| Information technology (IT) has long been
| |
| | information pursuant to HIPAA law by
|
| touted as the key to improved business
| |
| | using standard, HIPAA-compliant code
|
| processes. So, how is IT advancing to
| |
| | sets; HIPAA-compliant transactions;
|
| help make a claims manager's life easier,
| |
| | eliminate all proprietary and/or local
|
| better respond to patients' needs, meet
| |
| | codes for waived services, and
|
| mandated guidelines, ensure patient
| |
| | accommodate unique identifiers for
|
| privacy, and bring efficiencies to the
| |
| | providers, health plans (payers) and
|
| overall process?
| |
| | employers. Once the HIPAA EDI standard is
|
| New advancements, such as electronic data
| |
| | fully in place, it will help reduce
|
| interchange (EDI) systems that help
| |
| | management overhead and costs.
|
| connect insurers to patients and
| |
| | The next wave of technology advancements
|
| physicians, have already made their mark
| |
| | may lie directly on the Internet.
|
| in the healthcare industry. Nearly every
| |
| | Internet-based Web portals hold the
|
| large provider or hospital delivery
| |
| | promise of helping claims managers
|
| system has some sort of EDI system in
| |
| | improve the overall claims review process
|
| place. Electronic medical record (EMR)
| |
| | by enabling them to collaborate with
|
| systems hold the promise of making
| |
| | their customers and vendors
|
| patient information accessible to all
| |
| | electronically. This includes requesting
|
| parties, any time anywhere, yet only
| |
| | and receiving independent medical
|
| seven percent of today's providers have
| |
| | reviews, with HIPAA-compliant
|
| EMR systems in place. And, how do claims
| |
| | transmission of medical records and other
|
| managers tie into these systems securely
| |
| | sensitive PHI.
|
| and efficiently?
| |
| | As new forms of electronic data exchange
|
| According to the 1996 Health Insurance
| |
| | emerge, claims managers can look forward
|
| Portability and Accountability Act
| |
| | to a new era with improved turn around
|
| (HIPAA) legislation, all U.S. health care
| |
| | times; more manageable, lower costs;
|
| providers and payers must ensure they can
| |
| | increased security, and improved HIPAA
|
| send and receive private health
| |
| | compliance.
|