Articles

Due to the increase of medical transactions stored online and in the cloud, cyber intrusions will only increase. Cyber insurance also known as privacy and network security insurance can help cover the costs incurred if your computer system is compromised, or after a data breach which can include a HIPAA breach. Keep in mind breach notification is legally mandated in 47 states and regulations vary state by state to be sure you are aware of your states laws.

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The following frequently asked questions (FAQs) are adapted from the American Pyschiatric Association (APA).  It is relevant to all Behavioral Health providers with questions about managed care.

Q:  I am having a problem getting in the network of managed care company X.  They have a contract with a major employer in the area, so it is important for me to be able to join this network.  What should I do?

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What is the Sustainable Growth Rate (SGR) and How Does It Affect Medicare Payments?

The Balanced Budget Act of 1997 included a provision to balance the Medicare budget by adjusting the dollar conversion factor by a complicated formula based on the following four items:

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Telehealth (also known as telemedicine) is playing an ever increasing roll in the reimbursement process. Internet services continue to expand and many insurance payers/providers are now covering (paying for) telehealth services. Telepsychiatry (providing behavioral health services in a telehealth environment) has been highly successful because video conferencing makes providing psych services as realitvely simply and inexpensive process.

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What does it mean to accept assignment on the CMS 1500 claim form - also called the HCFA 1500 claim form.? Should I accept assignment or not? What are the guidelines for accepting assignment in box 27 of the 1500 claim?

These commonly asked questions should have a simple answer, but the number of court cases indicates that it is not as clear cut as it should be. This issue is documented in the book “Problems in Health Care Law” by Robert Desle Miller. The definition appears to be in the hands of the courts. However, we do have some helpful guidelines for you.

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