What Are The Different Types of Health IT?

The healthcare industry has seen considerable growth for many decades. With the various medical crises that western nations face in the form of obesity and illnesses resulting from what can only be called the modern lifestyle, the healthcare industry has experienced unstifled growth. All industries that are involved with healthcare have also subsequently experienced growth. One of those major industries is Health IT services.

What Is Health IT?
Much like regular Information Technology services, Health IT is essentially IT but focused around healthcare solutions. Electronic Health Records (EHR) are an example of Health IT services. However, despite that EHR systems are not a catch-all solution depending on what type of service you need. In this article, let’s cover some different categories of Health IT implementation.

Examples of Common Health IT Systems
All Health IT systems revolve around transmitting and storing healthcare-related data for all parties involved so that all healthcare operations and decisions can be met effectively and quickly.

Electronic Health Record (EHR) Systems
We’ve discussed these a fair bit in our post Which EHR Type Should I Use. Nevertheless, EHR systems are a critical part of Health IT systems and the operational agility of any modern healthcare practice. Gone are the days of archiving endless amounts of paperwork. With EHR systems, logging information and looking it up is significantly easier—which makes patient’s lives less stressful since they’ll have faster turnaround times on problems. Clinics will also be able to leverage their labor much more effectively too.

MPI (Master Patient Indexes)
A MPI helps bridge the gap between separate patient records that exist on different databases. EHR systems to allow for this somewhat depending on if you chose an EHR system that is right for your needs, but their ability to do so is generally limited.

Master Patient Indexes are fantastic at creating a centralized patient file so that duplicates are not created across different areas which could potentially lead to accidental false reporting which ultimately contributes to claim rejections. If you’d like to avoid as many claims rejections as possible, look to outsource your healthcare administration and medical billing remotely.

Patient Portals For Clinics
Many clinics have opted into taking their patient interactions and logging online. Outside of medical billing, there are things that must be relayed between doctor and patient. For example, if you set a doctor’s appointment, you can login to your patient portal to see your appointment date and any related information. If you go in for a blood test and they send the results to the lab, instead of having to check in with the office, you can simply login online and see if the results came in as well as if your doctor has made any notes.

Of course, a good doctor will always follow up and go over the information with you, but patients are often eager to see how their tests have come out, and want to know as quickly as possible the main details. Patient portals help solve this issue as well as relieve staff since fewer people will call to inquire about basic information.

Remote Medical Billing
While there are many more different Health IT solutions, those are typically the main 3 that you’ll hear the most about since they all provide almost universally needed solutions.

A solution that many clinics do not realize they could benefit from is remote medical billing services. The Psych Biller has helped many clinics and healthcare administrations outsource their medical coding and medical billing needs so that they can spend less time worrying about claims and more time helping patients.

Contact The Mental Health Billing Utah  today to outsource your medical coding and billing needs!

Prior authorization (PA) Policy Changes related to COVID-19

The information and guidance provided in this document are believed to be current and accurate at the time of posting this article.

Major medical insurance plans

Plan	Effective Date(s)	Policies
Aetna Check the Aetna COVID-19 Communications Update for state-specific information and detailed requirements	3/25/20 – 5/6/20	Transfers: Initial PAs waived in the following scenarios: Admissions to post-acute care facilities (including skilled nursing and extended acute rehabilitation) Facilities must notify Aetna of the admission within 48 hours and send medical records for concurrent review within 3 days Admissions to long-term acute care hospitals Facilities must notify Aetna of the admission within 48 hours Admissions — PA waived for admissions to acute care facilities in certain states Acute care facilities must notify Aetna of the admission within 48 hours Changes will be effective per state declaration for commercial fully insured patients Effective through 5/6/20 Lines of business: Commercial and Medicare Advantage
BlueCross BlueShield Association Check with individual BCBS plans for additional information	3/6/20	COVID-19 screening/testing: PA waived for COVID-19 diagnostic tests COVID-19 treatment: PA waived for “covered services that are medically necessary and consistent with CDC guidance for members if diagnosed with COVID-19” Not clear what constitutes “medically necessary covered services” Lines of business: Fully insured, individual, and Medicare members
		Anthem (CA, CO, CT, GA, IN, KT, ME, MO, NH, NV, NY, OH, VA, WI) – additional policy updates Effective 3/27/20: Transfers: PA requirements suspended for certain patient transfers DME: PA requirements suspended on durable medical equipment critical for treating COVID-19 Note: Most Anthem plans have implemented additional policy changes, including suspension or extension of certain PAs. For more information, visit the relevant state-specific provider communications page at Behavioral Health Billing Utah
		Health Care Services Corporation (IL, MT, NM, OK, TX) – additional policy updates Effective 4/2/20: Transfers: PA waived for transfers to in-network, alternative post-acute facilities until 4/30/20
		Regence (OR, ID, UT, select counties in WA) – additional policy updates Effective 4/1/20: Transfers: PA waived for transfers to post-acute care settings until 5/31/20 Applies to transfers that must happen quickly due to the impact of COVID-19 Discharging AND receiving facility/provider must notify Regence within 24 hours Extension of elective inpatient PAs: Regence is offering an extension of PAs for elective inpatient admissions Contact Regence for extension; duration not specified PA still required for professional services that occur during inpatient admissions for certain plans Extension of medication PAs: 6-month extension of existing medication PAs set to expire between 3/23/20 and 6/30/20 Effective 4/15/20: Extension of PAs for elective procedures: PAs extended for certain elective procedures; duration of extension not specified (contact Regence)
Centene	3/12/20 (screening, testing); 4/1/20 (treatment)	COVID-19 screening/testing/treatment: PA/step therapy not required for medically necessary COVID-19 screening, testing, or treatment services Lines of business: Medicaid, Medicare, and Marketplace members
Cigna	3/17/20 (screening, testing, and treatment); 3/23/20 – 5/31/20 (transfers); 3/25/20 – 5/31/20 (elective outpatient services) 3/17/20 (screening, testing, and treatment); 3/23/20 – 5/31/20 (transfers); 3/25/20 – 5/31/20 (elective outpatient services)	COVID-19 screening/testing: PA not required for COVID-19 evaluation/testing COVID-19 treatment: PA not required for “medically necessary treatment” for COVID-19 PA for COVID-19 treatment follows the same protocols as any other illness based on place of service and plan coverage; PA generally not required for routine office, urgent care, and emergency visits Non-COVID-19 services: Cigna will not deny claims for other services that require PA for failure to secure authorization if the care was emergent, urgent, or involved extenuating circumstances; delays in the timely filing of claims or the ability to request PA due to COVID-19 will be treated as extenuating circumstances in the same way as during a natural catastrophe (e.g. hurricane, tornado, fires, etc.) Transfers: PA waived for the transfer of non-COVID-19 patients from acute inpatient hospitals to in-network long-term acute care hospitals and other subacute facilities, including skilled nursing facilities and acute rehab centers The notification required on the next business day following the transfer Coverage reviews for appropriate levels of care and medical necessity still apply to these admissions Extension of elective outpatient PAs: Duration of PAs for all elective outpatient services is temporarily increased from 3 months to 6 months Effective 3/25/20 – 5/31/20 PA decisions made between 1/1/20 and 3/24/20 will be assessed when the claim is received and will be payable if it is within 6 months of the original authorization Extension of medication PAs: Automatic 90-day extension of existing medication PAs set to expire between 4/1/20 and 6/1/20 Lines of business: Commercial and Medicare Advantage plans
Humana	3/23/20; 4/1/20	COVID-19 screening/testing/treatment: Effective 3/23/20, PA suspended on services with COVID-related diagnoses, excluding post-acute discharge, for both participating/in-network and non-participating/out-of-network providers Non-COVID-19 services: Effective 4/1/20, “nearly all” PA requirements suspended for participating/in-network providers for non-COVID-19 related services, including inpatient (acute and post-acute) and outpatient treatment and referrals Humana requests notification when the patient is admitted to the hospital, even what PA is not required Non-par/out-of-network providers must continue to follow referral requirements and submit PA requests per Humana’s policy PA still required for transplants and genetic-related services Extension of PAs for elective/nonemergent procedures and services: Previously approved PAs extended to a 90-day approval timeframe, except for home health authorizations, which are extended for 60 days Medications: PA still required for drug/pharmacy-related requests (Commercial, Part D, and Part B) Lines of business: Commercial employer-sponsored (fully insured and select self-funded plans), Medicare Advantage, and Medicaid plans
UnitedHealthCare	3/24/20 – 5/31/20	COVID-19 screening/testing: PA is not required for COVID-19 testing and COVID-19 testing-related visits Transfers to the different level of care: Suspension of PA requirements for admissions to post-acute care settings (long-term care acute facilities, acute inpatient rehabilitation, and skilled nursing facilities) Admitting facility must notify UHC within 24 hours for weekday admissions or by 5 p.m. local time on the next business day for weekend and holiday admissions Length of stay reviews still apply, including denials for days that exceed the approved length Discharges to home health will not require PA Transfers to a similar site of care: Suspension of PA when patient transfers to a similar site of care for the same service (e.g., hospital transfers or practice transfers) For inpatient/post-acute admissions, admitting facility must notify UHC within 24 hours for weekday admissions or by 5 p.m. local time on the next business day for weekends/holidays For other transfers, such as outpatient services, contact UHC using the phone number on the back of the member’s ID card to transfer the existing PA Extension of PAs for medical services: 90-day extension of open and approved PAs set to expire between 3/24/20 and 5/31/20 Extension based on the original authorization date; does not apply to authorizations issued on or after 4/10/20 Applies to in-network and out-of-network medical, behavioral health, and dental services (including many provider-administered drugs) PA still required for any additional visits or services beyond those approved in the initial PA Diagnostic radiology: PA not required for diagnostic radiology (diagnostic imaging) of the chest for COVID-19 patients Notification requested for CPT® codes 71250, 71260, 71270 for Medicaid or commercial members with known/suspected COVID-19 diagnosis PA continues to be required for all other chests CTs DMEPOS: For dates of delivery from 3/31/20 through 5/31/20, PA requirements are adjusted as follows: PA suspended for COVID-19-related orders for a respiratory assist device or a ventilator (codes E0471, E0465, E0466, E0467) Notification is requested, and PA will be required after 5/31/20 PA not required for COVID-19-related oxygen requests; exemption from current clinical criteria Changes in face-to-face evaluation requirements for the ordering provider for DMEPOS PAs: New PAs required for services completed before 10/1/19; may be done through telehealth PAs for services completed 10/1/19 or later are extended through 9/30/20 For new DMEPOS PAs, face-to-face assessments may be done via telehealth PA not required for DMEPOS repair when the claim uses the repair modifier Site of service reviews: Suspension of reviews for the site of service until 5/31/20 for certain surgical codes Lines of business: Commercial (fully insured), Medicare Advantage, and Medicaid plans
CVS	3/25/20	Extension of medication PAs: Extension of existing PAs set to expire before 6/30/20 for “most” medications The presumed 90-day extension (“if a current [PA] is set to expire on May 15, the expiration date will be extended to August 15”)
Express Scripts		Standard PA policies remain in place; Express Scripts is monitoring the COVID-19 situation and will update policies if or when the situation changes
OptumRx	3/19/20	Extension of medication PAs: One-time, 90-day extension of existing PAs set to expire on or before 5/1/20 for medications taken on a chronic basis Existing PA and renewal requirements remain in place for: Drugs with significant abuse potential Drugs dosed for finite durations or intermittently (e.g., hepatitis or fertility agents) Newly prescribed medications

Readmore Behavioral Health Billing Utah 

Extensive Coverage of Behavior Medicine Procedures

Our billing advisory has been able to cater to a majority of Behavioral Health Billing Utah  comprising of psychologists, physicians, and qualified nurses by employing a comprehensive billing and coding approach that covers the whole gamut of behavior medicine procedures including:

• Biofeedback, hypnosis, and bio-behavioral therapy of physical disorders
• Aspects of occupational therapy, rehabilitation medicine, and physiatry
• Preventive medicine

Enabling Accurate and Refined Medical Billing

A thorough knowledge of the Current Procedural Terminology (CPT) coding system covering the comprehensive health and behavior assessment and intervention of medical services has been pivotal in enabling accurate and refined medical billing on our clients’ behalf. Following list of CPT codes used in coding Behavior Medicine procedures is a valid endorsement of our integrity in compliant coding system:

CPT Codes	Corresponding Behavior Assessment and Intervention Medical Services
96150	For initial assessment of the patient to determine the biological, psychological, and social factors affecting the patient’s physical health and any treatment problems
96151	For re-assessment of the patient to evaluate the patient’s condition and determine the need for further treatment; a re-assessment may be performed by a clinician other than the one who conducted the patient’s initial assessment
96152	For interventional service provided to an individual to modify the psychological, behavioral, cognitive, and social factors affecting the patient’s physical health and well being
96153	For interventional service provided to a group; an example is a smoking-cessation program that includes educational information, cognitive-behavioral treatment and social support
96154	To code interventional service provided to a family with the patient present
96155	To code interventional service provided to a family without the patient being present

Infusing Modifiers for Mitigating Delay/Denial

Coupling a competent coding regimen with timely and accurate modifiers, our Behavior Medicine Billing Advisory has been able to mitigate undesirable delay/denial of its clients’ medical reimbursements. Modifier 22 for Extended Service and Modifier 52 for Reduced Service (where in the provider reduces or eliminates a portion of the service or procedure, which results in a reduction in reimbursement. The reduced service is identified by its CPT code and the addition of the modifier-52) are prime examples of Modifiers adopted in our billing management.

Multiple Benefits

The Behavior Medicine physicians, who lent preference to our billing and coding competencies – complete with accurate charge-capture, intricate procedure coding, electronic filing of claims, patient billing, multi-tiered appeal process, denial elimination initiatives, and compliance standards – have been able to witness simplification of revenue cycle, appreciable increase in collection rates, more patient inflow and referrals, and Increased avenue for medical research and development.

Readmore BEHAVIORAL HEALTH BILLING SERVICES IN UTAH, UT

BEHAVIORAL HEALTH BILLING SERVICES IN UTAH, UT

Owing to its interdisciplinary nature – integration of knowledge in the biological, behavioral, psychological, and social sciences relevant to health and illness – Behavior Medicine physicians hardly find time to manage their medical bills filed and reimbursed efficiently. 

Outsourced Excellence

Alternatively, our Behavioral Health Billing Utah – comprising AAPC certified medical coders, who are proficient in generating diverse behavior medicine bills on advanced software such as Lytec, Medic, Misys, Medisoft, NextGen, IDX, etc., and applying specific CPT, ICD-10, & HCPCS; complying with HIPAA privacy norms; and processing the prepared bills with leading private insurance carriers such as United health, Wellpoint, Aetna, Humana, HCSC, Blue Cross Group, and Government sponsored Medicare and Medicaid as well – has been able fill in the void successfully, and ensure greater revenue generation for Behavior Medicine physicians, patient inflow and referrals, and medical efficiency.

Our Utah medical billers and coders use their experience and professional expertise to make your practice receive its rightful payments. They are bent on maximizing your practice’s reimbursement and are dedicated to stay ahead of the constantly changing healthcare insurance industry.

Their compliance with HIPAA and all the other medical billing laws can ensure safety, integrity and confidentiality of your data. Some of the cities where our billers are located in are, Salt Lake City, West Valley City, Provo, West Jordan and Sandy. These billers are adept in the following services:

• Electronic as well as paper claims filing
• Follow up on submitted and rejected claims
• Patient and insurance payment posting
• Handling patient inquiries for billing
• Generating Monthly financial report

The State of Utah seems to be struggling to find Medical Billers and Coders as per their requirement as the many physicians have looking for professional billers. This is one of the reasons why most of the billers have enrolled themselves in the state of Utah to get connected with physicians easily.

Physicians can now trust these billers to manage their reimbursements cycles while they concentrate on quality of patient care and strategy to grow their practice. Many physicians are looking towards the benefits of having trained and certified Billers servicing them locally.

Our Billers in the state of Utah are specialized to service medical practices as per the regulations of the state government. Their knowledge and experience has been acquired by years of efforts in perfecting medical billing procedures which they now leverage to help your practice collect more revenue.

The federal government’s effort to reduce healthcare cost can only be supported by physicians in the state of Utah by optimizing costs and enhancing revenue. Letting a specialist handle your medical billing can help you improve collections by 20%.

Accurate Coding and code audit along with timely insurance follow up and account receivables are the basis on which thesebillers in Utah guarantee higher profitability for your clinic. Their experience in various software and certification in the medical billing processes will support your practice to grow steadily.