Headlines for the Week of January 28-February 4, 2009:

Here are links to the current news in life, legal and healthcare.  If you find stories that you think should be included please email me at epeterson@mediconnect.net, or leave a comment on the blog. If you would like to receive this as an RSS Feed, click on the “subscribe link” at the top of this page.

Thanks.

02/04/09 USAToday.com: House Set to Pass Kids Health Bill
02/04/09 USAToday.com: Obama Catastrophe Coming If Congress Does Not Act
02/04/09 Newsinferno.com: Gardasil: More Adverse Reactions and Scandals
02/04/09 Newsinferno.com: Xigris Lin ked to Increased Risk of Deaths, FDA Announces Safety Review
02/03/09 Reuters.com: Doctors: Under the Drug Industry’s Influence?
02/03/09 USAToday.com: Trial Opens in Florida Widow’s Tobacco Lawsuit
02/03/09 Reuters.com: Obama hit by Withdrawal of Health nominee Daschle
02/03/09 Newsinferno.com: Chinese Drywall debacle Sparks Lawsuits
02/03/09 Newsinferno.com: Peanut Salmonella Company’s Texas Plant Had No License
02/03/09 Newsinferno.com: Diet Supplement Maker Gets Jail for Selling Illegal RX Drug
02/02/09 Newsinferno.com: Carbon Monoxide Poisoning Incident Sickens 15 in Philadelphia
01/28/09 USAToday.com:  More Americans having out patient surgery
01/27/09 Newsinferno.com: FDA to Take Closer Look at Plavix
01/27/09 Newsinferno.com: KV Pharmaceutical to Recall Most of its Drugs
01/27/09 Newsinferno.com: Peanut Butter Pulled From Starbucks
01/27/09 Insurancenewsnet.com: Most Carriers and Brokers are Still Confident about Future of Voluntary Market According to Eastbridge’s Year-End 2008 Survey
01/27/09 CNN.com: Zimbabwe Cholera death toll nears 3000

Headlines For the Week of Jan 6-14, 2009:

Here are links to the current news in life, legal and healthcare.  If you find stories that you think should be included please email me at epeterson@mediconnect.net, or leave a comment on the blog. If you would like to receive this as an RSS Feed, click on the “subscribe link” at the top of this page.

Thanks.

 
01/14/09 Newsinferno.com: Internal Emails Confirm Glaxo Avandia Cover-Up

01/14/09 WSJ.com: Apple CEO Jobs to take a Medical Leave of Absence

01/14/09 Newsinferno.com: Salmonella Outbreak tied to 3 Deaths

01/14/09 Newsinferno.com: One Million Stork Craft Cribs Recalled 

01/14/09 Newsinferno.com: Brain Shrinkage Seen with Hormone Replacement Therapy.

01/13/09 Newsinferno.com: UnitedHealth Group to Pay $50 Million to Settle Claims it Over Charged Millions

01/12/09 Reuters.com: U.S. Advisers back 1st drug from DNA- Altered Animals

01/12/09Cnn.com: Obama’s Big Idea: Digital Health Records

01/09/09 Newsinferno.com: Quest Diagnostic Testing Errors Reported

01/08/09 Newsinferno.com: CDC: Poor Infection Control Put Patients at Risk for Hepatitis B,C

01/06/09 Newsinferno.com: Medtronic Infuse Bone Graft to be Named in Another Lawsuit

01/06/09 Abcnews.com: Third-Hand Smoke—the Dust Finally Settles

Shakespeare’s Romeo once stated “What’s in a name?” Well, doctors, hospitals and insurers are asking the same question in their line of work…“What’s in a Code?”

 A whole lot, according to the Wall Street Journal. Currently, doctors and hospitals use the ICD-9CM billing codes, however, the new ICD-10 billing codes which are coming in October 2011 call for more details about the patients, their conditions and their treatments. (See “Look Out, Docs: Here Comes ICD-10)

For example currently, there are 5 codes for a sprained ankle; with the ICD-10 codes there will be 45 different codes, with very specific details attached to each one. The new system will have 155,000 codes including 68,000 codes describing diagnoses, up from 13,000 currently, and 87,000 codes for different medical procedures, compared with 3,000 today. Hospitals use both types of codes, but physicians use only the diagnostic codes.

“That’s very complicated to a provider,” an official at the Medical Group Management Association tells the WSJ. A rushed doc might just check “unspecified” to describe the injury.”

Apparently, the providers of our healthcare system could be in for a shock.
For doctors and insurers the battle lines are drawn. The Centers for Medicare and Medicaid Services are pushing for this new system, because they claim it can boost claims insurers return to doctors for coding errors by 10%. However, it could become a costly headache for patients and doctors − to the tune of $1.64 billion over the course of fifteen years. 

So what is better, having more specific information on each patient or having a frustrated doctor, who just puts in an unspecified code so he can get paid?  So I start where I began, “What’s in a Code?” A lot of money and a lot of reasons for doctors and insurers to keep on fighting.

Remember the old phrase, “What you don’t know can’t hurt you.” Or can it? Applying for life insurance can be more difficult and pricey than in years past.  Insurers are now scrutinizing potential client’s medical records more than before, which means if there are mistakes in your medical records it could hit you where it hurts-your wallet.

The Institute of Medicine estimates that as many as 98,000 people die each year in hospitals from medical errors. If these errors are turning up in hospitals, you can bet they are turning up in medical records, which can result in being denied life insurance or at least paying higher insurance premiums.

 “You need to make sure you know what’s in your medical records and correct any errors before you apply for insurance,” says Carolyn McClanahan a certified financial planner and former medical doctor.

Medical mistakes happen all the time; they can arise from mistyped diagnosis codes or transcription errors, even inaccurate diagnosis. “Part of the problem is that the U.S. healthcare system relies mainly on paper records, which makes it harder…spot errors.” says Joy Pritts, research associate professor at Georgetown University’s Health Policy Institute.

By having your own medical records, in an electronic format, you will be aware of any errors that need to be corrected. This is a huge dividend when it comes to applying for insurance and securing the lowest premium possible.

After all it’s your health shouldn’t you own it?

For a BGA, getting records as fast as possible is one of the most important aspects of APS retrieval. Over the years, and after retrieving 100’s of thousands of records, MediConnect Global has perfected retrieval with its patented online process that works equally well for the provider next door or across the country—a process that can provide APS retrieval in a matter of days.

The question is then, why isn’t the time required for retrieval uniform in all regions and geographies? It can vary by area from a few days to a few weeks- why?

The answer is a fairly broad one. The biggest delays are usually caused by either specific state and/or specific provider requirements.

A good case study is California. In California providers are not required to copy their medical records as an extension of HIPAA privacy rules. When an APS request is made, arrangements need to be made to have a copy service make copies—an added step. MediConnect Global maintains premium contracts with key copy service providers in California to expedite timely service.

In other regions, there are large copy service companies who contract with providers to manage their medical records. They may have their own specific set of rules that need to be followed to obtain APS records. Rules that include special authorizations, minimum amounts of time such as 14 days before checking back on status, and not following up directly with the provider all have the potential to slow the process down.

Other potential hold ups include specialized authorizations that providers may require. MediConnect is a strong proponent of universal authorizations that allow for one form that works for everyone and meets HIPAA requirements. Until the day a universal is available though, it is important to make sure all special authorizations are provided with your request.

In all these areas, MediConnect streamlines the process constantly looking for ways to maintain and increase the speed of retrieval as much as possible so BGAs can obtain their applicant’s records quickly and as cost effectively as possible. Insuring orders are completed properly and all special handling features are implemented helps maintain efficiency.

MediConnect’s APS record retrieval system saves you time and costs in a new applicant’s process. Often when an APS record is retrieved from a provider office the pages are in no particular order, which forces you to spend valuable time organizing the record before you’re able to review it.

With MediConnect’s new Full Chronological Sorting service, underwriters can get the record already sorted. Underwriters prefer getting the most recent medical activity at the front of the record, but if they prefer, they can have the record sorted with the oldest entry first.

You can order Full Chronological Sorting right now by selecting it in the Services and Options portion of the main order form or by contacting your account manager (carriers only).

The vast majority of healthcare providers will accept generic authorization forms for APS record requests. However, a small but vocal minority require their own customized “special authorization” forms. If you don’t complete these forms correctly it can really slow the process down.

So take some time to double-check just a few critical items before sending special authorization forms in. It will save you time and headaches - and facilitate a smoother and quicker retrieval process than what otherwise might have been.

First (and most importantly), always return completed special authorizations to MediConnect. The special authorization has the request number pre-printed on the top of the page. Simply fax it to 888-489-8706.

Other Items to Check:

• Is the form complete? (No blank lines).
• Is it signed (by applicant) and dated?
• Is the provider requesting an original? Mail in the original - don’t fax it back.
• Is an “Original Special Authorization” requested? A printed, copied, or faxed blank special authorization can be used, but it must be mailed in with the applicant’s original wet signature (not copied or faxed).
• Is a “Unique Special Authorization” requested? The provider wants the exact same special authorization form completed, signed and dated. Mail the very original paper form (completed) back to MediConnect.

By checking these few items and paying close attention to any instructions from the provider, special authorizations will be approved faster and more smoothly, ensuring your APS records are returned as quickly as possible.