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Biomedical subjects

J J Moynihan

Publications and source records attributed to J J Moynihan.

At least 19 recordsLinked to original sources
PubMed2000

HIPAA brings new requirements, new opportunities.

The passage of the Health Insurance Portability and Accountability Act of 1996 (HIPAA) brought with it the need for Federal rules to implement the act's simplification and cost-reduction efforts. HHS has published proposed rules related to security for the electronic transmission of health information, privacy of individually identifiable health information, transactions and code sets, and national provider and employer identifiers. Additional proposed rules will be published this year for claims attachments and health plan identifiers. Although HIPAA does not require providers to conduct business electronically, the new standards give providers the opportunity to reduce healthcare administrative costs significantly and undertake electronic commerce efficiently and cost-effectively.

Computer Security↗
PubMed1999

New security guidelines will foster EDI use.

Both HCFA and HHS have issued new policies that provide direction to providers and payers regarding maintaining confidentiality of the medical data they transmit. A HCFA draft policy allows Medicare contractors and others to use the internet to transmit Medicare information, marking a reversal of HCFA's previous stand on the issue. At the same time, HHS has issued a proposed rule governing security and electronic signature standards, which directs all organizations that deal with patient information to develop a policy that ensures security of patient data.

Centers for Medicare and Medicaid Services, U.S.↗
PubMed1999

EDI and imaging automate the business office.

By implementing electronic remittance posting and imaging in patient accounting, New York's Memorial Sloan-Kettering Cancer Center was able to eliminate 22 full-time equivalent supervisory and staff positions and save $365,000 in physical space, microfilm and media costs the first year the new system was operational. Memorial Sloan-Kettering currently is participating in a pilot program with its Medicare fiscal intermediary to determine how EDI can be used to manage claim-status information between payer and provider. By combining EDI, fax, and imaging technologies, Memorial Sloan-Kettering is making its patient accounting process more efficient and providing better service to its patients.

Cancer Care Facilities↗
PubMed1998

Payers required to adopt standardized electronic claims processing.

The Health Insurance Portability and Accountability Act of 1996 requires most claims payers to support electronic claims processing and uniform national standards for code sets and identifiers to streamline healthcare administration. The law will penalize payers that do not support the standards and are not prepared to conduct business electronically by the year 2000. Many providers may qualify as claims payers and, thus, will be subject to penalties if they do not adopt EDI for the transactions required by the Act. Providers also will have greater opportunity to eliminate paper, speed claims payments, and cut administrative overhead. Both providers and payers will have new guidelines for privacy and confidentiality, and violation of these guidelines will result in significant penalties. Consequently, all providers should become familiar with the legislation and evaluate their EDI strategy in light of new opportunities and responsibilities.

Chronology as Topic↗
PubMed1998

Eligibility and EDI create new opportunities.

A growing number of providers and payers are using EDI to automate the eligibility verification process. Some have integrated EDI eligibility verification into their patient scheduling routine. Others find it makes sense to integrate EDI eligibility into the patient registration process. Switching to electronic processing of eligibility information can make more information available faster to the many people involved in eligibility data processing. However, business office staff will have to be better trained to interpret eligibility data.

Diffusion of Innovation↗