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Here Comes the Health Insurance Marketplace

on 03 October, 2013

The Affordable Care Act was created to help provide more affordable health insurance and insure more Americans. On October 1, Americans will have access to the Health Insurance Marketplaces, which will be run either at the state or federal level. These Marketplaces were constructed to help American find affordable healthcare coverage and compare different plans. They have been designed for ease of use and to allow Americans to start shopping for insurance online after just a few steps.

Duplicate Medical Records Expenses

on 20 September, 2013

Duplicate medical records are frequently created because of errors in key fields (last name, first name, middle name, SSN, DOB and gender) or other patient identifiers. The use of multiple databases for patient information and the poor data conversions between them worsen the problem. These duplicates are more common than you might think; studies indicate that the average medical records system contains 8 to 12 percent duplicate data. Unfortunately, the duplicate records create several expenses that negatively impact the healthcare economy.

Obamacare Health Insurance Exchanges (HIX)

on 01 August, 2013

The Affordable Care Act was designed to make health insurance more affordable and easily attainable for Americans. Health Insurance Exchanges, scheduled to open on October 1, 2013, are an important component of this new medical insurance reform. These exchanges are online marketplaces for health insurance, controlled at a state, federal or joint-run level. Through the use of price calculators and new regulations, the Health Care Exchanges are predicted to help 29 million previously uninsured Americans purchase affordable health insurance by 2019. All exchanges are required to provide coverage by January 1, 2014.

ICD-10 Preparedness

on 01 July, 2013

UPDATE (April 8, 2014): The implementation date for ICD-10 has changed. More information can be found in our recent blog post.

Accuracy and speed through all phases of claims data entry will ensure an easier transition to the upcoming ICD-10.

ICD-10 is the newest code set for medical claims, scheduled to replace the current ICD-9 code set on October 1, 2014. ICD-10 has about 69,000 very specific codes to represent various medical conditions, as opposed to ICD-9, the current standard which only has about 13,000.

5010 Compliance

on 17 June, 2013

Since June 30, 2012, electronic medical claims have been required to be compliant with HIPAA’s 5010 standards. Any electronic claims transactions that do not meet the latest requirements are subject to penalties or fines totaling up to $25,000 for multiple violations of the same standard in a calendar year. Some believe that the likelihood of stronger enforcement will increase as we get closer to the upcoming ICD-10 implementation deadline.

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