Azalea Health Innovations Newsletter – July 2012


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We would like to wish you all a wonderful and safe Independence Day! With all of the fun events and festivities it is easy to forget the importance of handling fireworks with caution. For tips on ways to safely celebrate this July 4th with your friends and family visit the National Council on Fireworks Safety.

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Billing Tip: Ensuring Patient Eligibility

Just as doctors recommend preventative care for patients, we recommend preventative care for claims. That means verifying patient insurance eligibility before their visit. With drastic changes being made to our healthcare system, physicians and hospitals cannot afford to waste resources pursuing denials that are preventable. Claims filed with incorrect insurance information can cripple the cash flow of any practice. Our industry loses millions of dollars every year to denied insurance claims so it is not enough to simply trust the patient when it comes to their insurance coverage. Many patients do not know the details of their insurance plan coverage or how much of their deductible is remaining. The uncomfortable conversation with the patient about their procedure not being covered or overall inactive insurance coverage can easily be avoided. Simply verify patient eligibility ahead of time so that both you and the patient understand what is covered before the procedure. Major payors such as Medicare, Medicaid, United Healthcare, Blue Cross Blue Shield, and Tricare offer insurance eligibility tools online. Registering for access is simple and can help save you money. Scanning insurance cards into your EHR system can also be an invaluable step in the right direction.

Here are some general tips to be on the lookout for when validating eligibility

1. Always ask for copies of ID cards from patients even if they are repeat visitors. People switch jobs often these days and Medicare/Medicaid patients often jump back and forth between standard plans and advantage/CMO plans.

2. Double (and triple) check name spelling, DOB, and policy #s match what is on the ID cards

3. Verify primary vs secondary coverage – Patients do not always know which is which!

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OCR Reveals HIPAA Audit Protocol

The U.S. Department of Health & Human Services’ Office for Civil Rights (OCR) publicly announced its HIPAA audit protocol on June 26, 2012. The HITECH Act required OCR to create a test audit program to assess the national level of HIPAA compliance. In response, the OCR created the audit protocol and has conducted the first 20 audits. During the test audit, 115 covered entities total will be reviewed by December 2012. The main objective of the HIPAA audits is to help to identify best practices and to study trends.

Analysts of the OCR report that audits that have been conducted thus far have revealed numerous HIPAA violations.

For the full article from FierceEMR click here.

If you have concerns regarding your practice’s HIPAA compliance, please feel free to contact us, as we have a HIPAA Compliance officer on staff.

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Supreme Court Upholds Constitutionality of Affordable Care Act

On June 28, 2012, the High Court delivered its final decision on the Patient Protection and Affordable Care Act (ACA). After a series of split decisions, the U.S. Supreme Court ruled that the “Individual Mandate is a tax that is within Congress’ authority to levy on individuals with the means to purchase health insurance, but who choose not to.” The majority’s opinion was that an individual may choose to lawfully refuse health insurance and pay higher taxes or they may buy health insurance and pay lower taxes.

The Court also gave its opinion on the ACA’s expansion of Medicaid, concluding that states reserve the right to decide whether they would like to comply to receive additional federal funds for expanding coverage to residents that are 133% below poverty or not without penalty or rescission of existing federal funds. If a given state makes the decision to expand Medicaid coverage they must follow guidelines and regulations set forth by Congress.

For the full article from HIMSS click here.

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Upcoming Events:

AHI will be exhibiting at the Annual Meeting and Scientific Assembly held by the Florida Academy of Family Physicians in Orlando, Florida on July 13-15, 2012.

AHI will be exhibiting at the 13th Annual Fall Conference presented by HomeTown Health at Callaway Gardens in Pine Mountain, GA on November 7-9, 2012.

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Current Job Openings at AHI: Come join our team!

- Business Development Specialist- to learn more about this position and apply online click here.

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Thank you!

Azalea Health Innovations, Inc.
105 West Central Avenue
Valdosta, GA 31601
Toll Free: 877-777-7686
Local: 229-269-4620
Toll Free Fax: 866-683-8679
Web: http://www.AzaleaHealth.com
Email: marketing@azaleahealth.com

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