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One of the concepts Joe Denney, CHAM, has become familiar with in his position as director of revenue management at The Ohio State University Health System (OSUHS) in Columbus is something called pricing sensitivity, he says.
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In October 2002, HCA in Nashville, TN, won an $8.8 million arbitration decision against Humana Medical Plan Inc. of Florida for the late payment or nonpayment of 3,300 patient accounts at 16 hospitals in Florida. HCA alleged that Humana paid hospital bills for patients in its HMO, preferred provider, Medicaid, and Medicare health plans as much as one year late, and that its hospitals sometimes had to rebill the insurer three or four times to receive reimbursement.
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In December 2002, the Department of Health and Human Services (HHS) Office of Civil Rights (OCR) released an extensive guidance outlining various aspects of the privacy portion of the Health Insurance Portability and Accountability Act (HIPAA). That follows a recent decision by HHS to place OCR in charge of enforcing HIPAAs privacy mandates.
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The Department of Health and Human Services (HHS) has said for months that HIPAA would continue to be a work in progress. The agency proved that again last month when it added a new section to the guidance on public health disclosures and another on workers compensation disclosures.
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One of the many challenges facing providers under HIPAA, particularly in the context of oncology, cardiac surgery, and OB/GYN services, involves health care services provided to a family member.
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The Centers for Medicare & Medicaid Services (CMS) has created a Privacy Accountability Database to aid in tracking, reporting, and accounting the disclosures made from all CMS systems of records permitted by the Privacy Act of 1974 and HIPAA.
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Several years ago, when The Ohio State University Health System (OSUHS) decided to convert from its homegrown computer system to a commercial product, Joe Denney, CHAM, who was then director of patient access and financial services, was given a choice between two career options.
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The University Hospital of Arkansas in Little Rock has instituted its first recognition program aimed specifically at access personnel, says Holly Jones, revenue integrity specialist and a member of the committee that selects the winner.
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HHS: 450,000 health workers may get vaccine; Outlier payment scrutiny to be increased, CMS says; Hospitals can offer free rides despite gift limits; HHS offers guidance on HIPAA privacy rule; HAM offers more with HIPAA insert.
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One of the problems facing providers under HIPAA will be how to deal with minors, including newborns.
