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What is the difference between unidirectional and bidirectional integration with a lab?
In a physician practice or in a hospital, the EMR/EHR needs to be integrated with the Laboratory to send the lab requests and receive lab responses electronically.
If only any one of the interface [lab request or lab response] is integrated, it is called as unidirectional integration.
Whereas in Bi-directional integration, both HL7 lab requests and HL7 lab responses are integrated electronically with the EHR
What is Opt-in Opt-Out HIE?
These are the two main models for patient consent to exchange personal health information through the HIE network.
Opt-in: Requires authorization from the patient through signing a standardized consent form, before the patient's health information may be exchanged through the network.
Opt-out: The patient is given notice – through mail, brochures and other means - and patient's health information will be exchanged through the network unless and until the patient formally raises any concern.
What is ONC-ATCB?
ONC- Authorized Testing and Certification bodies has been authorized by ONC under temporary certification program to perform testing on EHR modules / Complete EHR and can certify any EHR which meets the requirements.
What is the difference between modular certified EHR and complete EHR?
Modular certified EHR doesn't need to satisfy all the stage 1 meaningful use criteria. It is enough to get certified with security & privacy criteria plus few other criteria (of EHR vendor choice). Whereas complete EHR satisfies all the stage 1 meaningful use criteria.
I do use a modular certified EHR and I purchased some third party modules to meet some other criteria, do the third party modules also get certified?
Yes, if you are using any other third party softwares to achieve some of meaningful use objectives (like e-prescription), then it should also get certified.
Do ONC-ATCB certified products have to undergo re-certification for each new release?
For "minor product changes" [those modifications and updates to a certified product that are unlikely to affect the product's compliance with the certification criteria], retesting may not be required but the vendor is required to notify the ONC-ATCB and provide self-attestation that the changes are minor.
Modifications with a significant risk of affecting the product's compliance are considered to be a "significant product change". Retesting is required.
Is there any limit in number of CPT codes per bill?
Yes, CMS 1500 form accepts only six CPT codes for medical reimbursement from insurance payers.
What is a CPT modifier?
Modifiers are two digit value used with CPT code has special consideration on payment. It may increase or reduce the amount of provider's reimbursement claims. CPT code provides the details about the services render to patient, modifier with CPT code are used to specify that service has been adjusted due to specified conditions.
Where the modifiers are shown in CMS 1500 and X12 forms?
In CMS 1500 form, modifier are used in field 24d for medical reimbursement. In X12, Loop 2400:SV101 is used to populate the modifiers informations.
What is Multiple modifiers?
In certain conditions, two or more modifiers are required to completely explain the services/procedures rendered to the patient by provider. Modifier 99 is used when two or more modifiers effects the billing. Modifier 99 is added to the basic procedure code and all other modifiers are listed in the 24d in CMS form.
If modifiers are allowed, what is the maximum number of modifiers can be used in CMS and X12 forms?
In CMS form, maximum number of modifiers allowed with each CPT code is four.X12 allows four modifiers separated with colon as delimiter.
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