Electronic Data Interchange


EDI commonly refers to data formats used in the processing of medical claims. EDI standards, such as 5010, streamline the transfer of data between payers and providers. Look here for stories on emerging federal requirements, the role of claims clearinghouses, and transaction standards.


MGMA: Plan Identifier Not as Easy as Envisioned

Joseph Goedert | May 18
Implementation of a national health plan identifier under the Affordable Care Act, while a worthwhile effort, is not a slam-dunk process, the Medical Group Management Association contends.
Coding
Group Practices
Hospitals
Policy & Regulation
Payers
Revenue Cycle & Payments
Revenue Cycle Management

Big Jump in E-Prescribing in 2011

Joseph Goedert | May 18
Physician use of electronic prescribing technology skyrocketed in 2011, according the annual National Progress Report from e-prescribing network operator Surescripts.
Medication Management
EHR
Group Practices
Hospitals

MGMA: Extend Medicare eRX Deadlines

Joseph Goedert | May 16
The Medical Group Management Association is asking federal officials to extend the Medicare e-prescribing program’s reporting and hardship exemption request deadlines of June 30, saying the requirements are confusing and unfair.
Group Practices
EHR
Medication Management
Policy & Regulation

Clearinghouse Gateway EDI Buys NHXS

Joseph Goedert | May 15
Gateway EDI, a veteran national claims clearinghouse, has acquired NHXS, a revenue cycle management software vendor serving physician practices. Terms of the acquisition were not disclosed.
Revenue Cycle Management
Revenue Cycle & Payments
Group Practices
Vendor News
Payers

AMA: Postpone ICD-10 At Least Two Years

Joseph Goedert | May 14
The ICD-10 compliance date should, at minimum, be pushed back two years to Oct. 1, 2015, the American Medical Association contends in a comment letter to the Centers for Medicare and Medicaid Services.
Comments (1)
Coding
EHR
Group Practices
Hospitals
Payers
Policy & Regulation
Revenue Cycle Management

Report Posits that Decentralized Data Analysis Increases Privacy Safeguards

Joseph Goedert | May 07
A recent report from the Center for Democracy and Technology examines decentralizing analysis of health data to better protect privacy.
Data Security
Policy & Regulation
Hospitals
Group Practices
EHR
Payers

Emdeon Buy Targets Payers, Payment Integrity

Joseph Goedert | May 07
Revenue cycle management vendor Emdeon Inc. has acquired TC3 Health Inc., a vendor of cost containment and payment integrity software.
Revenue Cycle Management
Revenue Cycle & Payments
Payers
Vendor News

AMA Reminds Docs of Medicare E-Prescribing Deadline

Joseph Goedert | May 04
The American Medical Association reminds physicians that they must report generation of at least 10 electronic prescriptions by June 30 to avoid reimbursement penalties under Medicare’s e-prescribing program.
Medication Management
EHR
Policy & Regulation
Revenue Cycle & Payments

AMA Pushes E-Billing of Workers’ Comp Claims

Joseph Goedert | May 01
The American Medical Association is supporting a state rule that encourages electronic processing of workers’ compensation claims.
Group Practices
Revenue Cycle & Payments
Revenue Cycle Management
Policy & Regulation

HIT Vendor Round-up: NextGen, IVANS, Relay Health & NTT DATA

Joseph Goedert | Apr 25
Health information technology vendors have recently announced new initiatives including acquisitions, discounted purchasing opportunities and customer wins
EHR
Group Practices
Practice Management
Revenue Cycle Management
Revenue Cycle & Payments
Health Info Exchange

Rule Tightens NPI Use for Medicare/Medicaid

Joseph Goedert | Apr 24
The Centers for Medicare and Medicaid Services has issued a final rule tightening requirements for providers and suppliers to use a national provider identifier.
Policy & Regulation
Group Practices
Hospitals
Revenue Cycle Management
Revenue Cycle & Payments

KLAS: Computer-Assisted Coding Poised for Growth

Joseph Goedert | Apr 23
Spurred by adoption of ICD-10 code sets, nearly half of providers surveyed by vendor research firm KLAS Enterprises for a new report expect to buy computer-assisted coding software within two years.
Coding
Decision Support
EHR
Group Practices
Hospitals
Payers
Revenue Cycle Management
Vendor News

Express Scripts App Predicts Medication Non-Adherence

Joseph Goedert | Apr 19
Pharmacy benefit management firm Express Scripts is rolling out a software service to identify patients at high risk for not following their medication regime.
Medication Management
Hospitals
Payers
Group Practices
Decision Support
Disease Management
Chronic Care

WEDI Soon to Close Claims Attachments Survey

Joseph Goedert | Apr 11
The Workgroup for Electronic Data Interchange is reminding stakeholders that its survey to determine the industry status of electronic claims attachments and what stakeholders want in a standardized transaction will close on April 13 at Noon EST.
Policy & Regulation
Revenue Cycle & Payments
Revenue Cycle Management
Group Practices
Hospitals
Payers

HIT Vendor Round-up: Thomson Reuters, Psyche Systems, Merge & EZ-CAP

Joseph Goedert | Apr 11
Client wins and new alliances dominate recent health information technology vendor announcements:
Health Info Exchange
Systems Integration
Revenue Cycle Management
Revenue Cycle & Payments
Medical Imaging
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