Meaningful Use for Health Plans

Recently, I attended the CAQH CORE ( webinar discussing the issues and events expected to be dealt with during 2015.  This organization is responsible for establishing the operating rules for the exchange of HIPAA transactions.  While everyone is focused on ICD10, I believe that the work being performed through this organization will have a major impact on the healthcare industry as well.cadaceus_asterisk

The HIPAA legislation, back in 1996, established the initial specs for the electronic exchange of information used in specific healthcare transactions.  As part of the ACA, operating rules are being established through CAQH CORE to require all healthcare business partners to use these transactions instead of alternative methods for documenting these business processes.  For fifteen years, the intended benefit of using these transactions has not been realized.  The reason is not that the standards are not adequate, but that they are of limited benefit unless everyone uses them. Continue reading

Florida Medicare – Transitioning Dial-Up Users to a NSV.


First Coast Medicare(FCSO) is terminating dial-up connectivity on March 2, 2015. If you are currently using a dial-up connection to send claims and download remits, it’s time to switch. FCSO has provided a list of their approved Network Service Vendors(NSV) that you can use for these services to prevent any interruption to your cash flow. Continue reading

Looking toward the future – 2015

For any non-seasonal business, the calendar year end is a time to look backward at the year and evaluate your performance and to look forward toward the upcoming year to evaluate your challenges and goals.  At MEDTranDirect, 2014 was a pretty good year as we responded well to industry changes and dramatically expanded our market share in the HIPAA transaction processing business technology sector.

Looking forward to 2015, we have a somewhat unique perspective.  The healthcare industry as a whole is bracing for the impact of ICD-10.  The 10/1/15 deadline will influence the planning for most healthcare business partners including provider organizations, vendors, payers, and government agencies.  This single issue impacts almost every organization that must deal with these codes and their influence on recording diagnoses, procedures and the processing of claims. Continue reading