will be most affected in three areas: policies, business associate agreements, and breach notification. Physician practices have just about six months to work through all the changes, revise policies, and train staff on implementing them. The following policies/notices must be updated by September 23, 2013: Notice of Privacy Practices First-time business associate agreements that satisfy the newly revised requirements of HIPAA with agencies that the Final Rule now defines as business associates Revised policy on breach notification and incident management: Breach notification will change from showing threshold of harm to conducting a formal risk analysis to demonstrate that there is a low probability that protected health information has been compromised; Compromised means that the PHI has been acquired, accessed, used or disclosed for non-job related purposes or for personal gain Revised fundraising and marketing policies (if your practice engages in fundraising and/or marketing) Revised policy dealing with disclosure of Personal Health Information (PHI) for remuneration (if your practice is engaged in sale of PHI) Revised policy on patient s right to access PHI that is held in electronic format Revised policy regarding disclosing immunization records to schools New policy regarding dealing with release of PHI to family of deceased patients who are not appointed personal representative, and release of PHI after 50 years or more Munson will be providing a template for the new Notice of Privacy Practices to make the updating process easier for physician offices. BUSINESS ASSOCIATE AGREEMENTS In addition, HIPAA Final Rule makes large changes to the Business Associate Agreements (BAA): All existing Business Associate Agreements will need to be updated and signed by both parties but there is additional time to accomplish this. The deadline is Fall However, any new BAA signed after March 26, 2013 must reflect the new HIPAA language. Business associates of covered entities are now directly liable for compliance with certain requirements of the HIPAA Privacy and Security rules requirement. Failure to comply with obligations such as designating a security official, conducting risk analyses, or conducting security awareness and training programs for all staff could result in civil monetary penalties. In some cases criminal penalties may also apply. Expanded definition of who is a Business Associate to include the following: Subcontractors, Entities Providing Data Transmission Services, Document and Data Storage Organizations, Personal Health Record Vendors, and Financial Institutions Lending to the Health Care Industry. Continued on page 3 Page 2 Practice Pro March 2013

3 FIRST STEPS GETS THE CONVERSATION GOING Continued from page 1 About 50 percent of Munson patients say they have advance care directives. The national average is 23 percent, said Dinnen. We follow the whole process through to ensure the patient s exact wishes are in the hands of those who need to know, she said. It s the right thing to do financially, morally, and ethically. It s patient-centered, but is off the physician s shoulders because it s a referral system that works for them to meet their needs. Advance Care Planning will be surveying primary care physician practices to better understand how they can help PCPs meet Patient Centered Medical Home criteria. To learn more about Advance Care Planning or to schedule an informational session about First Steps for your office, contact Susan Wischman, ACP Community Outreach Coordinator, at (231) ; swischman@mhc.net. Susan Wischman and Jane Dinnen NEW HIPAA FINAL RULE STRENGTHENS PATIENT PRIVACY Continued from page 2 Your BAA contract with third party vendors will need to clarify who writes the Breach Notification letter to the affected individuals and who notifies Health & Human Services. BREACH NOTIFICATION Practices will most directly feel the impact of the change in breach notification. An impermissible use or disclosure of protected health information is now presumed to be a breach unless it can be demonstrated that there is a low probability that the protected health information has been compromised. A risk analysis will need to be done for all breaches. This rule change will likely result in more breaches being reported to the patient and Health and Human Services, something each physician office will want to avoid. Staff, already quite HIPAA savvy, should be extra cautious to avoid access or disclosure of patient information unless it is job related or otherwise permitted. New breach notification rule provisions will change the way practices, and their business associates, assess breaches. The new standard of risk analysis for compromised data does not replace the threshold of harm standard for breaches until Sept Look for more information on the new HIPAA Final Rule in future issues of Practice Pro. Together, we will continue to build our culture of compliance. For HIPAA questions or privacy concerns, contact Rochelle Steimel, Munson Privacy Officer, at (231) or rsteimel@mhc.net. To schedule HIPAA training for your practice, please contact Deb Kimball at (231) or dkimball@mhc.net. GETTING READY FOR ICD-10 Continued from page 1 The Trinity Health partnership made sense logistically, financially, and otherwise, Popa said. ICD-10 is such a large initiative, the reasons we decided to partner with Trinity were many, she said. Intellectual property and planning notwithstanding; why reinvent the wheel? In addition to assessment, education, and training efforts, several cross-functional committees have been working for almost two years to address ongoing ICD-10 issues for the hospital and for its physician partners, Popa said. No matter what, collaboration with our physicians will be key to our success as a whole, she said. Indeed, we prefer to partner with our physicians, because in the long run, it benefits everyone. To learn more about the surveys and upcoming educational opportunities, contact Karen Popa at (231) ; kpopa1@mhc.net. Page 3 Practice Pro March 2013

4 Who to Call When Scheduling Exams at Munson Medical Center Here s a handy reference on which phone number to call when scheduling a patient for an outpatient exam at Munson Medical Center. EXAM PHONE NUMBER Wayfinding Survey Provides Helpful Direction Thank you to everyone who participated in our recent Wayfinding survey. More than a third of you took the time to provide feedback. Directions provided by physician practices are a critical part of preparing patients for their visit to the hospital. Your responses are very helpful to Munson Medical Center s Wayfinding committee. Here are some highlights 87% of practices provide direction for patients with testing; mostly verbally 97% of physician staff are aware that Munson offers Radiology/Lab locations other than MMC and 85% encourage patients to use these other locations when appropriate In your opinion, patients best respond to a combination of verbal and written directions We will continue to work with physician practices as we develop wayfinding materials and resources for patients. ARTC Bone Density Cardiac Diagnostic Suite Cat Scan EEG Mammogram Diagnostic Mammogram - Screening Maternity Prepared Stay MRI Pre-Operative Assessment Center Respiratory Care (PFT) Ultrasound CT ABDOMEN EXAM NAMES CHANGING AS OF APRIL 2 In March, physician offices received communication regarding radiology exam names being updated as of April 2. For offices with an EMR, it is important that all CT Abdomen names are updated in your EMR so that they match the new exam names. This is necessary for interfacing reports electronically. A list of the CT Abdomen exam updates is also available online at munsonhealthcare.org/radiologyexams. For offices using paper forms, the Outpatient CT Order (form #6618) is being revised. Additional forms can be ordered by faxing a Forms Order Requisition to (231) If you need a Forms Order Requisition, call Munson Forms at (231) If you have any questions regarding Munson Radiology Services, please contact Dan Fly at (231) Page 4 Practice Pro March 2013

5 ADA ALERT DAY OFFERS FREE DIABETES RISK TEST Northern Michigan residents are encouraged to take a free online test to determine if they are at risk for type 2 diabetes. Diabetes Alert Day on Tuesday, March 26 is a national day set aside by the American Diabetes Association to raise awareness of the risk factors for type 2 diabetes. The test is available at diabetes.org/risktest or at nmdiabetes.org. April Events BARIATRIC SURGERY SEMINARS - Presented by Grand Traverse Surgery Prudenville Thurs., April pm Mercy Community Health Center Prudenville Traverse City Tues., April pm Munson Medical Center, Conference Rooms 1-3, Lower Level Cadillac Thurs., April pm Mercy Hospital Cadillac, Dublin Room NEUROSURGERY SEMINAR: SOLUTIONS FOR CHRONIC BACK PAIN - Presented by J. Eric Zimmerman, MD Traverse City Tues., April pm Munson Community Health Center, Rooms A & B ORTHOPEDIC SEMINAR: WEAK KNEES? STAY IN THE GAME WITHOUT PAIN - Presented by Justin Hollander, DO Traverse City Wed., April pm Munson Community Health Center, Rooms A & B For more information or to register, go to munsonhealthcare.org/mmcclasses. Diabetes Day Open House Receive updated information and educational materials to help control blood sugar. See the latest in blood glucose meters, insulin pump therapy, and learn about the newest therapies and medications. Munson Medical Center diabetes educators will provide carbohydrate counting information, taste-testing, recipes, and meter maintenance (bring yours for an accuracy check). Learn about heart health, exercise options, how to use Community Health Library resources, talk with a Munson pharmacist about your medications, and more. The following physicians will be on hand to answer questions: Todd Adams, DO, Interventional Cardiologist Steve Lamie, MD, Internist Jeff Szczepanski, DPM, Podiatrist Jill Vollbrecht, MD, Endocrinologist SAVE THE DATE Wednesday, April pm Bayview Wesleyan Church 720 Wayne Street Traverse City, MI Jeffrey Wentzloff, MD, Ophthamologist Page 5 Practice Pro March 2013

6 1105 Sixth Street Traverse City, MI BAYSIDE ALLERGY HAS MOVED Bayside Allergy, office of James McClellan, MD; Rebecca DeCarolis, PA-C; and Kirsten Schmitt, PA-C, has moved to a new location. Bayside Allergy can be reached at: Bayside Allergy 447 Munson Ave. Traverse City, MI (231) phone (231) fax James Robertson, MD Now Practicing at Kids Creek Children s Clinic Dr. James Robertson has relocated his practice to Kids Creek Children s Clinic. Dr. Robertson can be reached at: Kids Creek Children s Clinic 5024 N. Royal Dr. Traverse City, MI (231) phone (231) fax 2013 Northern Michigan Physician Directory Now Available You should have received or will soon receive a copy of the 2013 Northern Michigan Physician Directory, which includes contact information on all physicians and midlevels in northern Michigan. If you would like additional copies, please use your Munson Requisition List Form or contact Patrick Wood at (231) or pwood1@mhc.net. There is no charge. The Physician Directory is also available online at munsonhealthcare.org > For Physicians > Resources > Directories. To update your providers information in the directory, please contact HealthLink at (231) , , or healthlink@ mhc.net. For additional information, call HealthLink at (231) or Page 6 Practice Pro March 2013